Posted by Mitch on August 15, 2001, at 10:09:42
In reply to Re: Bipolar meds/anxiety-follow up from anxious mom, posted by cb on August 15, 2001, at 7:23:42
> > So, given the lithium, Wellbutrin, and Zyprexa your son is still showing mixed anxiety and depression but the manic symptoms are currently being controlled, right?
> Actually, we have only seen the mania in response to the AD. His predominant problem is the depression - the anxiety is a pretty new symptom (last 3 months).
You are in one of those dilemmas where you can get the highs under control, but there is lingering depression, but adding an antidepressant provokes breakthrough manic symptoms. I am bipolar and have fought with that for a long time. It looks as though his doc is looking to adding/switching to an SSri (since he had an AD response to it previously). I was on lithium+Prozac for about 7 years. It worked ok, but I had to keep the Prozac dose very low or it would set off very pronounced hypomania. If he adds an Sri I would suggest a low dose of Paxil (5mg/day) and watch him closely to see how he reacts to it. If he gets a *little* high-I wouldn't get real concerned as long as doesn't become irritable or hostile and he is sleeping a reasonable amount. The main reason I mentioned Paxil is that it tends to be anxiolytic and it has a short half-life, so if it "boomerangs" on you, it will get out of his system rapidly if you withdraw it.
> He's getting pretty frustrated since he hasn't felt "good" in 6 mos. (including 3 in the hospital), and senior year of high school starts in 3 weeks!
The anxiety in some part could be the pressure to "get well" before school starts and some anticipatory anxiety about the atmosphere there given his recent problems (how classmates are going to treat him). Does he ruminate about and feel apprehensive about returning to school?
poster:Mitch
thread:75085
URL: http://www.dr-bob.org/babble/20010814/msgs/75130.html