Posted by Elizabeth on January 23, 2002, at 15:12:14
In reply to Anti-depressant Least Likely to cause cycling?(BP, posted by cara52 on January 22, 2002, at 12:07:50
I think Wellbutrin is relatively safe. The TCAs are probably the most dangerous. MAOIs seem to cause hypomania a lot, but TCAs are more likely to cause dysphoric hypomania. SSRIs are less likely to cause mania than TCAs and possibly MAOIs. I'm not sure about the newer ADs. My pdoc says he think Effexor may be worse than the SSRIs for causing mania.
Ideally, it might be best to avoid ADs altogether. But some people find that mood stabilizers alone aren't enough. Some mood stabilizers, such as lithium and Lamictal, often have antidepressant effects, and others can as well, but some people need ADs too. I think that doctors who refuse to prescribe ADs to bipolars (or only do so very rarely) are doing their patients a disservice.
Also, a note to MB:
> If Wellbutrin is the best for not inducing mania, I wonder why my thoughts raced more on Wellbutrin than on any SSRI ever. I wonder if this is diagnostic. I mean, I wonder if my horrible experience with Wellbutrin is an indication that I'm not bipolar."Racing thoughts," by itself, isn't diagnostic of mania. Wellbutrin can cause a lot of anxiety (this was its effect on me, and I'm not bipolar) which can lead to racing thoughts. Also, while WB is less likely to cause switching in bipolar patients than other ADs, that doesn't mean that it is more likely to *work* in bipolar d/o than other ADs!
poster:Elizabeth
thread:91108
URL: http://www.dr-bob.org/babble/20020116/msgs/91285.html