Shown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by Janelle on June 15, 2003, at 18:23:09
A pdoc who I did NOT care for kept insisting to me that SSRI's can induce hypomania or even full-blown mania and I did not believe him. He spouted it like the gospel and seemed very close-minded to anything to the contrary.
I was also skeptical because I had been on Paxil, an SSRI for MANY years with NO hypomania. Ironically, although I didn't recognize it at the time, I did exhibit hypomanic symptoms toward my last days on the med, before it pooped out and I had to taper off.
Since then, and it has been years, I've been on therapeutic doses of two different SRI's (I purposely left the other "S" out because one is not literally an SSRI) -- EffexorXR (an SNRI) and Celexa (SSRI) and BOTH of these meds induced big time hypomania and cycling in me.
The Celexa was worse! I went from being the angriest, most pissed off person, I would go off on anybody and everybody, overreact to minor things, etc. to crashing into depression where all I did was stay in bed because my body could not sustain the outpouring of adrenalin that must have accompanied the hypomania which lasted for days.
Anyway, I now have a different pdoc (thank goodness - the other one was also a cold fish and a jerk in personality) who lowered my Celexa by a lot, increased Depakote and we SEEM to be moving in the right direction.
That pdoc left the organization (figures, he was the BEST one I've ever had) and I hope the replacement will continue to work with me on the balance between SSRI's and mood stabilization. I'm afraid if I go off the Celexa (SSRI) altogether I will get depressed again. That's part of my diagnosis. I may have to ratchet up the Depakote a bit more.
I'm also on a low dose of Lithium which could be increased, but the pdocs all say that Depakote is the med of choice for the kind of moods and cycling I'm *blessed* (NOT!) with.
Posted by McPac on June 15, 2003, at 19:41:03
In reply to I never would've believed it but (re SSRI's):, posted by Janelle on June 15, 2003, at 18:23:09
The question is, did the ssri's CAUSE your anger OR did they just trigger the hypomania, which had anger as one of it's symptoms? (There is a difference; I'm wondering if it is the ssri ITSELF that caused the anger or if the ssri could have been "interchanged" with any other anti-dep. and merely acted as a catalyst which triggered the hypomanic anger?)
I am REALLY beginning to believe that MANY people get very bad anger/irritability that is CAUSED by the ssri's. They then, in many cases, attribute the anger/irrit. to hypomania, or some other psychiatric condition when for MANY (if not MOST) it is the ssri ITSELF that is to blame! These supposedly "safer, better, less side effect" ssri's (so the hype goes) will one day be acknowledged for being just the opposite. If it weren't for ocd and absolutely NEEDING to take an ssri (not much else to choose from for severe ocd), I'd run from these ssri's.
Posted by avid abulia on June 16, 2003, at 13:35:30
In reply to Janelle, Re: I never would've believed it but , posted by McPac on June 15, 2003, at 19:41:03
> The question is, did the ssri's CAUSE your anger OR did they just trigger the hypomania, which had anger as one of it's symptoms? (There is a difference; I'm wondering if it is the ssri ITSELF that caused the anger or if the ssri could have been "interchanged" with any other anti-dep. and merely acted as a catalyst which triggered the hypomanic anger?)
> I am REALLY beginning to believe that MANY people get very bad anger/irritability that is CAUSED by the ssri's. They then, in many cases, attribute the anger/irrit. to hypomania, or some other psychiatric condition when for MANY (if not MOST) it is the ssri ITSELF that is to blame! These supposedly "safer, better, less side effect" ssri's (so the hype goes) will one day be acknowledged for being just the opposite. If it weren't for ocd and absolutely NEEDING to take an ssri (not much else to choose from for severe ocd), I'd run from these ssri's.i gotta agree with you on the SSRI issue... i`d rather deal with my 4 hours of ritual per day than SSRIs.
~AA
Posted by Janelle on June 16, 2003, at 14:27:20
In reply to Janelle, Re: I never would've believed it but , posted by McPac on June 15, 2003, at 19:41:03
I'm not sure I quite follow your question - "did the ssri's CAUSE your anger OR did they just trigger the hypomania, which had anger as one of it's symptoms?"
Based on what I THINK I understand of it, I would say that the SSRI's triggered the hypomania, which had anger as one of its symptoms because I had so many OTHER symptoms of hypomania along with the anger.
Thus, I would say that the SSRI's did NOT cause the ANGER, per se.
So, yes, the ssri ITSELF could have been "interchanged" with any other anti-dep. and merely acted as a catalyst which triggered the hypomanic anger.
I am with you all the way in your belief that MANY usually calm, passive people get very bad anger/irritability that is CAUSED by the ssri's.
Believe me, if I didn't have depression issues, I'd get the he!! off the SSRI totally. However, staying on a very low dose seems to be okay. Time will tell.
Posted by McPac on June 16, 2003, at 16:12:25
In reply to SSRI's and causation ... » McPac, posted by Janelle on June 16, 2003, at 14:27:20
I'm not sure I quite follow your question - "did the ssri's CAUSE your anger OR did they just trigger the hypomania, which had anger as one of it's symptoms?"
>>>>>>Based on your response below it looks like you did follow it.
Based on what I THINK I understand of it, I would say that the SSRI's triggered the hypomania, which had anger as one of its symptoms because I had so many OTHER symptoms of hypomania along with the anger.
>>>>>>>>>>Janelle, what OTHER symptoms of hypomania did you have (besides the anger)? Could the other symptoms have been caused solely by the ssri and NOT by hypomania? IF the ssri DID cause the anger (not hypomania) then perhaps it caused other symptoms as well? (For instance, say, lack of sleep, irritability, etc....IF the ssri caused anger then why not these as well...esp. since anger symptoms could easily contribute to lack of sleep, irritability, agitation.....in other words, the ssri could cause symptoms that would look/resemble hypomanic dysphoria when it may not be. Many patients may conclude, "well, the med must have triggered my bipolar" when in fact it MAY have just been a bad reaction to the med (I tell you, there is "more than meets the eye" about these ssri's for MANY folks. I believe they INDUCE anger for MANY, not by triggering hypomania (though for some I'm sure it can too), but by something in the med itself that causes terrible anger/irrit.
Thus, I would say that the SSRI's did NOT cause the ANGER, per se.
>>>>>>>>>>>That's what I was wondering in your case.
So, yes, the ssri ITSELF could have been "interchanged" with any other anti-dep. and merely acted as a catalyst which triggered the hypomanic anger.
I am with you all the way in your belief that MANY usually calm, passive people get very bad anger/irritability that is CAUSED by the ssri's.
>>>>>>>>>>Yep...like me.
Believe me, if I didn't have depression issues, I'd get the he!! off the SSRI totally. However, staying on a very low dose seems to be okay. Time will tell.
>>>>>>>>>>>>Janelle, do you need an ssri or could a good ol' tca help (Tofranil, or something like that)? Take care!
Posted by Janelle on June 16, 2003, at 19:35:44
In reply to Janelle, Re: SSRI's and causation ..., posted by McPac on June 16, 2003, at 16:12:25
Hi - the OTHER symptoms of hypomania I had (besides the anger) included irritability, going off on anyone and everyone, overreacting to minor events, restlessness. My feeling is that these symptoms were caused by the SSRI. The only *typical* hypomanic or even regular manic symptom I did NOT have was sleeplessness - I would get so riled up each day that I'd fall asleep exhausted at night - of course, my pm meds helped!
You raise a CONFUSING but interesting issue! Did the ssri's cause the hypomanic symptoms or did the ssri's cause anger which then caused the rest of the symptoms - IS THIS WHAT YOU ARE ASKING????
As for the good ol' TCA's, I did have good results with Elavil (amitryptiline - spelling?) many years ago, but dry mouth, constipation and the rest of the SE's - yucko.
I will talk to my pdoc (I'm getting assigned to a new one cuz the one I love so much is leaving) next month and assess what to do with regard to the ssri and mood stabilizers.
I also want OFF of Klonopin (anti-anxiety) as I've been on it for many years, have habituated to it; I can take a mega dose of it and NOTHING, not the least bit drowsy. If she (pdoc) doesn't want to taper me off, I got a good schedule from on here that I printed out and I'll do it MYSELF. That one (Klonopin) is useless for me.
Posted by McPac on June 16, 2003, at 21:03:48
In reply to McPAC: answers, etc.! » McPac, posted by Janelle on June 16, 2003, at 19:35:44
Hi - the OTHER symptoms of hypomania I had (besides the anger) included irritability, going off on anyone and everyone, overreacting to minor events, restlessness. My feeling is that these symptoms were caused by the SSRI.
The only *typical* hypomanic or even regular manic symptom I did NOT have was sleeplessness - I would get so riled up each day that I'd fall asleep exhausted at night - of course, my pm meds helped!>>>>>>>While these symptoms ("going off", temper/rage, overreacting CAN be caused by hypomania, they can also be caused by ssri's (these feelings naturally go along w/ feelings of anger). EVEN IF you could NOT sleep, many people can't sleep well when terribly p!ssed off...that wouldn't necessarily mean hypomania, it could be attributed to the anger.
You raise a CONFUSING but interesting issue! Did the ssri's cause the hypomanic symptoms or did the ssri's cause anger which then caused the rest of the symptoms - IS THIS WHAT YOU ARE ASKING????>>>>>>>>>(I knew this was going to be confusing for me to explain, it's tricky for me to word it without being confusing, lol...but I think you understand me Janelle. Let me try to explain it this way. Let's say that a bipolar patient takes ANY anti-dep. (TCA, MAOI, SSRI, whatever). Let's say that after taking that pill, the bipolar person can't sleep well...the person gets insomnia DUE TO a side effect from that anti-dep. In such a case, the person would NOT say, "this anti-dep. triggered hypomania and it is my hypomania that is the reason for my sleep problems". In THIS example, it is NOT hypomania (a doctor would NOT say, "oh, you are having a hypomanic episode") RATHER, it is sleeplessness (a side effect) caused by the drug. Yet, what I'm saying is that MANY bipolars will take an ssri, develop terrible anger/irrit./temper/ (those feelings all go together---how can you have terrible ANGER without feeling irritable?) and then automatically say, "oh no, this ssri has triggered my bipolar hypomania" when, just like the sleeplessness example, it may be that the anger/temper/irrit. is a SIDE EFFECT of the ssri, NOT hypomania! (Again, I KNOW that AD's can and do trigger hypomania but my point is that rather than automatically concluding that the anger is hypomania, it may simply be a side effect of the ssri. (Big difference because understanding the difference can have big implications for many people).
As for the good ol' TCA's, I did have good results with Elavil (amitryptiline - spelling?) many years ago, but dry mouth, constipation and the rest of the SE's - yucko.>>>>>>>I'll take dry mouth and constipation over terrible anger/irrit/impotence or sexual dysfunction (throw in huge weight gain for many people), but that's just my preference.
I will talk to my pdoc (I'm getting assigned to a new one cuz the one I love so much is leaving) next month and assess what to do with regard to the ssri and mood stabilizers.
>>>>>>>>Good luck Janelle, hope you get a good one!
Posted by McPac on June 16, 2003, at 21:08:27
In reply to Re: Janelle, Re: I never would've believed it but » McPac, posted by avid abulia on June 16, 2003, at 13:35:30
i gotta agree with you on the SSRI issue... i`d rather deal with my 4 hours of ritual per day than SSRIs.
~AA
>>>>>>>>>>>avid, I read where you said you had suffered 4 head injuries....do you believe they may have contributed or exacerbated your problems (ocd)? I had 1 significant head injury that I definitely believe GREATLY contributed to my problems, including ocd. Take care!
This is the end of the thread.
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