Posted by Ted on August 9, 2001, at 21:47:39
In reply to Re: bipolar meds and anxiety, posted by cb on August 9, 2001, at 19:28:10
Well, the doctors and nurses are right -- SSRIs will often trigger mania -- but that shouldn't happen if a mood suppressor is prescribed properly. That is how my bipolar disorder was discovered in fact. But in my opinion, if the mania is still happening with a mood suppressor, then I think the mood suppressor needs a dose increase.
I would drop the wellbutrin quite a lot, maybe even eliminate it. Then jump to an SSRI in low dose (probably zoloft or celexa -- they seem the weakest) and simultaneously raise the mood suppressor (neurontin or depakote or lithium) to maintain stability. If SSRIs are totally out of the question, even at low doses, then try a tricyclic like desipramine, but I think tricyclics have the same problem as SSRIs when it comes to triggering mania.
>he ended up suicidal (mixed state?).
Possibly. That is how I was a few years ago, without meds.
>Synthroid cause?
I doubt it, but others can probably provide better info.
>SHouldn't the klonopin have helped.
Eventually, yes, if enough is taken. But that is the wrong tool for this problem.
Ted
> > Thanks for such a quick response! His problem with antidepressants is that they tend to make him manic. Zoloft was great for the depression but always led to manic episodes. He's tried Paxil and Celexa as well. Same results. After each manic episode he tries to get by without an AD but gets very depressed. Before his hospitalization he was on depakote and celexa - he ended up suicidal (mixed state?). Dr said no more SSRIs - the nurses at the hopital swear that the SSRIs lead to mania regularly.
> His wellbutrin was lowered from 400 mg a day to 300 mg but it doesn't seem to have reduced the anxiety. Dr. thinks synthroid may be contributing to it? SHouldn't the klonopin have helped.
> Thanks again - you are great!
poster:Ted
thread:74366
URL: http://www.dr-bob.org/babble/20010809/msgs/74390.html