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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by bipolarspectrum on September 29, 2003, at 19:24:18
I am a bipolar who only experiences medication-induced mania. I recently tried a low dose of wellbutrin (25-100mg) and became hypomanic. However, its the only antidepressant that ever had a positive effect, as the rest caused too many side effects. I was wondering if anyone has had any luck adding anything to help stop mania associated with wellbutrin? Like a moodstabilizer, antipsychotic or benzo??
Posted by stjames on September 29, 2003, at 23:45:06
In reply to Controlling WELLBUTRIN-induced hypoMANIA, posted by bipolarspectrum on September 29, 2003, at 19:24:18
AD's almost always cause mania in persons with BP.
Posted by Chicklet on September 30, 2003, at 4:09:50
In reply to Controlling WELLBUTRIN-induced hypoMANIA, posted by bipolarspectrum on September 29, 2003, at 19:24:18
Posted by DayByDay on September 30, 2003, at 13:14:15
In reply to Controlling WELLBUTRIN-induced hypoMANIA, posted by bipolarspectrum on September 29, 2003, at 19:24:18
I have the same problem as you, experience mixed mania on medications only, so that´s why i´m getting of prozac and trying replace it with lithium and lamictal, it to early to say if it works good though...
Posted by Sebastian on October 1, 2003, at 18:25:03
In reply to Controlling WELLBUTRIN-induced hypoMANIA, posted by bipolarspectrum on September 29, 2003, at 19:24:18
zyprexa compliments it very well. I don't know what hypo-mania is. But the more zyprexa I take the more wellbutrin I can stand.
Posted by fluffy on October 2, 2003, at 17:59:51
In reply to Re: Controlling WELLBUTRIN-induced hypoMANIA, posted by Sebastian on October 1, 2003, at 18:25:03
b.p.s--
There really isn't a way to stop AD induced hypomania once it has started. The only way to make it stop is to discontinue, then start a mood stabilizer (depakote, lithium, and tegretol, lamictal, zyprexa are the standards). Once you have a mood stabilizer on board, you could re-start the AD. You should tell your doctor about your reaction right away. And if you haven't tried a mood stabilizer yet, it might be worth a try. (sorry if you know all of this, or if you have already gone down this road)
I am bipolar II, and I used to respond to AD's alone, but I had a really nasty spell on them the second time around. So now I'm taking Lamictal and trying Trileptal as an add-on. (I had some break through stuff going on.)
If you have any questions, just let me know. Otherwise, there is a great site about the bipolar "spectrum" and the controversy with AD use. http://www.psycheducation.org/bipolar/controversy.htm
take care,
Katy
Posted by bipolarspectrum on October 2, 2003, at 20:44:33
In reply to Re: Controlling WELLBUTRIN-induced hypoMANIA, posted by fluffy on October 2, 2003, at 17:59:51
Katy,
Thanx for the post. I am also bipolar II and have tried every single antidepressant (fluoxetine, paxil,moclobemide,st.johns,zooloft, lamictal (alone), trancyclowhatever,remeron,serzone). Every one of these medications caused me severe side effects except prozac, which helped my depression but left me anxious and sleeping poorly. Wellbutrin sent me into a hypomanic state at 37.5 mg. However, this was the most robust effect of all the antidepressants. I was wondering if you know of any mood stabilizers which would compliment wellbutrin, particularly help with anxiety and sleep?
Thanks again for the post, particularly the bipolar website-very educating
mike
Posted by fluffy on October 3, 2003, at 10:46:42
In reply to Re: Controlling WELLBUTRIN-induced hypoMANIA, posted by bipolarspectrum on October 2, 2003, at 20:44:33
Hi Mike--
I've had the same experiences as you. Gone through the gamut of AD's---Paxil, Lexapro, Zoloft. At first, when my doc thought I was just having a random, stress induced major depression, he prescribed Paxil (as I was having co-morbid generalized anxiety---now I think I was having mixed states b/c they were terrifying and I had suicidal ideation). But the Paxil SEEMED to work over two months or so. I discontinued, thinking that it was just a fluke. About a year later, I had my first clear-cut bout of hypomania, followed by a major depression. Of course, I did not report the hypomania to my doc. I only reported the "leaden paralysis", slowness and sleepyness. So he prescribed a more activating AD (Lexapro) which promptly sent me into a terrifying mixed state. I'm really surprised I didn't kill myself then...I thought about it 24-7. Couldn't sleep a wink. I felt like I wanted to peel my skin off and kick walls in. He didn't recognize my symptoms as mixed, since I didn't fully report them. Then he prescribed a "less activating" AD--Zoloft. Still, my mixed state continued. He then recognised that I was perhaps bipolar, and tried Neurontin, which didn't do a damned thing, then Tegretol, which I didn't stick with.
At this point, I decided I'd had it, and I didn't want anything to do with psychiatry, and I left my doctor. I had a major, major depression that lasted 4 months or so. So I finally got some help at a local mood disorders clinic. They put me on Lamictal, which seemed to help the depression. But I couldn't sleep after awhile, and my symptoms returned. Now I'm taking Trileptal (it's like Tegretol with a lower side effect profile) which seems to be working. I've slept without my benzo for the first time in months.
And to answer your question...I would give Trileptal, Depakote, or Zyprexa a try with the Prozac or Wellbutrin. There seems to be some good data for the bipolar ii folks on the Prozac/Zyprexa combo. Of course all of these drugs come with side effects, so maybe give Zyprexa a go b/c it is sedating. But it can cause weight gain. Your doctor will know if it causes this side effect rather quickly, though. So if this happens, I would go with Trileptal or Depakote before you reach for the Lithium. Before you have another med change or add-on, does your doc believe in prescribing benzos? A benzo can help smooth your transition by helping you sleep in the mean time, while you adjust to the changes.
Lots of people have had success with the Lithium/Lamictal combo. I unfortunately didn't. Lithium caused some very severe cognitive side effects in me.
You still have many options left. I know how annoying it is to try so many drugs. But hey--I'll do anything to sleep and just feel better in the long run. I've just had too many terrible things happen in the past 2 years when my illness took over to not give it all I've got with the meds.
Good luck--write all you need to, and take care,
Katy
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