Posted by CA 2 NJ on April 18, 2007, at 9:41:10
In reply to Re: ADVICE NEEDED: Best Antidepressant for Bipolar I? » CA 2 NJ, posted by polarbear206 on April 18, 2007, at 9:20:53
> > Hello everyone! I hope you all are doing well and have a wonderful day! LOL I sound like Mr. Rogers... (for those of you old enough to remember the PBS TV Show Mr. Roger's Neighborhood.)
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> > I would like to know what the best antidepressant is for someone with Bipolar. I currently take Prozac but notice that in the literature it lists mania and hypomania as side effects.
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> > I should mention that I have just started taking Depakote ER at 500mg at bedtime so that should help with any wild mood swings. And if all goes well with the 500mg, My Psychiatrist mentioned going up to 1,000mg of the ER Version. In addition, I take 100mg of Seroquel at bedtime which is also supposed to help.
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> > I am sure there are MANY of you out there who have Bipolar and have had to take an antidepressant with or without a mood stabilizer. So I am wondering, which one(s) have worked best for you? Or have you heard of working best?
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> > I have a friend who has Bipolar among many other things that are similar to me, and she swears by Effexor. I have taken Effexor, but that was years ago before I was diagnosed with Bipolar. When they said I had Major Depression and Panic Disorder. And I have to say it made my Panic Attacks vanish and I was able to tolerate it for 3 years. The longest I've ever been on ANY med. But it was the only med I was on, so I don't know how it would do in a combo.
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> > Also I should mention that I have only been with my current Psychiatrist for about 3 weeks now and have only been on Prozac (now 10 mgs, was on 20 for a few days) for that amount of time. I'm not sure if it's working as I started taking it at the same time as Geodon. But I quit taking that yesterday because it seemed to give me extreme anxiety and insomnia. It was bad.
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> > When I started seeing my new Psychiatrist, he gave me the choice of either Prozac or Effexor. He told me that Prozac is better for Anxiety and Effexor better for depression, so I went with Prozac because my anxiety has been horrible for months. Although I always thought Prozac is the most stimulating???
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> > I can't say whether or not the Prozac is working or will work at 10mg or even 20mg, so I am not against it at all. And it does seem to help with my appetite, so I like that. But not enough to not feel my best on a day-to-day basis.
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> > I just want to get some opinions from people who have been where I am. So if any of you have any information you'd be willing to share, I would be very grateful as I'm to go see my Psychiatrist soon and he wants to discuss this then.
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> > Thanks so much for reading my lengthy post. I hope someone out there will give me something to go on as I NEED to get better. I've been out of work for almost 2 years because of all this! :( Before I even knew I was Bipolar!
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> > Take good care everyone. I hope to hear from you soon! Have a great day! :)
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> > Hugs,
> > CA 2 NJ
> >
>
> Hi,
>
> I'm back to answer your questions. I'll help you out with my experiences. I am a psychiatric nurse from Pa. I have what is called "soft" bipolar II. I am on a drug regime of Effexor, Lamictal and Lithium. In my own opinion, Effexor is one of the best AD's on the market. I have been on it for years, and have been highly functional. I am very passionate about helping those seek out proper diagnosis and treatment. It's very sad that many bipolars walk around for 10 years or so before being diagnosed. My illness erupted after the birth of my son 18 years ago. I threw myself into gaining as much knowledge about my illness. I basically diagnosed myself. My life turned around when I started Lamictal. I've been on it for about 10 years now. I still have some soft cycling around my time of the month and when the seasons change (this is very common with bipolar). My bipolar is depression dominated with atypical features. I have some mixed states and I get irritable, anxious and have anxiety. My ups consist of good energy, goal directed activity, and and the dreaded sleep disturbances. I absolutely love effexor, can't say enough good things about it. I've been on many AD's. To name some; imipramine, prozac, paxil, desipramine, rememron, parnate (made me hypomanic) wellbutrin (gave me anxiety, did nothing for depression). The best I did before Effexor came on the market was combining an SSRI with a tricyclic. So,as you can see, the Effexor was the perfect choice for my situation. The only drawback is sexual side effects. Since adding Lithium, I lowered my dose and this is much improved.
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> Right now the most impportant thing is to stop you cycling and regain a normal sleep/wake cycle. As I said in the above post, Depakote will help you. You have to be very careful with AD's and Bipolar I. Take the least amt. possible to prevent mood cycling. Once you feel stable, as far as the cycling goes, and the depression is still lingering, you can play around with you dosages. Keep it low and go slow is my motto.
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> Polarbear,
> Effexor, 225mg
> Lamictal 200mg
> Lithium 300mg
>Oh thank you, thank you, thank you! I am SO HAPPY about your response! And I believe you're 100% correct with Effexor being a good choice for those with Bipolar. I also remember it helping with my anxiety which even now is a problem with all the "sedating" drugs I take. At this very moment I feel it coming on stronger and stronger. :(
I know this Prozac is doing it to me. This darned anxiety. Either that or it's the Xanax and I really doubt that one! :)
Since My Psychiatrist wants me to stay where I'm at with my meds until my appointment in a week & 1/2, I called My General Physician as they know all about me and my history. I wanna see if they will give me a script for 37.5 of Effexor XR. I believe they will. I hope so anyway!
Also I am in total agreement with you about starting low and going slow. I say that myself! LOL And I like to take the least amount of medication needed. It seems like my new Psychiatrist just can't wait to ramp up the dosage even though I've told him I am very sensitive to meds and a little goes further with me than most.
He just laughed and said that all of his Anxiety patients are the same way. Well duh! Doesn't that mean maybe he should stop going by the PDR and take this into consideration? I dunno. Kind of irritates me when Doctors don't listen to me...
I am actually considering finding a new Psychiatrist as this one is an hour away and I don't like how he wouldn't change the Prozac to Effexor when I spoke to his office yesterday. He's the one who gave me a choice of the 2 in the 1st place. And the ONLY reason I chose Prozac is because he said it was better for anxiety and Effexor is better for depression.
Anyway, I apologize for my rant. I'm just irritated and anxious about this whole situation. But thanks to you I now know I do want to try the Effexor again. Thank you so much! Your post has inspired me. :)
Take good care and I wish you all the best. Today and everyday. :)
Hugs,
CA 2 NJ
poster:CA 2 NJ
thread:750957
URL: http://www.dr-bob.org/babble/20070413/msgs/750981.html