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Re: hypomania...reaction to antidepressants? » madison88

Posted by Ritch on September 12, 2002, at 10:39:04

In reply to hypomania...reaction to antidepressants?, posted by madison88 on September 11, 2002, at 22:58:37

> It is now pretty clear to me that i had a few periods of hypomania when i first started on antidepressants and was not taking any mood stabilizers with them. The excited, agitated states were strange to me, i had never had them before. Once i was put on Neurontin and now Gabitril, i haven't had any as near as severe, although sometimes i get a real rush of agitated energy every now and then that doesn't last more than a day. As far as I know, there is no distinction made in the DSM btw a regular hypomanic episode and one that was caused by antidepressants. I have heard that someone was thinking about adding a category for people who like me get manic or hypomanic on antidepressants. Anybody hear anything about this? I really think Drs should be more watchful about these. I thought for a while that i was becoming bipolar and i didn't understand what was going on, b/c my dr kept saying i wasn't.

Madison,

You aren't supposed to count a hypomanic response (only) to a medication to make a diagnosis of BPII. Here's an excerpt from the American DSM criteria for BP-II hypomanic episode from mentalhealth.com:

Hypomanic Episode
A distinct period of persistently elevated, expansive, or irritable mood, lasting throughout at least 4 days, that is clearly different from the usual nondepressed mood.

During the period of mood disturbance, three (or more) of the following symptoms have persisted (four if the mood is only irritable) and have been present to a significant degree:
inflated self-esteem or grandiosity
decreased need for sleep (e.g., feels rested after only 3 hours of sleep)
more talkative than usual or pressure to keep talking
flight of ideas or subjective experience that thoughts are racing
distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli)
increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation
excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g., the person engages in unrestrained buying sprees, sexual indiscretions, or foolish business investments)

The episode is associated with an unequivocal change in functioning that is uncharacteristic of the person when not symptomatic.

The disturbance in mood and the change in functioning are observable by others.

The episode is not severe enough to cause marked impairment in social or occupational functioning, or to necessitate hospitalization, and there are no psychotic features.

The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication, or other treatment) or a general medical condition (e.g., hyperthyroidism).
Note: Hypomanic-like episodes that are clearly caused by somatic antidepressant treatment (e.g., medication, electroconvulsive therapy, light therapy) should not count toward a diagnosis of Bipolar II Disorder.



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poster:Ritch thread:119591
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