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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by B2Chica on October 9, 2004, at 19:30:10
if a person is NOT bipolar, would they still experience manic or ultra-rapid cycling 'episodes' from SSRI's or other AD?
or is this a response that is only from those with sometype of bipolar?
Posted by newwife on October 9, 2004, at 19:42:00
In reply to mania from meds if not Bp?, posted by B2Chica on October 9, 2004, at 19:30:10
this may not be the answer, but i am on lexapro and it works great, i am not bi-polar, but when i tried wellabutrin i had raging thoughts of wanted to hit someone. it was like a rage that i never felt before. lets just say i quit taking it after 3 days. meds react differently to everyone. is this what you wanted to know?
Posted by B2Chica on October 10, 2004, at 11:21:55
In reply to Re: mania from meds if not Bp?, posted by newwife on October 9, 2004, at 19:42:00
slightly.
last year i was Dx by a Gp and PA, 1pdoc (saw two more in hospital and witnessed my episodes of mania AND major depressive outburst) all agreeing that i am bipolar 2.
since my pdoc was not listening to me (or helping much) i finally got the opportunity to switch. This one is Great but he's really questioning the bipolar. see barely one week after i saw him i attempted suicide and ended up in custody so all he knows is my alleged depression.
i have had one episode that he even called manic "but i'm not convinced you are bipolar".
So i feel a little helpless and i'm trying to do as much digging as possible.
now that episode that he called manic only lasted a few hours, but when i was originally Dx it lasted almost a week -before i got into the doctors and Dx.
Then when i was on other medications...they made these MUCH MUCH worse -effexor made me rapid cycles like everyother day or so...SEVERE mania, where i couldn't really carry on conversations.so my question is these "episodes" that i had could they have been That severe if i really don't have bipolar??
Is it standard or typical that ONLY those with bipolar(1,2 or 3) react in this way?i KNOW i'm no doctor and i guess i'm not really wanting to self diagnose, but i have SO many questions again and i just am looking for some answers.
And Yes i do realize there are all questions i should ask my pdoc but there never seems to be enough time with him.Thanks for any advice out there.
B2c.
Posted by Ritch on October 10, 2004, at 11:27:01
In reply to mania from meds if not Bp?, posted by B2Chica on October 9, 2004, at 19:30:10
> if a person is NOT bipolar, would they still experience manic or ultra-rapid cycling 'episodes' from SSRI's or other AD?
> or is this a response that is only from those with sometype of bipolar?
>
>It depends on what psychiatrist you talk to. There is a controversy right now about "unipolar" vs. "bipolar" people. You have doctors that stick to the 'traditional' belief that mania that is brought on by drugs, substances, or medical conditions doesn't count and those people shouldn't be considered (and treated) as bipolar. That is the strict definition. But there are a lot of doctors who subscribe to the "bipolar spectrum" theory that all phenomena related to 'abnormal' elation and depression lies on a continuum and that distinctions of "unipolar" or "bipolar" are relative and that nearly all should be considered to have some degree (more or less) of bipolarity. I think it is an interesting idea, but what if psychiatrists starting treating a lot more depressives (recurrent unipolar depressives) as though they were bipolar .. and they weren't any better off or they were worse off in the long run? IOW, does witholding antidepressants (or minimizing them) and giving patients more "mood stabilizers" really improve their long run prognosis? I think that is the current argument that hasn't really been settled.
Posted by linkadge on October 10, 2004, at 19:12:33
In reply to Re: mania from meds if not Bp? » B2Chica, posted by Ritch on October 10, 2004, at 11:27:01
I think that lithium can be useful in many mood disorders. Many depressed people will say that it does not make them happy, but there is research to suggest that lithium will prevent suicide in unipolar or bipolar more than antidepressants will.
Believe it or not. Antidepressants do not prevent suicide statistically. The only two medications that have a statistically significant antisuicide effect are lithium, and clozaril (an antipsychotic)
Linkadge
Posted by Michael Bell on October 10, 2004, at 23:34:07
In reply to mania from meds if not Bp?, posted by B2Chica on October 9, 2004, at 19:30:10
>
Absolutely. I've never had depression nor bipolar disorder. But when I was taking Nardil I made the mistake of having a few drinks at the same time. Let me tell you, I had a full blown manic attack, completely out of my mind. Nothing at all like the usual drunk experience.if a person is NOT bipolar, would they still experience manic or ultra-rapid cycling 'episodes' from SSRI's or other AD?
> or is this a response that is only from those with sometype of bipolar?
>
>
Posted by Ritch on October 11, 2004, at 10:26:33
In reply to Re: mania from meds if not Bp?, posted by linkadge on October 10, 2004, at 19:12:33
> I think that lithium can be useful in many mood disorders. Many depressed people will say that it does not make them happy, but there is research to suggest that lithium will prevent suicide in unipolar or bipolar more than antidepressants will.
>
> Believe it or not. Antidepressants do not prevent suicide statistically. The only two medications that have a statistically significant antisuicide effect are lithium, and clozaril (an antipsychotic)
>
>
> Linkadge
>
>If I could tolerate lithium better (with my IBS problems) I would add it to my Depakote right away. But even 150mg/day provokes bad diarrhea and I won't put up with that anymore. Lithium also possesses some mild antipsychotic qualities that Depakote doesn't seem to...
Posted by linkadge on October 11, 2004, at 10:35:11
In reply to Re: mania from meds if not Bp? » linkadge, posted by Ritch on October 11, 2004, at 10:26:33
I know what you mean. I had to discontinue. It is a hard medication to tollerate.
Linkadge
Posted by B2Chica on October 11, 2004, at 16:52:43
In reply to Re: mania from meds if not Bp? » B2Chica, posted by Ritch on October 10, 2004, at 11:27:01
THANKS Ritch.
that's right along the lines of some info i've found (basically still ongoing-no assurity yet).
Thanks.
b2c.
> > if a person is NOT bipolar, would they still experience manic or ultra-rapid cycling 'episodes' from SSRI's or other AD?
> > or is this a response that is only from those with sometype of bipolar?
> >
> >
>
> It depends on what psychiatrist you talk to. There is a controversy right now about "unipolar" vs. "bipolar" people. You have doctors that stick to the 'traditional' belief that mania that is brought on by drugs, substances, or medical conditions doesn't count and those people shouldn't be considered (and treated) as bipolar. That is the strict definition. But there are a lot of doctors who subscribe to the "bipolar spectrum" theory that all phenomena related to 'abnormal' elation and depression lies on a continuum and that distinctions of "unipolar" or "bipolar" are relative and that nearly all should be considered to have some degree (more or less) of bipolarity. I think it is an interesting idea, but what if psychiatrists starting treating a lot more depressives (recurrent unipolar depressives) as though they were bipolar .. and they weren't any better off or they were worse off in the long run? IOW, does witholding antidepressants (or minimizing them) and giving patients more "mood stabilizers" really improve their long run prognosis? I think that is the current argument that hasn't really been settled.
Posted by delna on October 13, 2004, at 8:22:49
In reply to mania from meds if not Bp?, posted by B2Chica on October 9, 2004, at 19:30:10
> if a person is NOT bipolar, would they still experience manic or ultra-rapid cycling 'episodes' from SSRI's or other AD?
> or is this a response that is only from those with sometype of bipolar?
>Hi
This a question I have asked myself alot. According to every psychiatrist I have seen, I am not unipolar but have bipolar II. However I can only remember getting blatantly hypomanic after I started SSRI's and then at high dose of venlafaxine.
My doctors agree that a unipolar patient will not switch into mania regardless of the doses of antidepressants given. Apparently the pathologic mechanism of Bipolar is different from unipolar depression.
Once I became clearly hypomanic, my history was looked into closely and it was found that i did have bipolar all along but i didnt have distinct periods of highs and lows. Infact I had many mixed states and rapid moodshifts since childhood.
according to papers and 'Dr Akiskal' a leading voice on the bipolar spectrum, bipolar depression looks very different from unipolar and presents at a different stage of life. From what I have read and experienced these are the unique defining points of bipolar illness1. Early onset ( before 20)
2.history of alcohol and drug abuse
3.psychotic episodes
4. Extereme exhaustion and vegetative depressions
5. Aggression and agitation
6. Oversexed even during depressive phases.There are ofcourse many others and everyone is different. These are just a few points that made it clear that I had BPII and not unipolar. I have resisted this diagnosis for 10years but I finally gave in and took Lamotigine along with my effexor and wellbutrin. the change has been amazing; i hardly swing. Lamotrigine has been a great help for me as a moodstabalizer.
Best,
D
Posted by theo on October 13, 2004, at 9:59:46
In reply to Re: mania from meds if not Bp? » B2Chica, posted by delna on October 13, 2004, at 8:22:49
What dose of Lamictal do you take?
Posted by delna on October 13, 2004, at 10:08:05
In reply to Re: mania from meds if not Bp? » delna, posted by theo on October 13, 2004, at 9:59:46
> What dose of Lamictal do you take?
200mg lamictal
Posted by B2Chica on October 13, 2004, at 11:48:54
In reply to Re: mania from meds if not Bp? » B2Chica, posted by delna on October 13, 2004, at 8:22:49
delna, delna, delna!
THANK YOU.this is Great information, andthat you got it from several doctors is reassuring.
i'm fairly sure that i am bp2 but am glad my pdoc is questioning everything. but when i first went to the doctor (just over a year ago) is was actually for mania not depr. looking back i realized that all my symptoms for past months WERE depression (atypical-oversleep, overeat, crying all the time, could hardly move, terrible concentration...etc.)
anyway i experienced this BEFORE i ever went on any medication.
i got Dx of Bp2 right away and they started me first on effexor and i KNOW i experienced Extreme depression AND EXTREME mania while on this rapid cycling like every other day...it was HORRIBLE. (i was Dx by several doctors with bp2.)so to know that what i have experienced was....well it just validates these 'episodes'.
And THANK YOU! for the name reference, 'Dr Akiskal'. i'll be looking up his info.
as for these...
> 1. Early onset ( before 20) (yes)
> 2.history of alcohol and drug abuse (shyly...yes)
> 3.psychotic episodes (no)
> 4. Extereme exhaustion and vegetative depressions (yes)
> 5. Aggression and agitation (yes, yes AND yes)
> 6. Oversexed even during depressive phases. (unfortunate to my husband...no)
Again, thank you so much. i really don't even care about the label anymore i just want to get on some medications so i can be stable again (whatever that is), i want normal sleep, no night bunnies, no more days that i can't get out of bed, and no more intense anger and agression -that one scares me...i am NOT a violent person...
i did really like my trileptal when i was on that and i hope to get back on that and wellbutrinXL.
i guess in time. Maybe if i drink a cup of coffee the morning before my next appt. with him...that'll show'em ...(that's all it takes for me to shoot into hypo/mania)
ok, maybe not.With every fiber delna...Thank You
B2c.> Hi
> This a question I have asked myself alot. According to every psychiatrist I have seen, I am not unipolar but have bipolar II. However I can only remember getting blatantly hypomanic after I started SSRI's and then at high dose of venlafaxine.
> My doctors agree that a unipolar patient will not switch into mania regardless of the doses of antidepressants given. Apparently the pathologic mechanism of Bipolar is different from unipolar depression.
> Once I became clearly hypomanic, my history was looked into closely and it was found that i did have bipolar all along but i didnt have distinct periods of highs and lows. Infact I had many mixed states and rapid moodshifts since childhood.
> according to papers and 'Dr Akiskal' a leading voice on the bipolar spectrum, bipolar depression looks very different from unipolar and presents at a different stage of life. From what I have read and experienced these are the unique defining points of bipolar illness
>
> 1. Early onset ( before 20)
> 2.history of alcohol and drug abuse
> 3.psychotic episodes
> 4. Extereme exhaustion and vegetative depressions
> 5. Aggression and agitation
> 6. Oversexed even during depressive phases.
>
> There are ofcourse many others and everyone is different. These are just a few points that made it clear that I had BPII and not unipolar. I have resisted this diagnosis for 10years but I finally gave in and took Lamotigine along with my effexor and wellbutrin. the change has been amazing; i hardly swing. Lamotrigine has been a great help for me as a moodstabalizer.
>
> Best,
> D
>
>
This is the end of the thread.
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