Posted by McPac on June 16, 2003, at 21:03:48
In reply to McPAC: answers, etc.! » McPac, posted by Janelle on June 16, 2003, at 19:35:44
Hi - the OTHER symptoms of hypomania I had (besides the anger) included irritability, going off on anyone and everyone, overreacting to minor events, restlessness. My feeling is that these symptoms were caused by the SSRI.
The only *typical* hypomanic or even regular manic symptom I did NOT have was sleeplessness - I would get so riled up each day that I'd fall asleep exhausted at night - of course, my pm meds helped!>>>>>>>While these symptoms ("going off", temper/rage, overreacting CAN be caused by hypomania, they can also be caused by ssri's (these feelings naturally go along w/ feelings of anger). EVEN IF you could NOT sleep, many people can't sleep well when terribly p!ssed off...that wouldn't necessarily mean hypomania, it could be attributed to the anger.
You raise a CONFUSING but interesting issue! Did the ssri's cause the hypomanic symptoms or did the ssri's cause anger which then caused the rest of the symptoms - IS THIS WHAT YOU ARE ASKING????>>>>>>>>>(I knew this was going to be confusing for me to explain, it's tricky for me to word it without being confusing, lol...but I think you understand me Janelle. Let me try to explain it this way. Let's say that a bipolar patient takes ANY anti-dep. (TCA, MAOI, SSRI, whatever). Let's say that after taking that pill, the bipolar person can't sleep well...the person gets insomnia DUE TO a side effect from that anti-dep. In such a case, the person would NOT say, "this anti-dep. triggered hypomania and it is my hypomania that is the reason for my sleep problems". In THIS example, it is NOT hypomania (a doctor would NOT say, "oh, you are having a hypomanic episode") RATHER, it is sleeplessness (a side effect) caused by the drug. Yet, what I'm saying is that MANY bipolars will take an ssri, develop terrible anger/irrit./temper/ (those feelings all go together---how can you have terrible ANGER without feeling irritable?) and then automatically say, "oh no, this ssri has triggered my bipolar hypomania" when, just like the sleeplessness example, it may be that the anger/temper/irrit. is a SIDE EFFECT of the ssri, NOT hypomania! (Again, I KNOW that AD's can and do trigger hypomania but my point is that rather than automatically concluding that the anger is hypomania, it may simply be a side effect of the ssri. (Big difference because understanding the difference can have big implications for many people).
As for the good ol' TCA's, I did have good results with Elavil (amitryptiline - spelling?) many years ago, but dry mouth, constipation and the rest of the SE's - yucko.>>>>>>>I'll take dry mouth and constipation over terrible anger/irrit/impotence or sexual dysfunction (throw in huge weight gain for many people), but that's just my preference.
I will talk to my pdoc (I'm getting assigned to a new one cuz the one I love so much is leaving) next month and assess what to do with regard to the ssri and mood stabilizers.
>>>>>>>>Good luck Janelle, hope you get a good one!
poster:McPac
thread:234181
URL: http://www.dr-bob.org/babble/20030614/msgs/234442.html