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Re: maybe esp if w/ anxiety(Re: Depakote for dysth...) S.D.

Posted by JahL on January 15, 2001, at 12:39:25

In reply to maybe esp if w/ anxiety(Re: Depakote for dysth...) JahL, posted by S.D. on January 13, 2001, at 19:52:37

> > > What I'd like to know is, has anyone successfully treated UNIpolar depression with this stuff (alone)?
> > > I am particularly concerned with treating anhedonia/cognitive dysfunction.

> I still haven't seen any journal articles, but with phillybob's excerpt from dr. Hume ( ), I now have seen two doctors' opinions from experience with multiple patients (the 2nd being dr. jim phelps ) and another's (dr. martin t. jensen ) example of a single patient.

> None of these mention anhedonia specifically, but the 2nd and 3rd do specifically mention poor concentration. That may be a clue if it is similar to the cognitive dysfunction you mention.
> Also the 2nd and 3rd both mention anxiety and either irritability or anger. So if you have these, it may be another indication that mood stabilizers are likely.
> Unfortunately my suspicion is that identical presentations can have any of several causes, or at least may require any one of many possible (unknowable a priori) med combos.
> S.D.

Dear S.D.

Thanx 4 the links; I hadn't seen the Jim Phelps article, which I found compelling reading.

He suggests that profound insomnia & concentration difficulties (always the hallmarks of my depression) are the primary indicators of good mood stabilizer response (& are suggetive of possible Bipolar-II dx in context of failed AD trials).

His description of Bipolar-II replicates my symptomology precisely; I have free-floating anxiety (racing thoughts/restlessness+social phobia) & am generally an extremely agitated/irritable individual. As far as anger goes, well I am the archetypal Angry Young(ish) Man! (The "Dysphoria" he mentions describes my anhedonia)

Phelps' comments on the nature of the concentration difficulties faced by Bipolar-IIs were also worryingly accurate.

In short, this article has given me some heart, suggesting as it does (like yourself) that mood stabilizers are quite possibly indicated in my case. It will make sticking to some decent-length trials (say Lamotrigine, Topiramate & maybe Gabapentin) that bit easier.

Perhaps the *addition* of an SSRI would more directly address the anhedonia issue??





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