Posted by morgan miller on April 12, 2011, at 13:29:42
In reply to Re: am I really bipolar?, posted by mellow on April 12, 2011, at 12:42:41
Bipolar has a fairly wide spectrum, and no one truly understands exactly what is going on in the brain to cause the reactions and behaviors people with bipolar disorder experience.
I've also done very well on just an antidepressant, though I did experience hypomania at times on it. I am bipolar for sure, there is no doubt in my mind.
Abilify at the dose you are taking is going to have stabilizing effects without antidepressant effects. The lower doses of Abilify, like 2 or 3 mg, are the ones that have antidepressant effects, especially when used as an adjunct to an antidepressant.
Celexa and other antidepressants are powerful drugs. Selective serotonin reuptake inhibition along with other mechanisms, like boosting brain antioxidants and impacting sigma 1 opiod receptors(in Celexa and Lexapro's case likely Sigma 1 agonism), have a profound antidepressant and anxiety reducing effects, much more so than any antipsychotic has potential for. Sigma 1 agonists may be responsible for the calming impact that some antidepressants have. There is also some evidence that sigma 1 agonists may improve neuroplasticity. So, there are other mechanisms than selective serotonin reuptake inhibition by which drugs like Celexa exert therapeutic benefits.
Right now, your "mood stabilizer" is Abilify. This was chosen at the dose it has been used because your condition manifested in psychotic symptoms. Otherwise, if you had just experienced agitated mixed states, you may have only been prescribed depakote, with possibly a low dose of Zyprexa, depending on the severity of the episode.
It is possible, you could slowly transition from the dose of Abilify you are on, to a 5 mg dose plus a moderate dose of Depakote, maybe 750 to 1000 mg, and a smaller dose of lithium, maybe 300 mg, and of course keep the Celexa on board. I know this is more medications, but the combination at these doses may be much less likely to cause any long term health issues that you might be concerned about.
If you are really doing well right now, there is probably no reason to change anything until everything in your life is going the way you want it to-job, social life, and overall strength and independence. Even then, you would want to be extremely careful about making any changes in medication.
I agree that talking to your doctor about lower the dose of Abilify to 15 or 10 mg and staying on Celexa might be a good idea.
If you start a religious workout and diet lifestyle(for life!), and keep up with supplements you know help, your chances of success in all areas of life, including medication changes, will be that much greater.
Morgan
poster:morgan miller
thread:982538
URL: http://www.dr-bob.org/babble/20110406/msgs/982567.html