Would you like the short answer or the long answer? In short, if you have bipolar disorder, no, you shouldn’t be taking an antidepressant – even if you’re depressed – in many, if not most, cases.
The long answer is, naturally, more complicated.
It’s at this point I must remind you that I’m not a doctor and nothing in this article should be taken as medical advice. Do not make medication changes based on this article. Do have a conversation with your doctor if you have any concerns.
Bipolar I and Antidepressants
I can say, with quite a bit of certainty, that if you have bipolar I, you should not be taking an antidepressant alone (this is called monotherapy). In fact, the International Society for Bipolar Disorder (ISBD) Task Force agrees with me on this. No antidepressant monotherapy in bipolar I. Period.
Additionally, antidepressants should not be used in bipolar I mixed states. Period. Antidepressant use, even adjunctively (with another medication), should be avoided if two or more manic/hypomanic symptoms or psychomotor agitation is present. Antidepressants should not be used in people with bipolar disorder who rapid cycle.
Now, in some cases, antidepressants can be used in bipolar I disorder if a mood stabilizer is on board first, if you’re in a straight bipolar depression. However, you should keep in mind that researchers who have looked at this have not seen treatment benefits for people with bipolar I who take antidepressants. This does not mean that it never works, but that means that it often doesn’t and, in fact, can, in many cases, make the bipolar disorder worse.
Bipolar II and Antidepressants
I can say, with slightly less certainty, that people with bipolar II should not use antidepressant monotherapy either. Now, the ISBD Task Force did not explicitly make this recommendation – but I think they’re wrong. I think it’s clear that people with bipolar disorder should not be put on antidepressants alone no matter what variety of bipolar disorder they have.
As for adjunctive therapy, I think adjunctive therapy with antidepressants is reasonable in bipolar disorder if:
- You don’t rapid cycle, are in a straight depressive episode and you’ve tried anticonvulsants and antipsychotics first
- If you’ve previously responded positively to antidepressants
- If your depression returns immediately upon cessation of an antidepressant
What’s the Big Deal about Antidepressants?
Antidepressants are dangerous in bipolar disorder because they increase switching from depression to hypomania, mania or mixed states and rapid cycling. And none of those is where you want to be. And, as I mentioned above, there actually is no good evidence of the effectiveness of antidepressants in bipolar disorder and that is why no antidepressant is Food and Drug Administration (FDA)-approved for use in bipolar disorder treatment.
What Can a Person with Bipolar Take Instead of an Antidepressant?
The medications that have been approved for the treatment of bipolar depression are:
- Quetiapine (Seroquel)
- A combination of olanzapine and fluoxetine (Symbax)
- Lurasidone (Latuda)
And while the trial data I’m aware of was negative, doctors often use lamotrigine as well (although this use is off label).
In addition, aripiprazole (Abilify) has shown to be antidepressant-like when used adjunctively in unipolar depression so it’s often used this way in bipolar depression as well.
Finally, psychiatrists will often try other anticonvulsants and antipsychotics to lift the mood as well. This study suggests that there is some evidence for the efficacy of carbamazepine (Tegretol) and valproate (Depakote, Epival).
There Should Be Fewer Antidepressants in Bipolar Treatment
The telling statistic for me in bipolar treatment with antidepressants is this: when a person with bipolar disorder is treated:
- By a community psychiatrist – 80% are on antidepressants (and I bet you the number is higher for those treated by general practitioners)
- By a mood disorder clinic – 50% are on antidepressants
- By a specialty bipolar clinic – 20% of people are on antidepressants
So the more of a specialist you are, the less likely you are to prescribe antidepressants. We, the average patients, do not necessarily have access to specialty bipolar clinics, but we sure can use that piece of information in our own treatments.
If You’ve Got Bipolar – Try Antidepressants Last
I’m not saying that antidepressants are never appropriate, of course, sometimes they are, what I’m saying is that antidepressants should be tried after other options because not only might those other options make you better, they are much more likely not to make you worse.
So please, please, if you’re bipolar and a doctor is just prescribing an antidepressant for you: get a new freaking doctor – they don’t know what the heck they are doing.
Reference
I laid out more information and the new recommendations for antidepressant use as recommended by the ISBD here.
I’m bi polar more on the depressive side very few maniacs the family doctor wants me to add Prozac to my pills lamotrigine I’m afraid of getting worse I drop very bad this time of year. My phsychiatrise has me on the lamotrigine
https://natashatracy.com/medicationtype/bipolar-disorder-not-antidepressants/
I have read another article regarding a similar topic written by you. Link above.
You miss out a crucial bit of information that not many people know.
A portion of people prescribed antidepressants end up having a manic switch (or an episode of antidepressant INDUCED mania) on antidepressants even though they had never had a spontaneous manic episode in their life before.
These people are subsequently given bipolar diagnoses even though the manic episode never occurred and would likely never have occurred in many, if not for the offending antidepressant in the first place.
The theme seems to be “Antidepressants are dangerous in bipolar disorder” but not “You bipolar disorder diagnosis may be because of antidepressant induced mania in the first place, which you might never have had if antidepressants didn’t cause an iatrogenic manic episode”. The latter is true in many cases. The former assumes that bipolar disorder existed all along in the person and them switching on antidepressants is proof in itself of them being bipolar.
Even if a doctor diagnoses you as bipolar due to a manic reaction to antidepressants, it should specifically be written that he has diagnosed you as such because of adverse reactions to antidepressants and not because you had a spontaneous manic episode.
NIce explanation, Natasha.
You are absolutely right that whatever the case is one should not be habitual on antidepresents. Even I used to take almost regularly but then Stopped it immediately when my friends told me about it.
Thank you for having this site(blog?). I was diagnosed with BP2 about four years ago; after doing research, I feel it’s an accurate diagnosis & it helps explain the sudden swings of extreme irritability – OK, call it bitchiness! – that I had had for years (& it wasn’t PMS) I think the Deplore has helped. I tried adding lamictal, but it had the unfortunate side effect of nausea and each time I took it, I threw up. So I quit Lamictal.
I’m really messed up here. Ok- I can get into some pretty low depression. I have long periods where I don’t leave my house or I hardly leave it. I have narcolepsy and it sucks~the meds don’t always work & u have to take breaks from the med’n so u don’t become tolerant. And there’s only one med to take. Then in late 2006, I suddenly went deaf in one ear; it was from a very rare brain tumor. The tumor was also wrapped around four of the major cranial nerves &many others & it was The surgery to remove this tumor was about 15hrs The tumor caused a lot of nerve damage & I’ve had several surgeries since to work on it. In 2012 a second brain tumor was removed; this one was a rather common tumor &different from the first one. But just a few months after that, my doctors found a third brain tumor -this one is the same type as the first but is in a different place. This is wrapped completely around the carotid artery so it’s considered inoperable. I’ve had had radiation; I was lucky to have access to cutting edge technology. There are no drugs for this tumor. Oh, I was diagnosed with ADHD as an adult & looking back, I know I had it as a kid except that I excelled in school (only because I didn’t need to study!) So, bottom line, here, is that I ramble, so I apologize for that. I think I tend to forget about the Bipolar because of the other crap. It would be nice to become un-depressed!
I hope some of this made sense. Thanks for reading.
I am on sodium valporate 400mg mood stabiliser also lexapeo 20mg. Seems to work for me. Mist stable ive been long longtime. Still get little euphoric n angry n sad but always wil cause bipolar do t go away but is bearable now.
I have BP I and depression. Ive been on several different medications, most recently lamictal seroquel and latuda. My swings are severe, I also have every addictive personality there is: alcohol gambling shopping ect. Lamictal has always worked but my depression is horrible. Just want to stay home sleep. My dr wants to put me on abilify im scared of the weight gain but more the fact it has made some extreme gamblers and I have already lost one house and I do not want to go there again. Any thoughts of abilify luvox saphris
I’m tired of trying and waiting a couple months to see if a medication works.The waiting has become unbearable it has become years I can continue living like this.I beent through what feels like all the antidepressants old and new with various combinations since I was 16 I’m 26 now, I don’t how much longer I can keep doing this.Any advice will be greatly appreciated.
You ever been checked for autoimmune diseases? I have suffered with depression since childhood, and just recently found out I have celiac’s. Since going on the gluten free diet in late June, I am feeling fewer ups and downs and much less depressed. Ya just never know cuz docs don’t ever check for that stuff. Look up symptoms of things autoimmune, and see if anything lines up.
I am not sure why doctors never seem to want to investigate causes of things, rather they throw people on antidepressants. Antidepressants never worked for me, because I have had a disease, not depression. Depression was merely a symptom.
Best of luck to you.
Dee, while celiac unfortunately tends to take a long time from initial (often vague, non-specific) symptoms to getting diagnosed, you’re right that physical causes of mental health symptoms should be on a lot more doctor’s radar screens. Most family docs seem to know to check for thyroid being out of whack, but not so much iron, B12, etc. When psychiatrists don’t at least seriously consider those things, especially after several failed trials of psychotropic medications, it really borders on malpractice.
;)
I just found your website. Thank you for all of the valuable information.
I”ve spent the better part of my 44 years of life horribly depressed. Around the age of 5, I began to self harm. Along with both of these issues I also have PTSD, anxiety issues and was finally diagnosed five years ago as a Bipolar 2. I’m currently on Lamictal, Fetzima, and Klonopin. I take 0.5mg Klonopin in the daytime and 2mg at night for insomnia.
Since I started being treated for Bipolar, my periods of hypomania have decreased along with my raging outbursts of anger. I no longer self injure either. The one thing that still plagues me is my profound depression. It’s debilitating and I am beginning to not even leave the house.
I’m now finding out that I shouldn’t be taking the anti depressant since it’s not obviously working. Does anyone have any suggestions as to what I should do? I also see a therapist once a week.
Hi Anna,
You’ll want to read this for antidepressant options that are _not_ antidepressants: http://psycheducation.org/antidepressants-in-bipolar-disorder-the-controversies/antidepressants-that-arent-antidepressants/
– Natasha Tracy
I Have bolar 1 with psychosis, I am labeled high functioning, although it keeps me from engaging in normal functions associated with happiness. The only time I feel alive, is when I am in my manic phase, that is until my body gets tired, and signals me to come back down to earth and i get outright “bitchy”.
Lately at work I have decompensated on a nightly basis! I love everyone I work with, however it doesn’t keep my paranoid deviations from happening. I was first diagnosed at 25, i am now 40, I have been on every medication associated with bipolar! They all seem to work for a cycle or two then I decompensate more severely than the last time! I have suffered hallucinatons and obsessive thoughts, once thinking I had bugs crawling on me! Doctors reassured me it was a self induced stress reaction! I am considered high functioning because I have a 3.89 in college and have held this job for 11 years. My job by the way is a waiter, the worst job you could have with bipolar! The only reason ii have lasted so long is because, my owner keeps refusing to let managers fire me! I don’t consider myself hi functioning but society seems to merely because my boss hasn’t fired me! I somehow managed to excell at school do in part to my mania, I however self sabotaged myself in final quarter/ interning! I was studying social work, and found myself a hypocrite, how do I help others when I can’t help myself?!
At this point in my life, I just want to rest! I am tired of fighting to better myself and my situation.
I am going to try for disability, I’m tired of the “work” it takes to work!
DO ANY OF YOU FEEL LIKE THIS TOO!
Hi Jamie,
I have had many of the same issues are you mentioned. Long story short, I finally got a diagnosis of Celiac Disease. Since going on the gluten free diet, MANY symptoms of my “mental illness” have disappeared.
I get to wondering how much suffering we all have that is supposedly mental, but really are physical issue manifesting itself as mental.
Hang in there,
D
My experience with antidepressants was very bittersweet. When I was kinda diagnosed with bipolar (pdoc did want to conclude diagnosis even though evidences were very clear) I was prescribed Zoloft combined with a mood stabilizer. Since there was no clarity on my diagnosis I stopped with the stabilizer and kept with the antidepressants because I thought I was inclined to have depressive episodes.
I must say it helped me a lot when I was extremely depressed and suicidal.
But afterwards it triggered manic episodes. With the correct diagnosis this year the new pdoc stopped with Zoloft and put me in lithium. I feel so much better!
unfortunately I’m on Effexor, Bupropion, Seroquel, Lithium and Epival… The Lithium has been making me sick since I started taking it in March… :( and just now, my Pdoc realized I was probably on too much medication… I’ve been getting discouraged about the treatments not working in making me feel better, and the amount of pills i take in the morning, as well as the amount of pills I take in the evening…. almost a full meal LOL… I’m hoping the Pdoc will take me off the Lithium and on something else that won’t make me sick all the time…. was told Lithium was a great treatment, but I think i’m an exception.
I’ve been diagnosed with Bipolar II last year and have been on a good dose of Effexor for over 10 yrs treating what we thought was depression. Effexor is making me rapid cycle but my Pdoc is too scared to wean me off because he says it’s very difficult to wean off. What would be a good way to have him wean me off? I’m tired of feeling like a yoyo all the time, it’s draining, and the fact that my Pdoc is “scared” to take me off Effexor shouldn’t affect him giving me the proper treatment. Thanks. :)
Hi Julie,
You may wish to read what I wrote about this subject here: https://natashatracy.com/treatment-issues/withdrawal/antidepressants-effexorpristiq-venlafaxinedesvenlafaxine/
– Natasha Tracy
Julie, Effexor is gross to come off of, but any competent pdoc should be able to help you taper it. Slow and steady works (where “slow” and “steady” are different for different people). Natasha’s post she mentioned covers it nicely. I added a comment there about compounding pharmacies which can help make it simpler, though they aren’t required.
In my case he would have been right. Although I self-diagnosed as BP and my next Dr. just though the last one had done the diagnosis. So now my official diagnosis is BP-@ yet it was made by me. In my case I stopped effexor cold turkey a couple times and went into severe depression sort of mixed with a very numb yet not really anhedonia feeling. I waited it out about two weeks last time and it wasn’t fun and am still on the Effexor-XR @100 mg. I did decrease it from 150 mg. I aslo at this time started 100 mg. Lamictal and that has made a drastic difference. I went from being, no exageration suicidal 24/7 with zero break for many years. Now I am only suicidal about 20-25 if that percent of the time in my waking hours. I respect Natasha very much but I’ve been playing this game I believe even longer then her. All this is anecdotal and your results may very. I believe the two work with me and I’m changing nothing right now. Research may say one thing, but who chooses what variables, how they are looked @ and who interprets them is a variable and questionable in itself. For me Lamictal is the only thing that has really helped me in thirty or so years. Though it could be that combined with the Effexor. To me those two medications (drugs) are as inportant as almost any drug is to anyone for anything. If you do decide to get off it I would get an extremely scale and actually remove a little at a time from the capsule to wean off it. These SSNRI’s are I believe more like benzodiazepines then opiates to wean off. It’s not just a few days but weeks and maybe months. Just my 2 cents worth yet from personal experience. WN
I attempted suicide years ago. After having a severe accident involving hip replacement and an implant in my back from a foolish stunt while manic. They administered 5 days of treatment of 50,000 volts. I can’t say if it helped or not don’t remember much.
I apologize for the dual post but I found a more appropriate place to comment on this subject.
Personally, I went through meds for about 25 years. Nothing worked. So, as a result. I don’t trust diagnosis.
I was in an adult group home with a guy who heard and talked to voices. Amazingly enough, one of the best treatments for this is to not talk back. We all have inner voices. It’s how we coach ourselves and reinforce memory.
Simple point. “Disorder” can be defined as “something out of place or handled inappropriately. If you don’t like the results of your disorder, don’t do it. Period. It takes great effort to do this, keep trying.
Recognize that something like Tourette’s is not controllable. So it’s classified as a “syndrome.” Which indicates it is something that can go away given time. Most manifestations of Tourette’s disappear into adulthood. Although the tics can change into form that is consciously controlled. e.g. foot tapping, or tapping fingers.
At what point does a person “truly” need chemical help. Over the counter is just unregulated. It is still a prescribed solution to a problem with a specific need. Could the prescription needed actually be a change in behavior?
James
Also, some disorders are triggered by stress. Which to me, indicates a flawed response to a situation that is handled differently under relatively no stress.
Take a deep breathe and focus on a peaceful response.
James
Hi there , I have just found your site and find it very helpful, My 24 year old daughter was diagnosed as having BP 1 , two years ago after previously being treated for depression and anxiety only, I find it interesting how much I’ve read about his BP people should really not be taking anti depressants. She is currently taking lamictal, clonazapam and seroquel. Prior to these drugs she has tried depacote (weight gain) , abilify (trardiive and psychosis )geodon ..also negative . After stopping depacote she lost about 15 of the 20lbs she gained in a 2 month period . Went on seoquel and lamictal and all was well until the dosage went up on seroquel and now she’s carrying anither 20+ lbs and it’s devastating. She is seeing a weight management councillor and has a personal trainer 4 times a week and not losing a pound. She has asked pdoc about topmax for weight loss, but dr thinks Sapris is better,. Everything I’ve read about this drug is that it also causes weight gain. Could you please offer me some suggestions? I’m so grateful , she is compliant and knows she needs the mediation but my heart breaks for her , thank you
Hi Cindy,
I am a 54yr old woman and I just started using legal marijuana and i am doing a bit better after 3 weeks use. I am working on finding how much I need each day and what strains do what to me. Some help with sleep, other help with attention, others for panic; I had no idea they had so many kinds! I do not take any other meds and I do not use any other drugs. I live in a legal state and this is strictly medicinal, and admit a little fun at the same time. not like other pharmaceuticals. It is really working for me after trying many of the pharmaceuticals with awful side affect. After trying several, i became non-compliant because of the fear of the side affects.
best of luck to you,
dee
I was diagnosed with bipolar a month ago, after 2 months of anti-depressants courtesy of my family doctor put me in hospital. Technically and literally I put myself in hospital, but after flying, collapsing, and flying again within a 30 mnute period, and regularly throughout the day… these things can be dangerous. Obviously released the next monrnig and had to wait 2 weeks to see a pdoc (while still taking anti-depressants daily–it was more unbeliavably awesome than it sounds). No way I’ll go near another anti-depressant again, but at least I can now better make sense of the last 15 years of my life. Would have been nice to get this diagnosed at 20 instead of 35, but I can finaly begin living life again.
I just tried for two weeks to go off my SSNRI. I almost didn’t make it. If I had had a gun I would have used it no lie. The side effects are terrible and even dehumanize me to a degree. I really don’t know if any of these games are worth it. I’m not suicidal at this hour but is It really worth it. The whole game is becoming too much for me. I have no agenda to push or punish the makers of these drugs. I just want to feel normal. I don’t think it is going to happen. WN
Will, please tell me, in your opinion, what is normal? i think we with BP are pretty “normal” ~~~for having bp! ;) i kinda like that were a re “special”! normal peeps are dull and not a lot of fun! people with bp and other mi’s keep my mind active!
I’m certainly not normal emotionally. I spend the majority of the day on say 15-20 days a month trying to fight my urge to kill myself. I really try but I really don’t know how long I can go on. The games I play with myself to keep me alive are running thin. WN
well will, i personally hope you hang in there, i enjoy our letters! no one else will listen to my bs!
;)
Hey WN, l have been diagnosed with BP1 since l was 21. I’m now 58. I went through all the hell and then some as everyone posting. My son was also diagnosed with BP 1 when he was about 17. Last July when he was 21 he shot himself. We did everything we could. In the end we all make our own choices. If you are serious about ending your life, please baby- hang on. Talk to someone who loves you, see your Dr
again, go to the hospital- something!! Please, you can’t believe the horror you leave behind. I love you.
Thank you very, very much for this post. This confirms more or less my personal experience and what I have been researching on my own: that antidepressants are not particularly good for Bipolar II. My AD does not make me swing to hypomania, and I don’t rapid-cycle anyway, but it is clear to me ADs do nothing for my depression. I had already planned to talk to my doctor about dropping the anti-depressant and staying on lamotrigine + something else. Now I’m going to talk to him about the options you raised, about which I had never heard before. He clearly knows very little about Bipolar disorder, but I have few psychiatrists available where I live.
There is just one thing I should point out. You said that one approved treatment is “a combination of olanzapine and fluoxetine”. From what I gather, it only applies to bipolar I, not bipolar II.
Bear in mind, having Bipolar Type 1 or Type 2 is not like having Type 1 Diabetes or Type 2 Diabetes. BP types are used to describe a cluster of symptoms that are generally common to both, only their severity is different, with a cluster of more severe ones being labelled Bipolar Type 1. There are grey areas in between, and then some! My pDoc once describe Bipolar Disorder as a 3-D model, where a patient may concurrently exhibit symptoms that are classic Type 1, classic Type 2 and other symptoms straddling the line between the two. It’s not as black & white as Diabetes.
I take one of the anti-convulsants (Lamotrigine/Lamictal) for controlling my mood swings. Because of, or in spite of them, my moods are now fairly well under control, as evidenced by the fact that I’ve not ‘flipped’ following a very significant bereavement. So, as a control for the moods, it appears to work for me, although it may not for others, of course. However, I am still left with an unpleasant and pervasive mild but chronic depressive state for most of the time. It might be Dysthymia or it might be the BP, or a combination of both. The pDoc wanted me to take Quetiapine for it, but have to seen the side effects of that stuff? Possible weight gain … don’t need that as I’m already overweight. Can cause Diabetes Type 2 … already got that too (thanks to an earlier mood control drug that caused lethargy and weight gain) so I don’t want to make it any worse!
I dug around on the web to see if I could find any less toxic alternatives. I have in the Psychoatric Times an article wherein it mentioned some tests on using Vitamin B3 can be helpful in combating depression at the right dosage – that is to say, at least one trial showed it performed better than the trial placebo. So, I’ve been taking them: So far so good – mood has lifted a little but that may be in spite of the vitamin B3 and more to do with the fact that Spring is here. We shall see …
I DON’T RECOMMEND ANYONE TRYING THIS WITHOUT a) CHECKING WITH THEIR DOCTOR FIRST & b) WITHOUT CHECKING WHAT IS THE PROPER DOSE. (The dose may be different for different people, which is why I have not said what mine is.)
i was reading someones comment last night via aweber.com . there are people (many of which a doctors) out there that think because the meds are not working for people who have bipolar, they are faking the disease. you can comment on the site, but the doc has to approve what you say before it is posted. sure would be great to have someone with knowledge in this area to get on there and educate these people. I did mention you Natacha and suggested that this one person go read you blog. he insisted that 80% of the people with bp and schiz are helped with these drugs. i like the page cause there are so many actual doctors discussing all kinds of matters. shows what we are up against. mid evil treatment is still out there!
here is the actual thread. http://www.kevinmd.com/blog/2014/03/movie-psychiatry-real-psychiatry.html
the article may be a trigger to some, but it is the comments about how the MI are treated that had my attention.
Thank you so much for this website. After many, many years of misdiagnosis, and not understanding what was wrong with me, moderate suicidality, not recognizing the hypomania, and sudden mood shifts, I have finally been to a doctor who accurately diagnosed me and I have accepted that I have bipolar 2. I have learned so much from reading this site, that absolutely mirrors me to a “T.” I have a whole new understanding of myself and know that I am not alone and I am not a crazy person, who is “too sensitive.” That’s what I have been told all my life. I suppose when a doctor suggested diagnosis as a possibility to me 10 years ago, I wasn’t ready to hear it and dismissed it, and every doctor since then has missed it altogether.
I am also with a psychiatrist at a mood disorders clinic, who is also a researcher and mood specialist at a major university research hospital. I am on Wellbutrin and Lamictal, with Seroquel and klonopin as needed to sleep. The depression is a killer, still. Even with Lamictal and Wellbutrin, the dark hole is still there with a vengeance. The depression is incredibly resistant to treatment, and I have to work hard to be ok. Without meds, I am scared as to where I would be.
Over the years, the depression episodes are longer and closer together and more severe. This last episode hasn’t lifted in many months. It’s livable right now, and I can cope, but I can’t say it has lifted. The hypomania rears it’s head also in between and I have racing thoughts, can’t sleep, highly agitated, speaking too quickly, and restless energy like my skin is crawling, and I have to run from my body. The thoughts and my brain are jumping around so much, I can barely keep up with what I am thinking, and others around me can’t either!
I have had some good days here and there where I know what it feels like to have a normal mood – not depressed, not hypomanic. It’s amazing how different “normal” feels and how rarely I feel it. I am still living day to day, even hour to hour, not knowing how I am going to feel from one moment to the next.
This site gives me hope. And it also gives me ways to understand my illness and ways to cope. I am sure my illness contributes to why I have been single for 11 years and that pains me quite a bit. I have been living in the dark with this burden since I was a young child. I was very depressed back then, as well.
And no one knows. I am highly functional and do not show it. It’s even more isolating, the agony inside.
Anyway, thank you. I have been on Wellbutrin off and on for “depression” but the Lamictal is what the new doctor added a month ago as a mood stabilizer. I am very early in this process but I hope to find the right combo of meds and relief soon.
Thank you.
Be careful with the Seroquel(sp) that stuff can kill you. I was actually in the hospital telling people to change to something else as I had seen what it had done to others I knew. It really pissed off the staff. Then I pict up the newspaper one morning and there it is. Black box warning put on by FDA. I also believe the company holding the patent were caught repeatedly lying about it’s side effects and effectiveness among other things. It can put 50-100 lbs. on a typical person in 6-12 months sometimes. Your blood pressure can go through the roof and strokes are not uncommon. I wouldn’t tough the stuff with a ten foot pole on the end of a ten foot pole, especially for sleep. Many thinks can knock you out without that junk. Personally I think it would make a good candidate for being outlawed altogether, except maybe for extreme acute cases of Schizophrenia and maybe over the top bi-polar one acute episodes. It can kill make no mistake about it and I think it is used FAR to often. I have a very good friend who had neither Bi-polar or Schizophrenia and was being given large doses of it for reason I could never find out and he dropped dead of a stroke at 36. In fact sleep is the only reason I can see they were Rx ing it for him. Good luck Christine.
I’m not sure why I was under the impression that most people with BP were on meds! I am not even sure what my full diagnoses is so how can I go to a doc for help? Is this the therapist job to tell me? I don’t think she likes labels. I have asked her, but get really vague answers. I really don’t know. I think I have rapid cycling, pretty sure of it from all I have read, but I can’t diagnose myself can i? How do I tell a doc this?
When in my 20’s (50’s now) I used Zoloft and it was great for about a year and then stopped working. They upped it and nothing happened so they tried other things on me and still nothing. Wellbutrine was one. I stayed depressed almost all the time.
Most recently (the last 4 yrs) I have tried several SSRI’s and they all made me totally freak out! manic. While in the hospital they made me take them, but my heart raced so badly they had to give me Xanax, then the SSRI, then Xanax , SSRI, Xanax . . . It was a roller coaster w/o the fun!
Finally I told them I didn’t want to take them, but they insisted I stay on them for 4 weeks. Like a good girl, I did, but it never got better. After trying several of other SSRI’s, I cut it in half, still too strong, then in quarters, still too strong. Then forget about it! I have not had any since (two years clean). I am terrified of those things so thank you for sharing this about anti depressant drugs. It solidifies what I knew but thought I was the odd duck. Well I am, but that’s another story.
I wish there were something to help but because I have other issues beside BP, my therapist doesn’t recommend them. She once stated that she sees more harm from them then good.
It was a horrible time in life because the doc acted as if I were making it all up. I am crazy right? I am suicidal there for I have no ability to think rationally, right? He treated me like I was wasting his time. My feelings were not only hurt, but I felt like why bother anymore, I am a drain on everyone. the depression got worse.
I am constantly fighting the urge to not think about suicide as an option, but ever since I was on SSRI’s I think of it so often so it makes me wonder if for those of us who are susceptible to suicidal thoughts if the anti d’s more dangerous? Do the drugs stay in the system long term? Have there been any studies?
Thanks to the new healthcare in the US, I have a new doc that I get to see after the 1st. They have a group of mental health docs that collaborate with the family doctor for things they need help with. I sure hope they can help. but it would be good to go in there with more knowledge.
I would like to hear more of your thoughts about mood stabilizers and other choices for treatment. What are they for? How do they work, etc. Or if there is a link/s that you can post that is easy to read. I’d appreciate it.
I am so frustrated. I exercise every day almost, I eat well now, try to sleep (that’s not a choice), go to therapy and do deep breathing and am learning yoga.
If I had knowledge of the drugs before buying them at the pharmacy, I might be more willing to try them; I don’t really want to do pills because I have hallucinations and paranoia, along with other stuff, but if there is a safe feeling about them I might give them a try.
Side affects are scary things for people like me. My mind plays tricks on me so being consistent with pills is hard. Are being paranoid and having hallucinations BP issues?
Thanks for your help.
D
Originally, my GP treated me for depression using Paxil. Not only did I not get better but I spent months in a mixed state. I believe my psychologist may have been my saving grace as he encouraged my GP to add a mood stabilizer but it wasnt a large enough dose. I now see a psychiatrist that specializes in mood disorders and she refuses to use any form of antidepressant. I am stable after some trial and error and now working on insomnia which has its own challenges. I am very thankful to the individual who referred me to the psychiatrist I am seeing because I wasnt sure if I was going to make it.
I’ve found an interesting place with a crazy load of info on psych and meds articles, etc. For example: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3195150/ My meds shrink is professor, VP of clinical psych dept at University, speaker, written articles and a book. Seen him for about 20 yrs, so I trust this man with my meds and the changes we’ve been through. You have to give all info on how you’re feeling, thinking, what you’ve done that you might think is not quite right, because the more info they have, the better they can help you. If you’re frustrated with your meds Dr, fire them and get another. You are in control.
I have BPII and take wellbutrin with a hint of fluoxitine to try to help with the previously unbearable depression, and seroquel, topomax, and clonopin. I can’t remember when I last had a long crying spell, or when I couldn’t cut myself off at a few tears and sniffles, and try to straighten up. It’s weird. Very weird. Can’t say I’m happy, but I can say that I don’t feel suicidal today. One day at a time.
OOoops I meant this: http://www.nlm.nih.gov/
I really love the makeup and hat except for the nose. Very nice. WN Sorry if thats your real nose?
I have never never never ever had a good thing with any anti-depressant and I’ve tried each and every classification, at one point or another, since I was a wee child.
They either completely fail to do anything at all, start sort of working to then drop me like a leaded plate, to shooting my mood and mind up and making me “squirrely”, to complete and utter psychotic suicidal mixed mania. I KID NOT.
Yet, I’ve had some psychiatrists who “pushaw” the notion that those with Bipolar are not to take ADs and then I’ve had some that absolutely refuse to prescribe someone with Bipolar any ADs.
When I am handed a script for one, I just file it away and yes – I tell the pdoc, time and again, “do not prescribe any anti-depressant, I do not do well with them.” and still… I get a script.
I am just now beginning to accept my bipolar diagnosis. I have always been diagnosed with clinical depression.
My psychiatrist (and I) are experimenting with medications together, but this blog and your collective experiences have been better for me than any medications as they usually have side effects that are not welcomed. I have to be very careful with any substances. I do now know that one size does not fit all. Unfortunately, Americans believe that there is a magic pill for everything.
Good article, Natasha.
I’ve been on antidepressants since the year 2000. But the only time they were unaccompanied by either antipsychotics and/or mood stabililsers, I ended up in hospital – for months! Prescribed by my GP, of course. As my bipolar tends strongly toward the depressive end of the scale (as opposed to mania) this makes some kind of sense to me.
So my experience supports your premise completely.
Did I ever mention you look like Judd Hirsh? Sorry if I did already? Great actor! WN
They stopped my Paxil when I went into a manic episode, but after the episode ended the usual depression followed. I couldn’t stand it after awhile, so my Psychiatrist put me back on it. I’ve been on it a few months, and feel better. I know it’s a risk, but I’m not about to live with depression.
Hi Kendal,
I would never suggest that you “live with” depression, but I’m suggesting there are safer ways of getting out of it. For example, if you added a medication to the Paxil, you likely would still be out of your depression and you wouldn’t be so prone to go into mania.
– Natasha Tracy