Posted by linkadge on July 30, 2007, at 17:07:11
In reply to My Experience Mirrors Yours, posted by dewdropinn on July 30, 2007, at 12:25:10
>You may already be away of the "kindling" >theory, but if not, here's the nickle tour -- if >left untreated, epilepsy grows worse over time, >with seizures becoming more frequent and severe ->- a lot of researchers think the same thing is >at work with bipolar -- cycling if left >untreated becomes increasingly severe, >eventually bringing very obvious bipolar >symptoms to the fore.
I have heard of the kindling theory, but I don't really know if it really has all the answers. Not all epilepsy gets worse over time. Epilepsy in woman, for instance, can tend to get better after menopause.
>SSRIs are among the worse drugs for bipolars -- >so it goes to folllow that SSRIs kick this whole >process into hyper-drive. It makes you wonder >whether or not the emergence of wide-spread >bipolarity is associated with the wide-spread >administration of SSRIs.There could be a number of factors. I personally believe that the SSRI's antidepressants are inadequate for a lot of people. For the most part, a person has a choice between some sort of med with serotonin reuptake inhibition, or a mood stabilizer. Who says every depressed person has a too high level of the serotonin transporter? Infact the majority of studies suggest that there is a decreased level of serotonin transporter in depression!
I personally think that a patient could be unipolar, and yet still have an agitated response to an antidepressant. Even in healthy vaulenteers, SSRI's can induce akathesia, insomnia, etc etc. Animal models too, suggest that SSRI's can cause agitation, rapid cycling etc. It is my personal contention that a patient need not be bipolar to have a agitated type response to an SSRI. Some studies are showing that individuals with the SS varient of the serotonin transporter, have poor responses to SSRI's, and get all the nasty agitated side effects. I think that psychiatrty doesn't have all the answers, but they want to propose they have all the answers. As such, if you have a poor response to an SSRI, you must be bipolar. Perhaps there is yet some unidentified biochemical abnormalitity that would infact treat depressed patients who show poor response to SSRI's *and* poor response to mood stabilizers.
>Mood stablizers are a tricky bunch. They all are >capable of making you feel miserable, and they >can all have nasty start-up side effects -- some >can be downright vicious like depakote and >lithium, although many are able to take both >without serious problems. So, your response >isn't at all abnormal, and it doesn't mean that >mood stabilizers aren't the ticket to your >recovery.I have had it with mood stabilizers! Unless some real amazing mood stabilizers come around soon then I don't think I am going to go that route.
Mood stabilizers took me from depressed to more depressed. Lithium, depakote, tegretol, trileptal, even the so-called "magig bullit" lamotrigine made me feel so incredably lousy.The problem with me, is that after I fully withdrew from SSRI's, (ie say 4 months after), the cycling stoped. Ie, I only really had cycling upon withdrawl, not during treatment, and not some time after. After 4 months off AD's, I just sunk back into intollerable depression like before AD's. It was that 4 month period of what I consider wathdrawl induced rapid cycling which got me the diagnosis of bipolar.
>Anti-convulsants impact brain function in a >broad fashion, but most target specific areas of >the brain. So negative or positive responses can >vary widely depending upon the primary location >of your brain hyperactivity and the brain areas >that are targeted by a particular medication.I think thats overhyped. The so-called, temporal lobe selctivity of drugs like tegretol is not all that selective. Lamotrigine, for instance, affects sodium chanels througout the whole body. That is why it can, for instance, affect cardiac sodium chanels in higher doses. The drugs made me dumber than a bag of nails, they locked be into an intollerable depressive state. Lithium and depakote are certainly not limbic selective, they affect ion channels throughout the brain equally.
>For bipolar 1, antidepressants are usually >problematic, but there's some controversy over >whether or not this is the case with bipolar 2 >and the softer varieties of the disorder. >There's general agreement that you need to >stabilize mood first -- which sometimes means an >initial increase in depressionBut I am not really unstable. I have been drug free for almost 3 or 4 years. I have remained essentially stable (in a depressed state) the whole time.
> -- but this can >be treated with >antidepressants later on. It's almost as if the >anti-convulsant lays the foundation for >successful anti-depressant therapy by >counteracting the destabilizing aspects of anti->depressants.For me, antidepressants and anticonvulsants did not mix well at all. They did not restore response to antidepressants, they also did not have any antidepressant effect on their own. These were not really short trials either.
>It was only when I hit upon the right mood >stabilizer -- Lamictal -- at the right dosage -- >400mg -- that I was able to benefit from anti->depressant therapy -- EMSAM 9mg.
Thats great. I had been on lamotrigine up to 300mg. The higher I went the more lousy I felt. I couldn't think straght or thing straight, it gave me problems walking, sleeping eating, heart palpitions, strange paranoia. It did nothing for my depression if not made it worse.
>So, feeling bad on mood stabilizers is not >necessarily a bad thing -- and if you suffer >from a bipolar spectrum disorder, you will >almost certainly need to take one.
I don't think I can continue to take them. I think I have been misdiagnosed as bipolar based on a SSRI withdrawl induced manic/psychotic reaction from a abrupt dopamine rebound from SSRI withdrawl.
Thanks for the post. When you find something that works, it is easier to believe the accompanying theory. However, sufficiant trials of mood stabilizers have left me feeling consistantly worse.When antidepressants fail, and mood stabilizers don't help, you're kind a screwed.
Linakdge
poster:linkadge
thread:772375
URL: http://www.dr-bob.org/babble/20070730/msgs/772951.html