Posted by Ron Hill on May 30, 2003, at 2:13:32
In reply to Should BP II's nix the AD's?, posted by nmk on May 27, 2003, at 18:43:09
Hi Nicole,
> All you BP's out there, please help me with a question. Have been doing alot of reading lately and many doc's have stated that AD's should be used cautiously with BP I and II. Some say that if used, they should be administered in small doses while some say a mood stabilizer should be used solo.
Perhaps you have already seen this, Nicole, but I'll post it just in case you haven't run across it in your superhighway travels. It is on Dr. Phelps' web site and it discusses the AD controversy for BP patients:
http://www.psycheducation.org/bipolar/controversy.htm
> Has the combo of an ssri/snri with a mood stabilizer worked for you guys or is better to try the mood stabilizer solo?
Over the years I tried almost all of the SSRI/SNRI's as an add-on to a moodstabilizer for treat of the atypical depressive side of my BP II. Unfortunately, each and every time the AD eventually left me in worse shape than I was in without it.
Within hours of taking the first dose, each of the AD's would immediately induce some amount of mild euphoric hypomania (even with the mood stabilizer fully ramped up). This typically lasted a week or so. This hypomanic phase was followed by a week or so of relatively normal mood states. However, shortly thereafter, the AD would begin to adversely affect my dopaminergic pathways and, thereby, cause severe emotional blunting, apathy, anhedonia, anergy, hypersomnia, etc. The resulting AD induced atypical depression was worse than the depression associated with being on just a moodstabilizer.
This put me in a difficult place for several years. I struggled with depression when using just a moodstabilizer, but the situation would become even worse shortly after adding on an AD. Therefore, I turned my attention to supplements for treatment of my depressive side. About 18 months ago, I had good success using 200 mg/day of SAM-e. However, out of the blue after five months of very good results, SAM-e started to induce severe irritability and I pulled the plug on it.
The good news is that, with the help of others on this board, I have found a medication/supplements combo that is currently working incredibly well. I take 600 mg/day of Lithobid for my hypomania, 2.5 mg twice a week of Enada NADH in conjunction with 250 mg/day of TMG to treat the atypical depressive phase of my BP II disorder, and 250 mg/day of niacin to control my dysphoric mood states (irritability). I think the niacin is also helping my depression, but its main function is to control my irritability which it does exceedingly well.
I'll not bore you by listing all of the vitamins, minerals and supplements that I take since they are numerous. However, the ones I mentioned above are the heavy hitters and they are the main contributors to my current good mental health. Magnesium, fish oil, and phosphatidyl serine, are definitely worth honorable mention.
Will it last or will it be like SAM-e and turn against me? My hunch is that this combo will go the distance, but time will tell. If it turns against me, I’ll be back to the drawing board looking for other supplements. But in the meantime, I’m healthy and its time to get after the work that has piled up during my sickness.
My best wishes to you Nicole as you search for a solution to your depressive phase.
-- Ron
poster:Ron Hill
thread:229544
URL: http://www.dr-bob.org/babble/20030525/msgs/230143.html