Posted by SLS on March 4, 2016, at 6:56:45
In reply to Nardil safe?, posted by J Kelly on March 1, 2016, at 14:17:16
> Hello all.
Hi Jade.
Possible diagnosis: 296.53 (F31.4):
Bipolar I Disorder; Most Recent Episode Depressed, Severe Without Psychotic Features* Your depression does not have psychotic features as a natural part of the illness. However, a psychotic reaction to drugs indicates Bipolar Disorder I if the manic reaction persists after the offending drug is discontinued.
If you are concerned about a MAOI-induced psychotic reaction, you should consider:
1. Taking an antipsychotic or mood stabilizer right from the start to be used as a prophylactic. Once you respond to the MAOI and are stable for awhile, you can then try discontinuing the antipsychotic or mood stabilizer. You are likely to be Bipolar I based upon the severity of your psychotic reaction. Our cases are very similar.
2. Start the MAOI by itself and take an antipsychotic (Zyprexa) as an emergency drug if psychosis develops. The problem with this strategy is that it often happens that the patient does not recognize the onset of psychosis early enough to want to act on it. Once the emergency has passed, you can then choose to use another antipsychotic with a more acceptable side effect profile.
For me, Abilify helps with depression and seems to prevent mania while taking an MAOI. I would caution against using Geodon because it is a serotonin reuptake inhibitor and might precipitate serotonin syndrome.
- ScottSome see things as they are and ask why.
I dream of things that never were and ask why not.- George Bernard Shaw
poster:SLS
thread:1086626
URL: http://www.dr-bob.org/babble/20160131/msgs/1086699.html