Tricyclic Antidepressants

antidepressants

Question:

> This is just a thought. What if the suicidal feelings are being caused > by acute, uncontrolled mania and NOT depression? Wouldn’t adding an AD > to your stabilizer in that case be the last thing you’d want to do? > Sometimes it is very hard to tell the difference between a mixed state > and a severe depression. > In my own experience, I’ve found upping my Li dose helps me get rid of > both manic *and* suidcidal feelings. As for feeling blah and zombie-ish, > yes I experienced that, but it went away after 6 weeks. Just food for > thought.

Hey, I think this might have been what happened to me.  (discussed in detail on SSDM)  I’m taking your advice and upping my Li level to 900mg. Maybe dropping Welbutrin. Aurora

Response:

> I was just wondering if anyone else’s pdoc refuses to give them > antidepressants even with a mood stabilizer?

Dear Tristana, ADs have the potential of triggering a mania but as long as the pdoc is carefully monitoring the patient and eliciting feedback from him/her and SOs if applicable (with the patients’s permission of course) the incidence of a mania occurring is very much reduced. The selection of the AD also depends on the patient’s medical history (any seizures) and present physical condition (anorexia?, underweight?, overweight?). ECT is a nonmedication option for the alleviation of depression in BP but it too has the potential of triggering a manic episode. It is not necessary or desirable for anyone, BP or unipolar, to "tough it out" when experiencing a clinical depression. There are options available and the patient and doctor need to weigh the pros and cons of each . I hope this helps. Take care and be well, Lynda

Response:

- Hide quoted text — Show quoted text – > [snip Aurora's manic sounding post about adjusting meds] >   Sounds like you’re playing with both your meds and your pdoc, a good > way to wind up in the ditch.  The Li dose you mention is /significantly > below/ reported effective averages; let him raise it unless you are > specifically intolerant to the stuff.  Also, though Wellbutrin is least > likely of all ADs to drive a bipolar manic, it is also about the most > hazardous on the market for primary and side effects, being toxic as > hell in its own right; it is usually used only when nothing else works. > — > dmh > http://blitz.org/fishhook/ > Wow now that I read what I wrote it even sounds hypomanic.  Like > something the infamous Cindy would have written .  I think maybe I > will bring my Li back up.  Time to get honest with myself.  BTW, I am > not just taking Li as a stabilizer but 400mg Lamictal.  Lamictal on > it’s  own is not effective for me or even Lamictal and 450mg Li.  I > stopped taking Lamictal once and just took Li and almost ended up in the > psych ward(but dealing with airports does that to me anyway) so I know > the Lamictal is doing something. > What are the dangerous effects of Welbutrin that I should be made aware > of?  I did notice that when I ‘crashed’ soon after I started taking > it(too full for full effect) I was a lot more agitated and wanted to > trash the house but then the next day I was fine so I guess that could > be a dangerous side-effect.  I like the fact that it reduces my > appetite. > Aurora

  I have forgotten the specific toxic effects since going off the stuff six years ago.  You can certainly find a med sheet by going onto www.metacrawler.com and typing "wellbutrin."  I do remember that the side effects were "toxic" and not "mental," that is, they’d mess with your body chemistry rather than your brain chemistry.  Liver? — dmh http://blitz.org/fishhook/

Response:

This is just a thought. What if the suicidal feelings are being caused by acute, uncontrolled mania and NOT depression? Wouldn’t adding an AD to your stabilizer in that case be the last thing you’d want to do? Sometimes it is very hard to tell the difference between a mixed state and a severe depression. In my own experience, I’ve found upping my Li dose helps me get rid of both manic *and* suidcidal feelings. As for feeling blah and zombie-ish, yes I experienced that, but it went away after 6 weeks. Just food for thought.

Response:

hi hi if the doc is keeping close tabs on you and youre already on a mood stabilizer, it might be worth a shot…i notice that everyone has gone up from different a/d’s and we’ve gotten different one’s to work–so, like everything else, it’s going to be an arduous process…i personally went through the roof instantly (like the next day) from paxil..and the prozac wasn’t too hot either…but the effexorwith all the other crap im on seems okay… a – Hide quoted text — Show quoted text ->I was just wondering if anyone else’s pdoc refuses to give them >antidepressants even with a mood stabilizer? >Tristana >Hi Tristana, >Zoloft was the first SSRI I tried and it sent me to the hospital manic >and psychotic. My pdoc won’t try any of the others and I don’t want >to. >Tricyclics make me soooo much more depressed…and bloated…and >pukey. Who needs it? I have a bad ticker, so it’s dicey for me to take >them anyway. >I haven’t tried Wellbutrin. My pdoc talks about it every once in a >while, but she always decides against it. >I’m taking Remeron at a low dose now, but I have to take it 2 weeks >and stop for 2 weeks. If I don’t I start to get manic. Actually, I’m >only taking it because she wants me to give it a try. Left to my own >devices, I would probably dc it. It makes me nervous to take something >I know has the potential to make me manic. >Everyone reacts differently to these meds, and your reaction may vary >from time to time. Maybe your pdoc has had bad experiences treating BP >with antidepressants. >Good luck, >Trish

Response:

[snip Aurora's manic sounding post about adjusting meds] >   Sounds like you’re playing with both your meds and your pdoc, a good > way to wind up in the ditch.  The Li dose you mention is /significantly > below/ reported effective averages; let him raise it unless you are > specifically intolerant to the stuff.  Also, though Wellbutrin is least > likely of all ADs to drive a bipolar manic, it is also about the most > hazardous on the market for primary and side effects, being toxic as > hell in its own right; it is usually used only when nothing else works. > — > dmh > http://blitz.org/fishhook/

Wow now that I read what I wrote it even sounds hypomanic.  Like something the infamous Cindy would have written .  I think maybe I will bring my Li back up.  Time to get honest with myself.  BTW, I am not just taking Li as a stabilizer but 400mg Lamictal.  Lamictal on it’s  own is not effective for me or even Lamictal and 450mg Li.  I stopped taking Lamictal once and just took Li and almost ended up in the psych ward(but dealing with airports does that to me anyway) so I know the Lamictal is doing something.   What are the dangerous effects of Welbutrin that I should be made aware of?  I did notice that when I ‘crashed’ soon after I started taking it(too full for full effect) I was a lot more agitated and wanted to trash the house but then the next day I was fine so I guess that could be a dangerous side-effect.  I like the fact that it reduces my appetite. Aurora

Response:

Zoloft sent me manic last year, so since then, the pdocs have refused to put me on one.  Until last week, when I was very suicidal.  They put me on 10mg of Prozac hoping to boost me out of the depression without making me manic.  So, for me the answer to your question is yes.  But not for long!!!!

Response:

- Hide quoted text — Show quoted text -> I was just wondering if anyone else’s pdoc refuses to give them > antidepressants even with a mood stabilizer? > Tristana >   If lithium/valproates have the mood under control, antidepressants are > contraindicated, in that almost any of them will snap a bipolar into > full mania.  They are given only when lithium/valproate leaves the > client significantly depressed, which is not utterly usual. > — > dmh > http://blitz.org/fishhook/

Or if the client just likes to be stabilized at slightly hypomanic.   I’m still playing with dosages to see just how hypomanic I want to be stabilized at.  Toying with the idea of 900mg Li instead of 675mg.  My boss says I need to listen more and stop finishing people’s sentences and I’m not sure he’s just talking about the past. Li and Lamictal alone just turn me into a zombie which is unacceptable.  But 150mg of Welbutrin is leaving me slightly edgy so maybe I do need to up the Li. Before anyone flames me, my pdoc allows me to adjust my meds. Last time around(Depakote, Prozac) I was high enough that by evening many people in AA thought I was on coke.  I was on Prozac first then dx’d and put on depakote. I was still doing the shopping sprees and all that stuff to a lesser degree. And all the obsessive, impulsive stuff. I got really hypomanic when I went to New Mexico, spent thousands, but it was a blast.  Continued when I came back, moved out of where I was, started planning my move to NM with all this energy.  Got so paranoid of my SO that I tryed to move my stuff out of our apartment before he came back.  Tried to start a relationship with someone I met briefly in NM who wouldn’t deal with me because I was talking so fast and off on tangents.  Once I came down a little decided I didn’t really need meds anyway especially since my spiritual teacher recommended I stop taking them. I wonder if I’m setting myself up for this sort of thing again.  I find it hard to resist doing the pressured speech, finish other peoples’ sentences thing. Aurora

Response:

> I was just wondering if anyone else’s pdoc refuses to give them > antidepressants even with a mood stabilizer? > Tristana

  If lithium/valproates have the mood under control, antidepressants are contraindicated, in that almost any of them will snap a bipolar into full mania.  They are given only when lithium/valproate leaves the client significantly depressed, which is not utterly usual. — dmh http://blitz.org/fishhook/

Response:

- Hide quoted text — Show quoted text -> I was just wondering if anyone else’s pdoc refuses to give them > antidepressants even with a mood stabilizer? > Tristana > **** What doesn’t destroy me makes me stronger **** >                      Nietzsche > Some of my friend’s pdocs do refuse.  I find it unbelievable. Basicly I > decide for myself how much of which meds I will take and he just writes > the prescriptions.  Even if I am hypo he wouldn’t know because I always > see him in the morning when I am at my calmest. > I had to beg my pdoc for an AD, he just wanted me to up my Li and I > refused unless he would give me AD’s and I was starting to have suicidal > thoughts even though I wasn’t suicidal and I guess it freaked him out so > now I take Welbutrin and raised my Li half of what he wanted me to (up > to 675) but maybe I should raise to 900.  I tried taking 300mg Welbutrin > and I felt like I was on speed and almost had a breakdown over not being > able to find something so I stick to 150. > Aurora

  Sounds like you’re playing with both your meds and your pdoc, a good way to wind up in the ditch.  The Li dose you mention is /significantly below/ reported effective averages; let him raise it unless you are specifically intolerant to the stuff.  Also, though Wellbutrin is least likely of all ADs to drive a bipolar manic, it is also about the most hazardous on the market for primary and side effects, being toxic as hell in its own right; it is usually used only when nothing else works. — dmh http://blitz.org/fishhook/

Response:

I have had a seizure disorder most of my life; antidepressants may cause seizures in people who are susceptible. – Hide quoted text — Show quoted text -> I was just wondering if anyone else’s pdoc refuses to give them > antidepressants even with a mood stabilizer? > Tristana > **** What doesn’t destroy me makes me stronger **** >                      Nietzsche

Response:

>I have had a seizure disorder most of my life; antidepressants may cause >seizures in people who are susceptible.

Some do. Some have anti-seizure effects.

Response:

>My pdoc INSISTED that I take an antidepressant when I became suicidal. This >was along with the mood stabilizer and antipsychotic.  It worked.  Later >dropped the antipsychotic, got manic, dropped the antidepressant and >restarted the antipsychotic.  Fine now.  Keeping that leftover Zoloft for >next time I want to die.

I do that. What idiots we are. Jackie

Response:

> My pdoc INSISTED that I take an antidepressant when I became suicidal. This > was along with the mood stabilizer and antipsychotic.  It worked.  Later > dropped the antipsychotic, got manic, dropped the antidepressant and > restarted the antipsychotic.  Fine now.  Keeping that leftover Zoloft for > next time I want to die.

  This group might be a better idea than the Zoloft, or at least use both together, as the Zoloft takes a week or more to kick in.  The point is that if you should consider the idea of suicide, /get in touch with somebody/, almost anybody will do, but a friend is best (if it’s not in the middle of the night), your care team next best, but we’re always here, too.  Luck and good vibes. — dmh http://blitz.org/fishhook/

Response:

> I was just wondering if anyone else’s pdoc refuses to give them > antidepressants even with a mood stabilizer? > Tristana > **** What doesn’t destroy me makes me stronger **** >                      Nietzsche

Some of my friend’s pdocs do refuse.  I find it unbelievable. Basicly I decide for myself how much of which meds I will take and he just writes the prescriptions.  Even if I am hypo he wouldn’t know because I always see him in the morning when I am at my calmest. I had to beg my pdoc for an AD, he just wanted me to up my Li and I refused unless he would give me AD’s and I was starting to have suicidal thoughts even though I wasn’t suicidal and I guess it freaked him out so now I take Welbutrin and raised my Li half of what he wanted me to (up to 675) but maybe I should raise to 900.  I tried taking 300mg Welbutrin and I felt like I was on speed and almost had a breakdown over not being able to find something so I stick to 150. Aurora

Response:

My pdoc INSISTED that I take an antidepressant when I became suicidal. This was along with the mood stabilizer and antipsychotic.  It worked.  Later dropped the antipsychotic, got manic, dropped the antidepressant and restarted the antipsychotic.  Fine now.  Keeping that leftover Zoloft for next time I want to die. — For more information about this service, send e-mail to:

Response:

I was just wondering if anyone else’s pdoc refuses to give them antidepressants even with a mood stabilizer? Tristana **** What doesn’t destroy me makes me stronger ****                      Nietzsche

Response:

Filed under: Tricyclic Antidepress