Posted by Nancy Birkner on December 1, 1998, at 19:08:04
In reply to Re: question for the docs, posted by Dr. Bob on December 1, 1998, at 17:07:33
>No history of mania, other depressions
>She was put on Prozac, Neurontin and Zyprexa.
>She was not told what the latter two meds were for, except "for sleep."
> I think the most direct way to deal with this would be to talk to the doctor at the rehab program.
> It *is* possible to speculate, though... Maybe they were concerned about hypomania or mood lability (axis 2 features)? Or maybe they (the rehab doctors) elicited a different history?
My personal experience with Prozac was a severe reaction of ultra-rapid cycling and mixed states. Prior to consuming Prozac, never in my life had I experienced these symptoms. It has been documented by other psychiatrists that Prozac possesses the ability to induce bipolar manic symptoms (in a person with bipolar tendency) when not used in conjunction with mood stabilizers.Actually, what Dr. Bob said about the concern for the appearance of hypomania or other such axis 2 symptoms, was what similarly happened to me. It wasn't until I'd taken Prozac that the depression I suffered from was reassessed as Bipolar 1 illness, with Prozac induced ultra-rapid cycling and mixed states. Unfortunately, it was too late to undue the damage done. The condition lasted many months (early spring of 1997 until April 1998) completely treatment resistive until I underwent a drug trial for Ziprasidone (Zeldox).
Your patient believed that she had been prescribed Neurontin and Zyprexa for her insomnolence. It is not logical for these two powerful neuroleptics to be prescribed only for the purpose of the side-effect producing sleepiness. So, once again, Dr. Bob may have deduced correctly, when asserting that the rehab docs were concerned about underlying bipolar tendency in this patient.
Perhaps, this patient could obtain a copy of her medical record regarding this subject matter. For good reasons, including treatment compliance, a patient would be wise to obtain some understanding of her disorder, treatment options, and the consequences in refusing appropriate medication pertaining to her particular mental illness.
Finally, I'm very empathetic to your patient's tragic loss. But, she should not resort to self-medication. It only leads to more tragedy. It also stands between her and her ability to process her grief.
Perhaps, when my bipolar illness is under control, I'll finish my application to medical school. All I can do, now, is disclose my base of personal knowledge from experiences and research.
Mind Over Madness,
Nancy
B.A. Chemistry, U. of Nevada
Graduate Research in Neuroscience, U. of Nevada
Currently, I guess, I'm a mad scientist.
poster:Nancy Birkner
thread:1417
URL: http://www.dr-bob.org/babble/19981201/msgs/1420.html