Posted by Mitch on December 14, 2001, at 0:31:23
In reply to Can lithium work in 30 mins? Am I Bipolar?, posted by JeffH on December 13, 2001, at 15:21:32
> After a month, I finally found a pdoc at the U. of Arizona in Tucson who was willing to try opiates. Just for fun, I had been mood charting myself and discovered my depression was cycling daily from severe depression to a non-depressed state (although still had anhedonia).
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> Well, opiates went to the wayside temporarily when I was diagnosed Bipolar II and given a script for lithium. That night, I took the minimum dose (one capsule) and a half-hour later, I literally felt a jolt and my depression went away and has been gone now for two weeks!
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> I have been depressed for 33 years and have tried many medications (including lithium). Nothing else has ever worked. Why did it work now and so fast? Could the turmoil of my recent divorce turned unipolar depression into bipolar?
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> Anyway, tomorrow I go back to Tucson to get started on a TCA and possibly Mirapex. I still need to take care of that life-draining anhedonia.
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> Is there anyone else out there that is Bipolar who has been effectively treated with a mood stabilizer for depression but still has anhedonia? Is treatment different than people with unipolar depression and anhedonia?Hi Jeff,
Many people might think this is some sort of placebo effect related to a positive session with a decent pdoc. My next to last last pdoc thought it was a "placebo" effect when I switched from lithium to Depakote and complained about worsened depression. But, if lithium can *stop* working when you stop and start it again later-then who's to say it couldn't *start* working when it never worked before??
Anhedonia and dysthymia are still major troubles with BP-II's who are taking only mood stabilizers. Lithium is the only mood stabilizer that I have ever taken as monotherapy that could keep hypomanias in check and at the same time treat major depressions (also by itself). BUT, I have the same trouble with the dysthymia/anhedonia that you refer to. IMHO, I would try adding low-dose Wellbutrin (or bupropion-generic) before I would add a TCA. It is pretty cheap and you will get less side effects.
People with treatment-resistant unipolar depressions tend to tolerate antidepressants better with much higher doses. The trick to see if your bipolar hypothesis is correct is to add an antidepressant and see what happens and see if you get hypomanic. Some unipolar depressives can respond to lithium by itself. But, if you find yourself easily becoming hypomanic from antidepressants that is fairly tell-tale for bipolar.
Mitch
poster:Mitch
thread:86813
URL: http://www.dr-bob.org/babble/20011213/msgs/86861.html