[Iminphases]

Hi All,

I was diagnosed BP1 30 years ago. I haven't had a manic episode (full on psychotic breaks- total breaks with reality) in 28 years. The manic episodes were so devastating, so destructive that I still suffer from PTSD because of them. They happened because when I was first diagnosed I refused to take my prescribed med- lithium. Three years ago I started having problems with my kidneys so my Pdoc took me off lithium and put me on lamictal. The most insidious part of my BP1 symptoms is that I rapid cycle into depression. I have horrible, mind bending major depressive episodes (MDE) that lead to frequent thoughts of suicide. I have taken EVERY anti-depressive med I could that is safe to take as a BP1 and NONE have worked. My Pdoc has now recommended 10mg of Prozac one time per week. I have always been told to NEVER take a standard anti-depressant- especially Prozac- because of the threat of it causing manic episodes. It’s not that I don’t trust my Pdoc- he says new research has shown that 10mg of Prozac once a week will significantly help. I’m posting to see if anyone who has similar history like mine can confirm this research, taken Prozac or think this a good idea or bad idea. I’m in a MDE right now and almost (almost) want to risk a manic episode if it will cut through this depression. But then again… I don’t want to lose everything again like I have in the past. Please help.

[Guiness187055]

I am BP1 also. The ssri's send me big time manic especially prozac and zoloft. Wellbutrin and lamictal work good for my depression. Even the zyprexa helps a bit but never taking a ssri again. YMMV

[still_crazy]

hi. sadly, i don't think anyone can tell a person for sure, before treatment, what psych drugs will help, which will harm, or anything like that. even with the best psychiatrist around, a lot of it is guess work, largely guided by research that tends to be low quality and is often influenced by Big Pharma, one way or another.

having said that...prozac has a very long half life. when it hit the market, the standard dose was 20mgs. there is some indication that some people do well on lower doses of prozac.

there are, of course, non-antidepressant options for some people with bipolar I. mirapex is being used "off label". so are provigil and nuvigil. ritalin (and the newer one, focalin) can help provide energy and improve concentration, reduce fatigue, etc. now and then, amphetamines, such as adderall, dexedrine, etc., are used for people with depression, including some people with bipolar I.

i dont know of the research your psychiatrist is basing the recommendation on, but using a low dose of Prozac seems a prudent idea.

there are other, more "experimental" options...ketamine, opiates. ketamine has attracted a lot of interest lately, in particular.

[Have Faith]

I just posted a thread. There is a simple genetic test your pdoc can do (Just a swab of the cheek) that tells which meds you can metabolize and which won't work. I highly advise having it done so patients can show the results to their doc.