Posted by SLS on July 29, 2005, at 7:46:40
In reply to *PLEASE* help, posted by med_empowered on July 28, 2005, at 16:05:45
Hi M_E.
Perhaps the best place to start is to consider which mood stabilizers you are willing to try to be used as augmentors to antidepressants. At this point in time, I am partial to Trileptal, Lamictal, and Depakote. Low-dosage lithium might be an effective augmentor to an antidepressant, but I doubt on its own it will be helpful at full bipolar dosages.
Parnate might be the best choice of antidepressant to add to a mood stabilizer. It is usually a better choice for bipolar depression and pretty clean as far as side effects go. Postural hypotension is usually the most prominent, but I have always found it to mitigate over time.
Since I don't know what else you have tried, I don't know whether you feel ready to move on to an MAOI. Parnate + Lamictal or Parnate + lithium have been reported to be particularly successful. My own trepidation regarding the use of Lamictal is that it is not a very good antimanic for bipolar I. I don't know if it would be equally impotent with bipolar II, which is what it seems you suffer from. I would probably go ahead with the Parnate + Lamictal and perhaps use a second mood stabilizer (anticonvulsant or neuroleptic) if hypomania becomes problematic.
Good luck.
- Scott
poster:SLS
thread:534853
URL: http://www.dr-bob.org/babble/20050728/msgs/535231.html