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Re: Mania, med reactions, the DSMV + rapid cycling! » brynb

Posted by SLS on June 27, 2015, at 14:36:00

In reply to Mania, med reactions, the DSMV + rapid cycling!, posted by brynb on June 27, 2015, at 12:06:58

Real quick:

As you already know, the new DSM 5 now qualifies as bipolar disorder cases in which depression is chronic except for drug-induced manic episodes. It can happen with Bipolar I or Bipolar II. I'm a Bipolar I, and my case follows this pattern.

Rapid cyclicity can actually appear or disappear as the natural course of bipolar illness. It can also either be triggered or dissipated by drug treatment. I was an ultra-rapid cycler with a very regular period of 11 days (8 depression; 3 euthymia). My cycling was abolished by the introduction of lithium. It left me in a chronic state of depression. Removing the lithium did not yield a return of cycling.

I am unclear as to what your questions are, if any. However, you might want to take a look at Trileptal (oxcarbazepine) or even Aptiom (eslicarbazepine) if you haven't already. Trileptal is an excellent anti-manic mood stabilizer. Some doctors are using:

Trileptal + Lamictal

This combination is particularly good for mixed states. Lamictal itself is a poor anti-manic. Even though it helps more with depression, there is some data that it can penetrate rapid-cycling after six months.

From what little I have seen, I might suggest adding to this:

+ Abilify for residual depression and perhaps mania.
+ Wellbutrin for remaining depression
+ lithium (Low-dose for depressive component only; high-dose for mania and mood stabilization).

Just a few thoughts.


- Scott


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