Posted by azalea on October 2, 2008, at 21:04:13
In reply to SSRIs and BPII, posted by qbsbrown on October 1, 2008, at 22:03:55
You're absolutely correct about SSRIs causing mood instability in BPII. For sleep, what about Ambien (zolpidem) or Lunesta (eszopiclone)? Alternatively, Remeron (mirtazapine) or Trazodone . . . although they are antidepressants and may slightly increase the risk of cycling, though not as much as SSRIs.
With regard to Lamictal (lamotrigine), is it possible you had a bad reaction because of a combination with another medication? Quoting Dr. Phelps from www.psycheducation.org "about one in 20-30 people will actually get worse on it (in my experience, and that of numerous other psychiatrists who have used a lot of lamotrigine; the worsening is an increase in anxiety, irritability, or sleep problems, as though a lamotrigine was acting too much like an antidepressant. This reaction is one of the reasons why I try not to use lamotrigine when an antidepressant is already in use: lamotrigine is such a fantastic option, especially compared to the rest, I don't want to take any risk at all that it will be poorly tolerated. if things seem to be getting worse, is that lamotrigine, or might it be the antidepressant causing that? I try to avoid that situation)."
Or perhaps your doctor started at too high of dose or titrated too quickly. Some pdocs recommend starting Lamictal at 12.5mg daily and adding 12.5mg weekly. It takes a while to reach a therapeutic dose, but can be quite beneficial if you're sensitive to side effects.
For more information, here's the URL
http://www.psycheducation.org/depression/meds/moodstabilizers.htm#symptoms> I know the newer stigma about ssris inducing mania and instability.
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> I have BPII and ADHD. I've begun Lexapro+Depakote+Dexedrine.
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> The ssri helps me with socialability (like my normal self), but seems to add or cause more mood instability.
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> Plus I can only sleep regularly on an SSSRI.
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> But I have also noticed that I need about twice as much of the stimulant if using an ssri.
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> Lamictal is an exhausted option for me (insomnia, anxeity, naseau/headaches)
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> If it's just depakote/dexedrine, i don't feel depressed, but im not social. I'll hyperfocus and just do my own thing, plus sleep is crap.
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> So there's my dilema and crossroads.
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> I'd appreciate some help/advice/suggestions.
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> You guys are the best.
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> Depakote+Provigil I was very social on, but I still couldn't concentrate on the job (plus depakote makes me stupid)
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> It it too much to have Provigil+Dexedrine+Depakote?
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> I'll stop now
poster:azalea
thread:855207
URL: http://www.dr-bob.org/babble/20080926/msgs/855344.html