Posted by linkadge on March 16, 2006, at 9:45:03
In reply to Re: Never thought I'd hear this..... » linkadge, posted by SLS on March 16, 2006, at 6:23:57
>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.
That seems fair enough.
>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the antidepressants withdrawn.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 argue that the moment you went manic, was the real moment that the true antidepressant responce was gone forever.
>Clinicians' experiences seem to controvert your >conclusion.
Theres no way to proove that. So if a anti-manic agent blocks the antidepressant effect, and calms the person down (like it should) then we are to conclude that a person is bipolar. It is the logic that is used that is flawed. You can "respond" to a mood stabalizer insofar as it blocks the cycling that the antidepressant produced does not mean you would be cyling on your own.
>Stereotypy is not mania. The rats do not become >manic.Nor do they become depressed? If we throw away the mania model then we must throw away the depressed mouse model. Manic mice show many similarities to manic people. Decreased sleep, increased sexual persuit, increased risk taking, increased hedonic activities, agressivness, hyperlocomotion. As well, biochemically they exhibit similarities. Increased catecholamine release, PKC overexpression, certain patterns of epileptiform activity.
>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.My guess is that they are not. A lot of Dr. Manji's work shows that antidepressants activate some of the same pathways that are turned on in mania. For instance. TCA's increase PKC expression (dramatically). OTOH, PKC inhibitors are effective antimanic agents. Another thing that you have to consider is that antidepressants may me inducing *undetected* cylcing and hypomania in a lot of people.
Another thing to consider is that cumulative sleep deprivation can cause psychosis/mania in just about anyone, that is fairly documented. The TCA's can block certain sleep stages for a very long time. They're dirty drugs.
My mother had one manic episode (in reaction to a TCA which she took for about 6 months, and claimed it was the only time she felt good :)). I just don't see how that justifies a lifetime of lithium.Its my own personal experiement to prove this thing wrong. Maybe I will fail, and then I will accept treatment. I am going to proove that a single manic episode in responce to an antidepressant does not imply bipolar. So far (over 1 year off all treatment) has said to me that I don't cycle at all, but those are strong drugs.
Linkadge
poster:linkadge
thread:620137
URL: http://www.dr-bob.org/babble/20060315/msgs/620902.html