Posted by SLS on March 16, 2006, at 6:23:57
In reply to Re: Never thought I'd hear this....., posted by linkadge on March 15, 2006, at 9:52:07
> The only thing wrong with labling antidepressant induced mania as bipolar is that it can force a patient to take heavy, and perhaps unnecssary medication.
This is where I think it is important to determine whether or not there are any other signs of bipolarity. It is a judgment call. The other consideration is that an algorithm be used in such cases such that "heavy" medication be used only if "lighter" treatments fail. Again, this is a judgment call.
> The thing that scares me the most, is that patients who have manic reactions to medications are often placed directly on mood stabalizers, before trying the grosly simplistic: simply tapering the antidepressant.
When I first became manic on antidepressants, I had been in remission - my only true remission - for about 6 months. Lithium was introduced and the antidepressants withdrawn. To make a long story short, I never responded to those same antidepressants again. The antidepressant response could not be recaptured. This is the risk taken when one discontinues effective drugs. Perhaps this applies to reduced dosages as well.
> I would also argue *against* the notion that a positive responce to mood stabalizers means that a person is bipolar.
Clinicians' experiences seem to controvert your conclusion.
> The reason being is that Dr. Manji's work again shows that lithium, depakote, and antipsychotics are able to block the behavioral reactions of mice to amphetamines and high dose antidepressants.
And...
> I.e. you take a normal (non-bipolar) mouse, you can make it manic with drugs, and you can block the manic reaction with mood stabalizers and antipsychotics.
Stereotypy is not mania. The rats do not become manic.
> Think of it this way. You can induce a seizure in just about anyone with the right drugs. Why is is so inconcievable that a manic episode is not just a branch of the same phenomina ?
The question is not whether or not such a thing is possible, it is what are the odds that a manic reaction to therapeutic dosages of antidepressants indicate bipolarity. My guess is that the odds are heavily in favor of bipolarity.
- Scott
poster:SLS
thread:620137
URL: http://www.dr-bob.org/babble/20060315/msgs/620867.html