Posted by OldSchool on January 23, 2002, at 10:49:38
In reply to Re: Anti-depressant Least Likely to cause cycling?(BP, posted by Blue Cheer 1 on January 22, 2002, at 23:13:53
> I think Dr. Ghaemi says it as well as anyone. Avoid antidepressants; they'll worsen your course. If you're mixed, forget about antidepressants. If you must use them, then discontinue them about two months after an antidepressant effect is achieved.
>This is what Ive always heard/read about bipolar disorder. Avoid antidepressants whenever possible, as taking them increases your chances of setting off mania/hypomania. Ive got one of Stephen Stahl's books and in his bipolar combo section, only one of the possible combos he lists include mood stabiliser plus antidepressant. Here are the combos Stahl lists in this book Ive got:
1)First line monotherapy: lithium or depakote
2)Second line monotherapy: atypical anti-psychotics
3)Third line monotherapy: carbamazepine, lamictal, Neurontin and Topomax
4) Atypical combo: lithium or depakote PLUS atypical anti-psychotic
5)Benzo "assault weapon" combo: lithium or depakote PLUS benzo
6)Neuroleptic "nuclear weapon" combo: lithium or depakote PLUS neuroleptic
7)Mood stabiliser combo: two or more mood stabilisers combined
8)Antidepressant combo: mood stabilizer or atypical anti-psychotic plus antidepressant
Also remember that ECT is one of the most effective treatments for bipolar disorder. ECT has strong anti-convulsant properties (it pushes up the seizure threshhold and makes it harder to have seizures).
Old School
poster:OldSchool
thread:91108
URL: http://www.dr-bob.org/babble/20020116/msgs/91243.html