Posted by 4WD on January 12, 2006, at 20:29:50
In reply to Re: Med-induced hypomania? Crazy and hopeless » 4WD, posted by detroitpistons on January 12, 2006, at 10:37:31
Hi Marc,
Another coincidence! I saw my pdoc today and also got put on a mood stabilizer. I gave him the description I posted here and he said "okay, new plan." I asked if this was a med-induced hypomania and said it very likely could be. Especially after I told him all SSRIs made me more jittery and nervous (I had told him that before but I've always been on a very low dose that didn't cause such intense symptoms.)
I had been on Lamictal before (I posted about my experiences there on your other thread about Lamictal) so didn't want to try that. He switched me from Celexa to Effexor (which had worked for me in the past but pooped out) and added Depakote. So we'll see what happens.
I'd like to know the name of this kind of bipolar. I never experienced anything but plain old clinical major depressive disorder before I tried SSRIs. And I've been basically on edge ever since (since 1989). Never made the connection til I came here. Effexor was actually very helpful for anxiety for me but I still had only two speeds - energetic warp speed and total exhaustion- when I was on it. Maybe the depakote will help it along.
Only thing that worries me now is that Effexor quit working for depression a couple of years ago which is why I started trying other meds. If it pooped out then, I sure hope it will work again now.
Finally, another thing I did was take a mood chart with me. There would be a day of deep depression, followed by a couple of days of scared and jittery, followed by a day of okay, followed by a day of scared and jittery and suicidally depressed followed by an "excellent" day, followed by another suicidally depressed day.
Like you I was kind of surprised but am very relieved actually. Finally, an explanation. And a treatment plan that will actually work (I am determined to be optimistic).
Just as an aside, my pdoc said Lamictal was a great med for cycling and bipolar but as a maintenance med, not for an acute crisis. (I guess because it takes so long to work up to the therapeutic dose. You might need some Klonopin or something to ease your agitation until the lamictal can start to work if it's bad enough to make you nonfunctional.
Best of luck. We'll both get better!
Marsha
> Ok, I guess it's working now....
>
> Anyways, Marsha, what a coincidence! I just posted about this on the thread that I started(which you posted on) "When are benzos justified?" because Effexor had mostly alleviated my last depressive episode, but I was still feeling anxious and agitated, and started feeling some mild symptoms of depression again. As you probably know, I was considering starting Klonopin because I just thought the GAD was not going away with the Effexor. That's why I started that thread.
>
> Well yesterday I had an appointment with my pdoc, and described basically what you did:
>
> "I started feeling like I always had 10 things going at once and couldn't focus on any of them. I was super agitated and hyper and wired. I was waking up too early and sleeping badly. I was obsessing over things. I was less depressed but still very unhappy at times."
>
> I mentioned that my mind races, and he kind of zeroed in on that. He explained that I was experiencing a sort of hypomanic episode (although without the euphoria and grandiosity--falls somewhere on the bipolar spectrum), and he started me on Lamictal. The more I think about it, I guess the more sense it makes.
>
> I was surprised at first, but now I'm optimistic about it. If it is true that I'm experiencing hypomania, then I don't think it's caused by the Effexor because the first time I was on Effexor (same dose--225mg) it virtually eliminated the GAD, and this time around, it hasn't. So I think that maybe my condition has changed a bit since then. The last thing I expected was to be put on a mood stabilizer, but I trust the doc, and I'm hoping for the best.
>
> Hope that helps.
>
> Marc
>
>
>
> > I was on Celexa 10mg and Klonopin .5mg daily and doing only fair but functional most of the time. About three weeks ago I became very depressed (more than usual) and couldn't stop crying and was suicidal. My pdoc raised my Celexa dosage to 20mg and the Klonopin to 1.5mg daily. For a few days I felt better and then I started feeling like I always had 10 things going at once and couldn't focus on any of them. I was super agitated and hyper and wired. I was waking up too early and sleeping badly. I was obsessing over things. I was less depressed but still very unhappy at times. The 1.5mg Klonopin (triple what I'd been taking) felt like sugar pills. (.5mg t.i.d.)
> >
> > I reduced the Celexa back down to 10mg (I called him and asked to reduce it to 15mg - I didn't think he'd like the idea of reducing it to 10) but I was so freaking out I had to lower it quickly. After about three days, I was able to lower the Klonopin back down to 1 mg.
> >
> > After another couple of days, now here I am. Not wired or hyper any more but deeply, deeply depressed today. Suididal depressed. And scared. The kind of depressed where you feel like the deepest grief you can imagine along with the deepest guilt along with dread and fear in the pit of your stomach.
> >
> > Did I become hypomanic? How do you treat med induced hypomania? How do you treat depression when SSRIs or SNRIs improve the depression but make you so freaked out you can't sit still?
> >
> > Low dose (37.5) Effexor is the only drug that didn't do this to me but it pooped out on me a couple of years ago.
> >
> > I feel crazy and hopeless.
> >
> > marsha
>
>
poster:4WD
thread:596880
URL: http://www.dr-bob.org/babble/20060108/msgs/598448.html