Posted by SLS on June 5, 2006, at 8:46:51
In reply to Are SSRI's the problem? Continuous mood cycling, posted by sac on June 5, 2006, at 6:34:14
Hi.
> I've been struggling for years to find the best combo of meds to treat my bipolar II. It is very frustrating and I have been on them all...Depakote, Lamictal, Neurontin, Gabitril, Seroquel, Zyprexa, Abilify, Geodon, etc. etc. etc. I've have the most success with Lithium ER (Eskalith or Lithobid brand works better for me)
> Trouble is, I've also been on numerous AD's to treat my bipolar depression, right now I take 20 mgs. Prozac and only 300 mgs. Lithobid. I still cycle
Can you describe your cycle and what you experience?
I doubt 300mg of lithium will do much to prevent cycling. You should probably be on a dosage that provides a blood level of at least 6.0 mEq/L. Have you tried combining lithium with Lamictal? The NIMH has published studies indicating that this combination treatment works well to prevent relapse of bipolar I. I'm not sure if they tried it for bipolar II.
What about Tegretol or Trileptal?
It is part of traditional thought that antidepressants will precipitate or exacerbate cycling in people with bipolar disorder. However, some people are actually stabilized by SSRIs. I guess it makes sense to try mood stabilizers first and add antidepressants if necessary. If you are ready to try other antidepressants now, I would suggest that you look at Parnate at some point. It seems to be particularly effective in treating bipolar depression. Emsam has not been available long enough to evaluate its usefulness in bipolar disorder, but I would not rule it out.
- Scott
poster:SLS
thread:653104
URL: http://www.dr-bob.org/babble/20060604/msgs/653132.html