Posted by CK1 on March 9, 2005, at 19:54:31
Hi all,
I was given Paxil for anxiety 3 years ago and it worked great for a few years but quit working in January. I have since tried Effexor/Zoloft and they have done nothing besides make me feel worse. Has anybody ever had a really good experience on an SSRI only to have it "poop out", then you go on the SSRI "merry go round" and nothing works?
Well, this is a very good sign that you might have "Soft Bipolar Disorder" which is only improved with the addition of a mood stabilizer: depakote, lamictal, etc. In these cases, SSRI's and Stimulants can make you worse if a mood stabilizer is not added to your treatment. Hmmmmmm....It never occured to me that this could be a reason that I relapsed after feeling "soooo good" this summer.Read this:
After you try a series of antidepressants and they don't work or they do but "poop out" (which itself has been suggested represents a "soft sign" of bipolar disorder), a new strategy is worth considering anyway, namely a "consider possible bipolarity" strategy whether there are obvious symptoms to support the diagnosis, or not. Some people also think that obviously recurrent "unipolar" depression is a "bipolar" phenomenon simply missing the other pole, just as there are (about 10%, I believe Dr. Mauricio Tohen's work has shown) people with obvious manic episodes, thus clearly "bipolar", who never have depressed episodes, only the "one pole".A leading bipolar researcher, associated with Harvard, has also noted this association between "Prozac Poop-out" and bipolar disorder. He states there that transient antidepressant response ("poop-out," meaning acute improvement but later relapse) is a "soft sign" of bipolar disorder, not diagnostic in itself but suggestive. So, I think you could say there are 3 reasons to try treating you as though you have bipolar disorder: the "it's time for a new strategy" reason; the poop-out reason; and the recurrent unipolar reason above -- all even if you never had a symptom of hypomania at all. suggesting that your "recurrent unipolar" is a bit farther over toward bipolar than the pure unipolar end of the spectrum as your treatments thus far have been based upon. The good news in all this is that there may be some nifty treatment options for you when you look at mood stabilizers. Note that even old lithium has been used as an add-on to partially effective antidepressant treatment with good results in many studies -- so you don't even have to invoke "bipolar" to try that one!
Depression that doesn’t respond to antidepressants (or gets worse, or "poops out")
Many people have repeated episodes of depression. Sometimes the first several episodes respond fairly well to antidepressant medication, but after a while the medications seem to "stop working". For others, no antidepressant ever seems to work. And others find that some antidepressants seem to make them feel terrible: not just mild side effects, but severe reactions, especially severe agitation. These people feel like they’re "going crazy". Usually at this time they also very poor sleep. Many people have the odd experience of feeling the depression actually improve with antidepressants, yet overall —perhaps even months later —they somehow feel worse overall. In most cases this "worse" is due to agitation, irritability, and insomnia. In some cases, an antidepressant works extremely well at first, then "poops out". The benefits usually last several weeks, often months, and occasionally even years before this occurs. When this occurs repeatedly with different antidepressants, that may mark a "bipolar" disorder even when little else suggests the diagnosis.
poster:CK1
thread:468932
URL: http://www.dr-bob.org/babble/20050308/msgs/468932.html