Posted by Ron Hill on June 7, 2001, at 10:16:26
In reply to Re: Wellbutrin and bipolar syndrome, posted by Joanna on June 6, 2001, at 11:12:08
Joanna,
I agree with Sulpicia (L). IMHO, for a BP patient, it is extremely important to have a mood stabilizer in place prior to taking an AD (or stimulant). I base this recommendation/opinion on the medical literature that I have read on the subject and on my personal experience.
I am BP II currently taking Lithobid (600 mg/day), Paxil (10 mg/day), and Wellbutrin (100 mg/day). My meds are currently working extremely well (PTL). However, I was initially misdiagnosed as ADHD and prescribed Ritalin. The Ritalin pushed me into mania big time and it also began to make me cranky after a couple of months. In an attempt to fix the crankiness, my ex-pdoc added an SSRI antidepressant (Paxil). The Paxil pushed me further into mania, but the mania felt so good that I could not be convinced by the people around me that something was very very wrong. And my ex-pdoc did not recognize my mania but instead kept writing scripts for Ritalin and Paxil (can you say malpractice?).
To make a long story short, I lost my job as an environmental engineer, ran up $70K of credit card debt, cashed in and spent my retirement account, got a second mortgage on my house and spent it, etc. The thing about mania (hypomania) is that these actions actually seemed logical at the time.
I mention all this only to say that I have a BIG CONCERN about putting a BP patient on an AD (and/or a stimulant) without first having a mood stabilizer fully in place.
-- Ron
---------------------------------
> > Absent further info, without established mood stabilizer, wellbutrin is likely to set off mania.
> > S.
>
> Whoopee. Dr Doofus strikes again...[we have an idiot doctor.]
> Jay's symptoms have always been quite mild. I've know him for approx 20 yrs and for a long time we suspected that he may be bipolar but as he managed well just with lifestyle adjustments and Vit B complex and Vit C supplements he never sought medical help. He was "officially" diagnosed about 3 yrs ago when he needed help with sleeping due to stress, but as he always managed without meds he didn't want to start taking mood stabilisers. For him, the swing to hypomania is the time when he is creative and manages to cram in so much he leaves me way behind. He also has more and more severe headaches and feels very tired as he comes down. Most of the time - for months on end - he's 'normal'.
> His current depression is a result of the deaths, in short order, of both parents. He's been through a lot this past year. It was severe enough to disrupt his life to the stage where he relapsed into total apathy. It took a lot of coaxing for me to persuade him to seek help.
> He has kept a mood diary for many years now, I guess it's time to pay it closer attention.
> Apart from going back to the doctor, have you any further advice?
> Thanks for your time :)
poster:Ron Hill
thread:65495
URL: http://www.dr-bob.org/babble/20010605/msgs/65650.html