Posted by Scott L. Schofield on March 10, 2000, at 11:34:30
In reply to Re: Rapid Cycling Bipolar Disorder, posted by dove on March 9, 2000, at 14:59:34
> On another note, I used to find my depressions so much worse than my up-up-up-and-away mania's, but for the last five or so years, my mania's have been so mixed with aggressive depression and energetic hopelessness, that I find them much more dangerous for my safety. Possibly I am actually depressed and it's not manic, but it sure feels like some kind of evil malignant mania possessing me.
Dear Dove,I sometimes feel stupid when suggesting the most obvious. I haven't been around long enough to know which things people have tried in the past. It probably wouldn't make much difference anyway, having a sieve for a memory (and probably a shrunken hippocampus).
I can't imagine that you haven't tried one of the recognized mood-stabilizers yet, but I believe that Depakote would be the more established of these for treating mixed-states. If it were to work, it might obviate the need for adding or changing antidepressants.
It might also be worth getting some feedback regarding the use of Klonopin (clonazepam). It may take the edge off and moderate the manic component without sending you into a full-blown depression. Being a benzodiazepine, one would naturally have trepidations regarding the reputation of the benzos for being physically addictive. However, Klonopin is unique among them, having anticonvulsant properties and an ability to alter serotonergic activity (5HT2C receptor agonist, among others). It has even been demonstrated to be capable of augmenting the SSRIs, and promote a more rapid antidepressant response. I don't think these properties are likely to display tolerance, so long-term use can be justified. Klonopin is recognized as being effective in the treatment of dysphoric mania.
It sounds like you may be closer to an answer than you think. I hope so.
- Scott
poster:Scott L. Schofield
thread:25437
URL: http://www.dr-bob.org/babble/20000302/msgs/26619.html