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Re: Classifying manias

Posted by undopaminergic on December 9, 2019, at 3:55:27

In reply to Re: Classifying manias Lamdage22, posted by linkadge on December 4, 2019, at 18:51:29

> >Does it make a difference in your treatment whether >or not you were full blown manic or just hypomanic?
> >
> I think it can. For hypomania (i.e. that doesn't result in hospitalization) it may not make sense to take a regular mood stabilizer. An antipsychotic (as needed) may make more sense.

"As needed" is the key phrase when it comes to antipsychotics for (hypo)mania. In my view, they are merely antimanics and generally do nothing for depression, or even aggravate it due to the dopamine blockade. Mood stabilisers are a longer term solution (than acute antimanic effect), and they require time to start working, so augmentation with an antipsychotic in the beginning may be necessary.

Sometimes atypical antimanics may be preferable. Eg. serotonergics (like SSRIs) worked for me to dampen my mania. I have even found that stimulants can stabilise me in a state that is above "normal" but below hypomania. They do not induce a switch to (hypo)mania, but on the contrary, they work as stabilisers.

Memantine, however, can produce a state that resembles (hypo)mania, including the impulsiveness. As an example of impulsiveness, on a whim, I took a massive overdose of it, partly with a suicidal intent, and I ended up in intensive care, after which I was transferred to a psych ward.





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