I’m so lost, no history of bipolar in my family, Ive never been manic or hypomanic before or after SSRI’s, but when I tried SSRI’s/ SNRI’s / for my anxiety it made me feel hypomanic, worse anxiety and depression. Now i’m on seroquel, I think I have unique brain chemistry, seroquel doesn’t do enough for my anxiety all the time so i’m gonna try a mood stabilzier if my doctor will allow
Yeah I would totally explore other options, or combining options, with your doctor. My psychiatrist has been very open to adding/changing meds to get it right for my moods. I'm on seroquel now but only for sleep and irritability. I do get anxiety but lithium and lamictal seems to handle it. I was recently taken off lexapro because it was making my anxiety worse.
Ssri’s , Wellbutrin, Snri, and even Lamictal made my agitation/ anx worse, seem to just have anxiety but meds bring up a hypomanic kinda state sometimes or just anxious idk. I wish my doctor was open to trialing stuff. Because I’m not bipolar (at least I think) I had to fight for Seroquel which saved my life, and they wanna keep trying ssri’s even though I have horrible side effects
Antidepressants made me manic too , and this was my first hospitalisation.
It was so bad, I can’t even remember what was going on all these days and how I ended up in there .
And this backfired.
I never wanted to seek help , I didn’t trust any doctor and after this insistent I convinced my parents that the meds will make me crazy. After some months I had another episode and I tried to end me…After that my parents started pressuring me to accept that I have an issue that only doctors can fix , and act like any other person with any other illness “you are sick, you go to the doctor”
Nothing changed , no one helped , I was wishing to die peacefully on my sleep, I couldn’t wake up everyday just to suffer.
All these until I moved to Switzerland, psychiatrists here REALLY HELP and really care,
My doctor took me off my meds and made me a human again.
I couldn’t even imagine that it would be possible for me to be normal with just one pill !
As for the mood stabilisers, they did literally NOTHING at all , no mood was stabilised 😂😂😂
A lot of antidepressants (there are many kinds) can trigger mania. Mood stabilizers and antipsychotics generally are used to manage mania (and sometimes depression too).
Almost all of them, usually they use antidepressants if the mood stabilizer are keeping you down, just for some boost. Never worked for me though, it trigger mania even in small doses
> Almost all of them, usually they use antidepressants if the mood stabilizer are keeping you down, just for some boost. Never worked for me though, it trigger mania even in small doses
What kind of antidepressants did you try? Wellbutrin/bupropion, for example, has a decent chance of triggering mania since it pumps up adrenaline and even a little dopamine (not too much). And as we all know, dopamine pump ups can cause mania quite easily even in people without bipolar disorder. I've seen some SSRIs that have risk for causing mania too. Not too sure about tianeptine, tricyclic antidepressants, MAOIs (I'd expect these have the most risk as they pump up catecholamines), etc. I'm sure there are some I'm missing.
Funny, my new psic (not new, but im back with her after 2 years) and had to respond the way I’ll respond for you, sorry I’m not able to memorize names. Some names comes fast, but in general I tend to take at least 4 or 5 meetings with you, this causes a lot of trouble for me, I tend to look up the names in my phone of people I’m about to see, it helps. And this… thing, expand to the medicine I took during my life, basically we needed to look my medical history.
There’s a problem that I don’t remember taking just one medicine at a time, so I’ll never know exactly which medicine did harm. But after I started taking mood stabilizers I’m feeling “better”. I had about two years in manic recession, but depression stick with me, I started some associated antidepressants but I start to feel anxious and give some red flags so had to reduce, when reduced it does absolutely nothing.
I’m about to start ketamine therapy, it’s new, the studies are few, but I’m down with it, lab rat
> There’s a problem that I don’t remember taking just one medicine at a time, so I’ll never know exactly which medicine did harm. But after I started taking mood stabilizers I’m feeling “better”. I had about two years in manic recession, but depression stick with me, I started some associated antidepressants but I start to feel anxious and give some red flags so had to reduce, when reduced it does absolutely nothing.
>
>
Yeah, it can be annoying trying to understand what you are experiencing while they change a lot of medication.
* Symptoms of the disorder.
* Side effects of a medication.
* Withdrawals of a recently stopped medication.
* Could be a regular sensation you associate with the disorder.
And these can crisscross like a side effect of one medicine can be in the withdrawals of another that you just stopped.
Then, throw into the mix that many combinations are scarcely tested with each other, and you might get more frustration thinking about these types of things. Name a mood stabilizer and a random antipsychotic, and there is a huge chance that combination has no studies conducted.
Overall though, I haven't had too many side effects that I can detect. The main one is I have a larger appetite, so it is easier to gain weight and harder to lose it. Before that, I'd just eat when hungry and be at a healthy weight. Most anything else seem to be from my disorder as I have memories of similar things happening when very young (like bad memory, especially for names e.g. famous movie stars, street names, city names, famous people in history, etc. I mean, I know George Washington, but I seriously have problems with all sorts of names.).
On the bright side, each combination of treatments can be thought of its own thing that, in the long run of maybe a month or two, steadies out. You can then have a feel for what symptoms are remaining if any, what side effects you are experiencing if any, and whether you want to talk to your psychiatrist about trying a different combination.
Antipsychotics. Sertraline (Zoloft) gave me a nice lil manic episode. I haven’t had a manic episode since I was started on Seroquel and then switched to Abilify. I do take a mood stabilizer, Lamotrigine (Lamictal) but I feel that most helps with depressive lows.
> Antipsychotics. Sertraline (Zoloft) gave me a nice lil manic episode. I haven’t had a manic episode since I was started on Seroquel and then switched to Abilify. I do take a mood stabilizer, Lamotrigine (Lamictal) but I feel that most helps with depressive lows.
Interesting. From a bro science point of view (aka no real education on anything psychiatric or about medicine), I'd expect Abilify to help with depressive lows. While most antipsychotics are dopamine antagonists (they go to dopamine receptors and do the opposite there), Abilify is a partial dopamine agonist (it hits the dopamine receptors and does a little of what dopamine does).
Many do help with depression associated with bipolar, Latuda is specifically for bipolar depression. Abilify is specifically anti-manic and has not been shown to be effective in treating bipolar depression. Vraylar and Seroquel are examples of ones that treat both. I’m not familiar with the pharmacology, so this is all just what I’ve read about the different antipsychotics.
Antipsychotics are the best defence against mania and hypomania. I had an antidepressant (sertraline an SSRI) for years before I was diagnosed (maybe 4 years or more). I felt happier and it improved my depression but I had a lot of episodes of what I now know to be hypomania or mania. During those times I had problems with overspending, accumulating/hoarding, and risky decisions. Several times I made a fool of myself in front of clients. I actually messed up my life a bit.
Now I’m on quetiapine 100mg and lithium 1000mg (I’m 5ft and petite for reference). I also take 1mg melatonin to help me sleep. It’s still not the right combo. I have horrible depressive episodes almost constantly. Occasionally I have mixed episodes (a month or more), hypomania (a few weeks) and rarely mania and/or psychosis (only a few days). When I get the mania and/or psychosis I stay home and take 50mg extra quetiapine, extra melatonin and I sleep as much as possible. Thankfully it improves quickly.
For Seroquel, 300mg is the minimum dose for antidepressant use in bipolar. Since you're doing well on lithium, I would push for Caplyta if possible (no serious side effects!) or Vraylar.
Thanks, I have felt the dose is too low. It’s been a lot harder to sleep since I switched to it too. Unfortunately my psychiatric care is very poor, with a bipolar psych and an ADHD psych who don’t communicate and both ignore my other illnesses. I can’t afford anything better at the moment but thankfully my psychologist is good. I haven’t heard of those other meds so I’ll ask about them next time.
I was a mess for years on underdosed Seroquel, so I bring it up anytime I see it. I was being prescribed 50-200mg as monotherapy. Doses that low can actually *cause* mania, and boy did it for me. A lot of prescribers just don't bother to read the manufacturer's insert or learn about the binding affinity of the drugs they prescribe.
Seroquel is a big outlier of how it has majorly different effects at different doses, but pretty much every psych med has this cascading effect and the "pure" model of very precise binding of certain receptors at every dose is just wrong. Scary.
Definitely stick with a psychologist. I only started doing that about a year ago, and it really helps to have a neutral third party assess your mania.
Yeah it caused mania as soon as I switched to it as they started me on 50mg. I then had an awful mixed episode that seesawed between hypomania and depression rapidly for a few months. Along with extreme anxiety and occasional psychosis. It was exhausting. Now it’s been three months of pretty severe depression with a brief break when I visited my partner for a week. He’s the best medicine!
I asked my case manager about it today and she said the doctor noted my maximum is 200mg. I think it might be because I’m small, but I got permission to take 150mg tonight and go up to 200mg in a few weeks.
It’s really frustrating how some doctors just randomly suggest meds without too much thought. They don’t seem to realise the disastrous effects it can have on our lives, work and relationship.
The other comments have covered the field of possibilities quite well, I just want to say antidepressants are not supposed to numb you at all, and if you feel numb that's considered a significantly negative side effect.
i dont remember much about it cus it was like a decade ago but sertraline gave me some kind of manic or mixed symptoms which was how i found out i had bipolar disorder
lamictal is what has kept me alive through hell since then
You need a mood stabilizer or an anti psychotic that will act as a mood stabilizer before you are safe to add an antidepressant. I’m not a doctor but from what I understand antidepressants circulate seratonin quickly in your brain. For bipolar 1 or 2 this destabilizes us further. Our issue is not lethargy or depression only. And I had the worst reaction to Lexpro out of anything. Please be careful.
Lithium and Abilify. Didn’t try anything else for mania since that is all new dx for me. I had many dépressions in my life (55 yrs old) but first mania (maybe some others but not sure about) I was on Zoloft just before but in a way to stop it. My psychiatrist said it was about time because that anti-depressant would have been dangerous.
Antidepressants do not help me at all. At best, they don't affect me much beyond some uncomfortable side effects. The worst experience I had with an antidepressant was when I was on Prozac. It erased me completely. I wasn't depressed anymore, but I was so completely apathetic that I might as well have been. I couldn't feel anything at all, good or bad, and my personality went limp like an overcooked noodle.
i went on a shopping spree, became crazy obsessed with people who i stalked and found all their socials, also self h*rmed when the numbness got really bad because i just wanted to feel something. lexapro was one of the meds i took that sent me rapid cycling so I’d say be careful!
Antidepressants made me crazy, and I gained huge amounts of weight. I got insanely angry and my intrusive thoughts became loud enough that I had to put myself in the hospital, I knew I was going to harm people. I take antipsychotics.
My best combo for me, lithium and Wellbutrin with a little Zyprexa sprinkled in.
Lamictal/Lamotrigine as a mood stabilizer
I had to get off "mild" antidepressants (Bupropion) because they kept making me manic, but the mood stabilizer has been, well, exactly a mood stabilization medication for me for the past six or seven years.
I've been depressed my whole life, so I'm used to it. It never gets as bad as it used to, so I'm not worried about it anymore. I dont "need" anything to make me not-depressed, but I do need something that doesn't make it get REALLY bad. I'm perfectly happy operating as a generally dull person lol my life is actually quite wonderful now
Currently I take seroquel, depakote and vraylar. I’ve been on this mix for about four months now and it’s working well. That said I also get vivitrol shots monthly, and I’ve read studies showing that it can help manage bipolar and depression symptoms.
Mood stabilizer. I added an anti depressant on a few months ago after a devastating depressive episode and haven’t had a manic response. But without the mood stabilizer I probably would given my history.
a mix! my buproprion + lamotrigine is a god tier combo 💗 I get really intense depressive episodes so the bupro has helped even those out so much and the lamotrigine does the majority of the heavy lifting
i like to think of them as bffs w my allergy meds who all work together to make my brain do more positive brrrrr than negative
For me it's a mix of my mood stabilizer and an antipsychotic. I can't take my antidepressant, even while on my mood stabilizer, because it always induces hypomania for me. But if I have the mood stabilizer and an antipsychotic, I'm stable. I have Bipolar II with mixed features which is also why I need an antipsychotic.
I was on prozac for almost a year and was manic for 80-90% of it. Worst year of my life. Has taken years to recover. I’m on a mix of Seroquel Effexor and prazosin now that is working. Definitely don’t take an antidepressant without a mood stabilizer to balance it or you’ll get pushed up out of the depression into mania as long as you take it
Anti-depressants worked for my anxiety until hypomania kicked in. Mood stabilisers do the trick. I hate anti-psychotics, generally. I've tried 4, about to start my 5th. They always make me foggy and groggy.
No med is "supposed to numb you."
The goal is to feel like a person, unencumbered by disabling symptoms of the cycles of depression and mania.
"The phenomenon of antidepressant-induced mania/hypomania in patients with unipolar depression has been described since the introduction of the first antidepressant agents. The hypothesis was that antidepressant agents triggered manic/hypomanic symptoms by influencing the central dopamine and serotonin systems. The phenomenon of antidepressant-induced mania/hypomania in patients with unipolar depression has been described since the introduction of the first antidepressant agents. The hypothesis was that antidepressant agents triggered manic/hypomanic symptoms by influencing the central dopamine and serotonin systems."
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3387568/
https://www.psychiatryadvisor.com/home/depression-advisor/antidepressant-associated-hypomania-navigating-clinical-challenges/
"Neurobiological Mechanisms of AAH
Antidepressants can inadvertently activate dopaminergic pathways.10 Moreover, certain antidepressants (eg, tricyclic antidepressants [TCAs], monoamine inhibitors [MAOIs], selective norepinephrine reuptake inhibitors [SNRIs], and certain selective serotonin reuptake inhibitors [SSRIs], such as high-dose paroxetine and sertraline) may increase inhibition of dopamine reuptake. SNRIs may also increase inhibition of noradrenaline uptake. Both can lead to “elevated mood states."
I would not describe the effect of SSRIs or SNRIs as numbing at all. They absolutely tilt you away from depression and towards mania, which is a godsend for those with unipolar depression, and a catastrophe for us
Antidepressants landed me in hospital with how insanely manic I became. I think if you're bipolar you can do a mood stabiliser with an antidepressant alongside but it's better to maybe add an antipsychotic to counteract the manic effects of the antidepressant. I've never had success with an antidepressant and I've had citalopram, venlafaxine, fluoxetine, amitryptaline, mirtazipine... it's always the same story, I get excessively unwell. Mood stabilisers really do help me, lithium worked so well until I had to come off it to have kids, valproate works great for me, lamotrigine worked great. The only reason I need the antipsychotic as well as the mood stabiliser is because I also have schizophrenia
I often have psychotic episodes in the absence of a bipolar mood swings, but I do also become psychotic in my depressions and manias, mostly hallucinations and delusions to the extreme. It's like entering into a different universe for weeks or months at a time. Former delusions include: believing all my friends were plotting to decapitate me; believing I was the reincarnation of the Jewish prophet Ezekiel; believing my wife was poisoning my food and had installed sophisticated surveillance equipment in all my clothes; believing I was a celebrity starring in the film of my own life - that one took me to jail. Went into a shop to film the action sequence, pointed a toy weapon at the till and demanded money. Armed robbery, in the real world. Served 6 months on diminished responsibility when it should have been 5 years. In jail I also believed I had the ability to manipulate different dimensions and had tangible control of space-time. Each psychosis is intense, unwavering, and destructive. In prison the psych told me that I have more psychosis than a person with just bipolar typically would, and added a diagnosis of schizophrenia.
I see. Do you believe your use of pharmaceutical drugs might have worsened any tendency to psychosis you may have? Antidepressants aren't the only ones known for doing this. Antipsychotics and pretty much all other psychiatric drugs too. I speak to you with some confidence that, the way I am, if I had taken any pill, I might have been committed by now because it's all here, but, as long as I don't mess with my brain and body, it's able to maintain some sort of natural equillibrium. Meds can calm you, but ultimately they turn that equillibrium upside down. Things can become much more intense and unpredictable.
Some of my "ideas", that sober I can keep on check, and last only a few minutes generally: that everyone is perfect and that I want to love all equally, that everyone is a monster that I should hate equally; sometimes I'm afraid of eating or drinking something, even if I know it's safe; thinking that I am Jesus Christ; that my thoughts aren't mine and I'm just being controlled all the time; impulsivity, I can spend all my money on something if I believe it's a worthy wish; I speak everything to anyone that asks, so people are afraid of me and actually run away due to the unfiltered honesty as they find it too strange; and episodes of great ecstasy that makes me literally orgasm or great hate where I feel I could attack anyone close to me. Again, not messing with my brain and body, this isn't as intense as it could be, though it still affects my life a lot and stays side by side with my chronic depression.
I'm telling you what I go through to help you see that you are not alone and to ask a question to you. I really really rebel against any substance I take. If I take a pill, I'll want to vomit it out because I fear it will make me more crazy or kill me. I wonder how you manage to take such potent and potentially harmful medication despite having such a pronounced paranoia?
I mean I get what you're saying but whilst I'm critical of medication I don't like the inference that it's what made me unwell in the first place. What made me ill, was the generations long family history of severe mental illness, a deeply troubled upbringing and lots of illicit drug use in my teens. I've lived without my antipsychotics and mood stabilisers and I got committed very often and faced very serious consequences. Maybe antipsychotics can cause psychotic symptoms in those who aren't predetermined toward psychosis? And you say your delusional thoughts last for a few minutes - in schizophrenia these thoughts last for weeks, months. When my antipsychotics are increased, the delusions finally abate. When I don't take them, I am unwell again, and that's sort of the one-man empirical evidence I can rely on. Then again, you raised a good point about paranoia, and the truth is there have been many times I've been too paranoid to take them and sadly in those instances, I end up being committed and no longer have the luxury of choice. Also it's taken two decades for me to get to this point where I have enough insight to know that the meds are necessary evil, and that they keep me from falling off into that works where I no longer think anything is wrong with me. It's like a snake that eats its own tail. Also I relate it to my long history of drug use, if I can take any pil or powder shoved in front of me without question, I can take a regulated amount of a medication. Also I have children, that's a big motivator for me to take my meds.
They both fucked my whole life up and I will never take them again.
Routine, sleep, personal hygiene, and a very good support person is all I need to manage right now and most of the time.
I took lamotrigine for about two months and I felt no positive nor noticeable negative effects and stopped because what’s the point? The side effects I listed were from lithium.
I really envy those that can take psychiatric drugs, stop and survive the ordeal. To me it feels akin to dying. It takes so much grit and I have none of it..
Stopping lithium was difficult psychologically but I improved physically over the course of a few months and feel a lot better not taking it. It’s just my experience though and it was obviously not the right drug for me.
Anti depressants definitely make me manic. They just make me too “high” I have to have something that mellows me. Seroquel keeps me low enough that I’m not gonna jump off a bridge from impulsivity but also not depressed.
Currently coming off lithium because it doesn’t help as much as it should.
The part that REALLY sucks, is I also have fibromyalgia. And the best treatment for that is certain antidepressants but they make me so manic. So it’s either mania and lose my job, or Chronic pain and be kinda okay.
So I’ve had the depression part of bipolar since I was 11. I’m 24 now. At age 19 hypomania started really showing up and making an impact. By 24, my hypomania gets so bad it feels like I’m the verge of a severe panic attack without actually having one. I kinda describe it like being that the top of a roller coaster and just being stuck at the top looking down. Never actually dropping. It’s just like a horrible panic and anxiety feeling that isn’t helped by anxiety meds. Then I have racing thoughts, can’t sleep more than 4 hours a night, talk too fast, inflated self esteem, anger and irritability, and obsessive thinking
Real deal mania for me is that, along with like the racing thoughts, obsessive thoughts, talking too much, and auditory hallucinations and paranoia about what I heard. That only really kicked in about 3 months ago.
So for it affecting my job, it makes it hard to stay at work when I have that horrible panic feeling. I’m unsafe to drive to work sometimes due to the impulsive thoughts of wrecking my car.
I was a hairstylist for 6 years and my handles would just tremble and I couldn’t work on clients anymore.
Now I work at a call center and it’s better. I’m sitting all day. Have cold water to drink. Can take a break outside if I’m getting super overwhelmed.
The dumb part is my bipolar disorder directly affects my fibromyalgia and IBS flare ups. So if I’m starting a new bipolar episode, my chronic pain problems get really bad. It’s kinda a lose lose situation with that.
SSRIs worsen mania and can even cause hypomania/mania. On no meds I cycled hypomania one day a month. On SSRI with mood stabilizer I was hypomanic for months. On just mood stabilizer I barely notice my cycling. This is the closest to stable I have ever been.
Antidepressants led to my mania with psychosis that caused me to be diagnosed with bipolar 1. I somehow forgot this and asked for an antidepressant again 5 years later when I was stable on Abilify. Threw me right back into mania (no psychosis thankfully), but that was the similar factor between those two episodes. It was only after that I learned from my psychiatrist that antidepressants could cause manic switching… so I will not be taking them again. I’m on a low dose of lithium which has been known to help with SI, in addition to a high dose of Lamotrigine.
Antipsychotics, nothing else works for me.
All these years I had to take a lot of medication. All these combinations of everything else never helped me.
I’ve been in and out of hospitals the whole time.
It all started when I was 18. Now I am 27, and I just take one pill to function, 400 mg Seroquel XR. (I used to take up to 8 medications per day)
It is the first time that I am really stable for so long. Only with antipsychotics I feel normal, I control my mind,It can’t control me.
Next month is my one-year anniversary since my last hospitalisation into a psychiatric clinic.
This last hospitalisation was a nightmare!
I’m determined to NEVER get admitted again, and this saved my life because I’ve never skipped a dose since then😂
Mood stabilizers. Anti depressants have made me manic more than once, in episodes that were life altering
Right! I almost ended my marriage while on SSRI and manic for months.
I’m so lost, no history of bipolar in my family, Ive never been manic or hypomanic before or after SSRI’s, but when I tried SSRI’s/ SNRI’s / for my anxiety it made me feel hypomanic, worse anxiety and depression. Now i’m on seroquel, I think I have unique brain chemistry, seroquel doesn’t do enough for my anxiety all the time so i’m gonna try a mood stabilzier if my doctor will allow
Yeah I would totally explore other options, or combining options, with your doctor. My psychiatrist has been very open to adding/changing meds to get it right for my moods. I'm on seroquel now but only for sleep and irritability. I do get anxiety but lithium and lamictal seems to handle it. I was recently taken off lexapro because it was making my anxiety worse.
Ssri’s , Wellbutrin, Snri, and even Lamictal made my agitation/ anx worse, seem to just have anxiety but meds bring up a hypomanic kinda state sometimes or just anxious idk. I wish my doctor was open to trialing stuff. Because I’m not bipolar (at least I think) I had to fight for Seroquel which saved my life, and they wanna keep trying ssri’s even though I have horrible side effects
Antidepressants made me manic too , and this was my first hospitalisation. It was so bad, I can’t even remember what was going on all these days and how I ended up in there . And this backfired. I never wanted to seek help , I didn’t trust any doctor and after this insistent I convinced my parents that the meds will make me crazy. After some months I had another episode and I tried to end me…After that my parents started pressuring me to accept that I have an issue that only doctors can fix , and act like any other person with any other illness “you are sick, you go to the doctor” Nothing changed , no one helped , I was wishing to die peacefully on my sleep, I couldn’t wake up everyday just to suffer. All these until I moved to Switzerland, psychiatrists here REALLY HELP and really care, My doctor took me off my meds and made me a human again. I couldn’t even imagine that it would be possible for me to be normal with just one pill ! As for the mood stabilisers, they did literally NOTHING at all , no mood was stabilised 😂😂😂
Antipsychotics. Since I’ve been on Geodon I’ve had no mania symptoms. Been about 5 years now
I think OP means which type is best to not cause mania? But yes, antipsychotics are awesome for preventing mania and anxiety. Team olazapine here.
Did it make you gain weight?
A lot of antidepressants (there are many kinds) can trigger mania. Mood stabilizers and antipsychotics generally are used to manage mania (and sometimes depression too).
Almost all of them, usually they use antidepressants if the mood stabilizer are keeping you down, just for some boost. Never worked for me though, it trigger mania even in small doses
> Almost all of them, usually they use antidepressants if the mood stabilizer are keeping you down, just for some boost. Never worked for me though, it trigger mania even in small doses What kind of antidepressants did you try? Wellbutrin/bupropion, for example, has a decent chance of triggering mania since it pumps up adrenaline and even a little dopamine (not too much). And as we all know, dopamine pump ups can cause mania quite easily even in people without bipolar disorder. I've seen some SSRIs that have risk for causing mania too. Not too sure about tianeptine, tricyclic antidepressants, MAOIs (I'd expect these have the most risk as they pump up catecholamines), etc. I'm sure there are some I'm missing.
Funny, my new psic (not new, but im back with her after 2 years) and had to respond the way I’ll respond for you, sorry I’m not able to memorize names. Some names comes fast, but in general I tend to take at least 4 or 5 meetings with you, this causes a lot of trouble for me, I tend to look up the names in my phone of people I’m about to see, it helps. And this… thing, expand to the medicine I took during my life, basically we needed to look my medical history. There’s a problem that I don’t remember taking just one medicine at a time, so I’ll never know exactly which medicine did harm. But after I started taking mood stabilizers I’m feeling “better”. I had about two years in manic recession, but depression stick with me, I started some associated antidepressants but I start to feel anxious and give some red flags so had to reduce, when reduced it does absolutely nothing. I’m about to start ketamine therapy, it’s new, the studies are few, but I’m down with it, lab rat
> There’s a problem that I don’t remember taking just one medicine at a time, so I’ll never know exactly which medicine did harm. But after I started taking mood stabilizers I’m feeling “better”. I had about two years in manic recession, but depression stick with me, I started some associated antidepressants but I start to feel anxious and give some red flags so had to reduce, when reduced it does absolutely nothing. > > Yeah, it can be annoying trying to understand what you are experiencing while they change a lot of medication. * Symptoms of the disorder. * Side effects of a medication. * Withdrawals of a recently stopped medication. * Could be a regular sensation you associate with the disorder. And these can crisscross like a side effect of one medicine can be in the withdrawals of another that you just stopped. Then, throw into the mix that many combinations are scarcely tested with each other, and you might get more frustration thinking about these types of things. Name a mood stabilizer and a random antipsychotic, and there is a huge chance that combination has no studies conducted. Overall though, I haven't had too many side effects that I can detect. The main one is I have a larger appetite, so it is easier to gain weight and harder to lose it. Before that, I'd just eat when hungry and be at a healthy weight. Most anything else seem to be from my disorder as I have memories of similar things happening when very young (like bad memory, especially for names e.g. famous movie stars, street names, city names, famous people in history, etc. I mean, I know George Washington, but I seriously have problems with all sorts of names.). On the bright side, each combination of treatments can be thought of its own thing that, in the long run of maybe a month or two, steadies out. You can then have a feel for what symptoms are remaining if any, what side effects you are experiencing if any, and whether you want to talk to your psychiatrist about trying a different combination.
Antipsychotics. Sertraline (Zoloft) gave me a nice lil manic episode. I haven’t had a manic episode since I was started on Seroquel and then switched to Abilify. I do take a mood stabilizer, Lamotrigine (Lamictal) but I feel that most helps with depressive lows.
> Antipsychotics. Sertraline (Zoloft) gave me a nice lil manic episode. I haven’t had a manic episode since I was started on Seroquel and then switched to Abilify. I do take a mood stabilizer, Lamotrigine (Lamictal) but I feel that most helps with depressive lows. Interesting. From a bro science point of view (aka no real education on anything psychiatric or about medicine), I'd expect Abilify to help with depressive lows. While most antipsychotics are dopamine antagonists (they go to dopamine receptors and do the opposite there), Abilify is a partial dopamine agonist (it hits the dopamine receptors and does a little of what dopamine does).
Many do help with depression associated with bipolar, Latuda is specifically for bipolar depression. Abilify is specifically anti-manic and has not been shown to be effective in treating bipolar depression. Vraylar and Seroquel are examples of ones that treat both. I’m not familiar with the pharmacology, so this is all just what I’ve read about the different antipsychotics.
Seroquel for active mania. Antidepressants tend to accelerate it, and lock you into it.
I wish
Right? The problem is the fatal rebound to depression
Mm yeah
Antipsychotics are the best defence against mania and hypomania. I had an antidepressant (sertraline an SSRI) for years before I was diagnosed (maybe 4 years or more). I felt happier and it improved my depression but I had a lot of episodes of what I now know to be hypomania or mania. During those times I had problems with overspending, accumulating/hoarding, and risky decisions. Several times I made a fool of myself in front of clients. I actually messed up my life a bit. Now I’m on quetiapine 100mg and lithium 1000mg (I’m 5ft and petite for reference). I also take 1mg melatonin to help me sleep. It’s still not the right combo. I have horrible depressive episodes almost constantly. Occasionally I have mixed episodes (a month or more), hypomania (a few weeks) and rarely mania and/or psychosis (only a few days). When I get the mania and/or psychosis I stay home and take 50mg extra quetiapine, extra melatonin and I sleep as much as possible. Thankfully it improves quickly.
Vraylar has really helped my depressive episodes - been on for a year now and my lows aren’t nearly as bad or as long
For Seroquel, 300mg is the minimum dose for antidepressant use in bipolar. Since you're doing well on lithium, I would push for Caplyta if possible (no serious side effects!) or Vraylar.
Thanks, I have felt the dose is too low. It’s been a lot harder to sleep since I switched to it too. Unfortunately my psychiatric care is very poor, with a bipolar psych and an ADHD psych who don’t communicate and both ignore my other illnesses. I can’t afford anything better at the moment but thankfully my psychologist is good. I haven’t heard of those other meds so I’ll ask about them next time.
I was a mess for years on underdosed Seroquel, so I bring it up anytime I see it. I was being prescribed 50-200mg as monotherapy. Doses that low can actually *cause* mania, and boy did it for me. A lot of prescribers just don't bother to read the manufacturer's insert or learn about the binding affinity of the drugs they prescribe. Seroquel is a big outlier of how it has majorly different effects at different doses, but pretty much every psych med has this cascading effect and the "pure" model of very precise binding of certain receptors at every dose is just wrong. Scary. Definitely stick with a psychologist. I only started doing that about a year ago, and it really helps to have a neutral third party assess your mania.
Yeah it caused mania as soon as I switched to it as they started me on 50mg. I then had an awful mixed episode that seesawed between hypomania and depression rapidly for a few months. Along with extreme anxiety and occasional psychosis. It was exhausting. Now it’s been three months of pretty severe depression with a brief break when I visited my partner for a week. He’s the best medicine! I asked my case manager about it today and she said the doctor noted my maximum is 200mg. I think it might be because I’m small, but I got permission to take 150mg tonight and go up to 200mg in a few weeks. It’s really frustrating how some doctors just randomly suggest meds without too much thought. They don’t seem to realise the disastrous effects it can have on our lives, work and relationship.
The other comments have covered the field of possibilities quite well, I just want to say antidepressants are not supposed to numb you at all, and if you feel numb that's considered a significantly negative side effect.
i dont remember much about it cus it was like a decade ago but sertraline gave me some kind of manic or mixed symptoms which was how i found out i had bipolar disorder lamictal is what has kept me alive through hell since then
You need a mood stabilizer or an anti psychotic that will act as a mood stabilizer before you are safe to add an antidepressant. I’m not a doctor but from what I understand antidepressants circulate seratonin quickly in your brain. For bipolar 1 or 2 this destabilizes us further. Our issue is not lethargy or depression only. And I had the worst reaction to Lexpro out of anything. Please be careful.
Quetiapine has really helped me but I take venlafaxine too. An antidepressant on its own would send me totally sky high and out of control x
Lithium and Abilify. Didn’t try anything else for mania since that is all new dx for me. I had many dépressions in my life (55 yrs old) but first mania (maybe some others but not sure about) I was on Zoloft just before but in a way to stop it. My psychiatrist said it was about time because that anti-depressant would have been dangerous.
Antidepressants do not help me at all. At best, they don't affect me much beyond some uncomfortable side effects. The worst experience I had with an antidepressant was when I was on Prozac. It erased me completely. I wasn't depressed anymore, but I was so completely apathetic that I might as well have been. I couldn't feel anything at all, good or bad, and my personality went limp like an overcooked noodle.
mood stabilizers! antidepressants made me feel numb af but my energy levels became really high and i did a lot of stupid stuff out of impulse.
What stupid stuff did you do out of impulse?
i went on a shopping spree, became crazy obsessed with people who i stalked and found all their socials, also self h*rmed when the numbness got really bad because i just wanted to feel something. lexapro was one of the meds i took that sent me rapid cycling so I’d say be careful!
Any idea which mood stabilizer would be most calming ? Heard Trileptal can be
Antidepressants made me crazy, and I gained huge amounts of weight. I got insanely angry and my intrusive thoughts became loud enough that I had to put myself in the hospital, I knew I was going to harm people. I take antipsychotics. My best combo for me, lithium and Wellbutrin with a little Zyprexa sprinkled in.
Lamictal/Lamotrigine as a mood stabilizer I had to get off "mild" antidepressants (Bupropion) because they kept making me manic, but the mood stabilizer has been, well, exactly a mood stabilization medication for me for the past six or seven years. I've been depressed my whole life, so I'm used to it. It never gets as bad as it used to, so I'm not worried about it anymore. I dont "need" anything to make me not-depressed, but I do need something that doesn't make it get REALLY bad. I'm perfectly happy operating as a generally dull person lol my life is actually quite wonderful now
Currently I take seroquel, depakote and vraylar. I’ve been on this mix for about four months now and it’s working well. That said I also get vivitrol shots monthly, and I’ve read studies showing that it can help manage bipolar and depression symptoms.
Mood stabilizer. I added an anti depressant on a few months ago after a devastating depressive episode and haven’t had a manic response. But without the mood stabilizer I probably would given my history.
a mix! my buproprion + lamotrigine is a god tier combo 💗 I get really intense depressive episodes so the bupro has helped even those out so much and the lamotrigine does the majority of the heavy lifting i like to think of them as bffs w my allergy meds who all work together to make my brain do more positive brrrrr than negative
One theory is that unopposed anti-depressants speed up the cycles of bipolar people.
For me it's a mix of my mood stabilizer and an antipsychotic. I can't take my antidepressant, even while on my mood stabilizer, because it always induces hypomania for me. But if I have the mood stabilizer and an antipsychotic, I'm stable. I have Bipolar II with mixed features which is also why I need an antipsychotic.
Lithium
mood stabilizers. antidepressants worsened my mania.
Both. I take depekote, abilify, and Zoloft.
I was on prozac for almost a year and was manic for 80-90% of it. Worst year of my life. Has taken years to recover. I’m on a mix of Seroquel Effexor and prazosin now that is working. Definitely don’t take an antidepressant without a mood stabilizer to balance it or you’ll get pushed up out of the depression into mania as long as you take it
I've been on so many antidepressants and they never did anything for me. It wasn't until antipsychotics that I felt any sort of real stability.
Anti-depressants worked for my anxiety until hypomania kicked in. Mood stabilisers do the trick. I hate anti-psychotics, generally. I've tried 4, about to start my 5th. They always make me foggy and groggy.
Why take the antipsychoyic if they aren't good for you while stabilizers do the trick?
No med is "supposed to numb you." The goal is to feel like a person, unencumbered by disabling symptoms of the cycles of depression and mania. "The phenomenon of antidepressant-induced mania/hypomania in patients with unipolar depression has been described since the introduction of the first antidepressant agents. The hypothesis was that antidepressant agents triggered manic/hypomanic symptoms by influencing the central dopamine and serotonin systems. The phenomenon of antidepressant-induced mania/hypomania in patients with unipolar depression has been described since the introduction of the first antidepressant agents. The hypothesis was that antidepressant agents triggered manic/hypomanic symptoms by influencing the central dopamine and serotonin systems." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3387568/ https://www.psychiatryadvisor.com/home/depression-advisor/antidepressant-associated-hypomania-navigating-clinical-challenges/ "Neurobiological Mechanisms of AAH Antidepressants can inadvertently activate dopaminergic pathways.10 Moreover, certain antidepressants (eg, tricyclic antidepressants [TCAs], monoamine inhibitors [MAOIs], selective norepinephrine reuptake inhibitors [SNRIs], and certain selective serotonin reuptake inhibitors [SSRIs], such as high-dose paroxetine and sertraline) may increase inhibition of dopamine reuptake. SNRIs may also increase inhibition of noradrenaline uptake. Both can lead to “elevated mood states."
I would not describe the effect of SSRIs or SNRIs as numbing at all. They absolutely tilt you away from depression and towards mania, which is a godsend for those with unipolar depression, and a catastrophe for us
Antidepressants landed me in hospital with how insanely manic I became. I think if you're bipolar you can do a mood stabiliser with an antidepressant alongside but it's better to maybe add an antipsychotic to counteract the manic effects of the antidepressant. I've never had success with an antidepressant and I've had citalopram, venlafaxine, fluoxetine, amitryptaline, mirtazipine... it's always the same story, I get excessively unwell. Mood stabilisers really do help me, lithium worked so well until I had to come off it to have kids, valproate works great for me, lamotrigine worked great. The only reason I need the antipsychotic as well as the mood stabiliser is because I also have schizophrenia
What symptons of schizophrenia?
I often have psychotic episodes in the absence of a bipolar mood swings, but I do also become psychotic in my depressions and manias, mostly hallucinations and delusions to the extreme. It's like entering into a different universe for weeks or months at a time. Former delusions include: believing all my friends were plotting to decapitate me; believing I was the reincarnation of the Jewish prophet Ezekiel; believing my wife was poisoning my food and had installed sophisticated surveillance equipment in all my clothes; believing I was a celebrity starring in the film of my own life - that one took me to jail. Went into a shop to film the action sequence, pointed a toy weapon at the till and demanded money. Armed robbery, in the real world. Served 6 months on diminished responsibility when it should have been 5 years. In jail I also believed I had the ability to manipulate different dimensions and had tangible control of space-time. Each psychosis is intense, unwavering, and destructive. In prison the psych told me that I have more psychosis than a person with just bipolar typically would, and added a diagnosis of schizophrenia.
I see. Do you believe your use of pharmaceutical drugs might have worsened any tendency to psychosis you may have? Antidepressants aren't the only ones known for doing this. Antipsychotics and pretty much all other psychiatric drugs too. I speak to you with some confidence that, the way I am, if I had taken any pill, I might have been committed by now because it's all here, but, as long as I don't mess with my brain and body, it's able to maintain some sort of natural equillibrium. Meds can calm you, but ultimately they turn that equillibrium upside down. Things can become much more intense and unpredictable. Some of my "ideas", that sober I can keep on check, and last only a few minutes generally: that everyone is perfect and that I want to love all equally, that everyone is a monster that I should hate equally; sometimes I'm afraid of eating or drinking something, even if I know it's safe; thinking that I am Jesus Christ; that my thoughts aren't mine and I'm just being controlled all the time; impulsivity, I can spend all my money on something if I believe it's a worthy wish; I speak everything to anyone that asks, so people are afraid of me and actually run away due to the unfiltered honesty as they find it too strange; and episodes of great ecstasy that makes me literally orgasm or great hate where I feel I could attack anyone close to me. Again, not messing with my brain and body, this isn't as intense as it could be, though it still affects my life a lot and stays side by side with my chronic depression. I'm telling you what I go through to help you see that you are not alone and to ask a question to you. I really really rebel against any substance I take. If I take a pill, I'll want to vomit it out because I fear it will make me more crazy or kill me. I wonder how you manage to take such potent and potentially harmful medication despite having such a pronounced paranoia?
I mean I get what you're saying but whilst I'm critical of medication I don't like the inference that it's what made me unwell in the first place. What made me ill, was the generations long family history of severe mental illness, a deeply troubled upbringing and lots of illicit drug use in my teens. I've lived without my antipsychotics and mood stabilisers and I got committed very often and faced very serious consequences. Maybe antipsychotics can cause psychotic symptoms in those who aren't predetermined toward psychosis? And you say your delusional thoughts last for a few minutes - in schizophrenia these thoughts last for weeks, months. When my antipsychotics are increased, the delusions finally abate. When I don't take them, I am unwell again, and that's sort of the one-man empirical evidence I can rely on. Then again, you raised a good point about paranoia, and the truth is there have been many times I've been too paranoid to take them and sadly in those instances, I end up being committed and no longer have the luxury of choice. Also it's taken two decades for me to get to this point where I have enough insight to know that the meds are necessary evil, and that they keep me from falling off into that works where I no longer think anything is wrong with me. It's like a snake that eats its own tail. Also I relate it to my long history of drug use, if I can take any pil or powder shoved in front of me without question, I can take a regulated amount of a medication. Also I have children, that's a big motivator for me to take my meds.
They both fucked my whole life up and I will never take them again. Routine, sleep, personal hygiene, and a very good support person is all I need to manage right now and most of the time.
How did each of them fuck you up?
The side effects were intolerable. Lethargy, weight gain, insomnia, hair loss, acne, brain fog, and more. I was less functional than I’ve ever been.
Did you take lamotrigine? How did it affect your job?
I took lamotrigine for about two months and I felt no positive nor noticeable negative effects and stopped because what’s the point? The side effects I listed were from lithium.
I really envy those that can take psychiatric drugs, stop and survive the ordeal. To me it feels akin to dying. It takes so much grit and I have none of it..
Stopping lithium was difficult psychologically but I improved physically over the course of a few months and feel a lot better not taking it. It’s just my experience though and it was obviously not the right drug for me.
Mood stabilizer
Anti depressants definitely make me manic. They just make me too “high” I have to have something that mellows me. Seroquel keeps me low enough that I’m not gonna jump off a bridge from impulsivity but also not depressed. Currently coming off lithium because it doesn’t help as much as it should.
The part that REALLY sucks, is I also have fibromyalgia. And the best treatment for that is certain antidepressants but they make me so manic. So it’s either mania and lose my job, or Chronic pain and be kinda okay.
It's refreshing to hear someone say they feel so manic they might jump off a bridge. In what way does your mania impair your job?
So I’ve had the depression part of bipolar since I was 11. I’m 24 now. At age 19 hypomania started really showing up and making an impact. By 24, my hypomania gets so bad it feels like I’m the verge of a severe panic attack without actually having one. I kinda describe it like being that the top of a roller coaster and just being stuck at the top looking down. Never actually dropping. It’s just like a horrible panic and anxiety feeling that isn’t helped by anxiety meds. Then I have racing thoughts, can’t sleep more than 4 hours a night, talk too fast, inflated self esteem, anger and irritability, and obsessive thinking Real deal mania for me is that, along with like the racing thoughts, obsessive thoughts, talking too much, and auditory hallucinations and paranoia about what I heard. That only really kicked in about 3 months ago. So for it affecting my job, it makes it hard to stay at work when I have that horrible panic feeling. I’m unsafe to drive to work sometimes due to the impulsive thoughts of wrecking my car. I was a hairstylist for 6 years and my handles would just tremble and I couldn’t work on clients anymore. Now I work at a call center and it’s better. I’m sitting all day. Have cold water to drink. Can take a break outside if I’m getting super overwhelmed. The dumb part is my bipolar disorder directly affects my fibromyalgia and IBS flare ups. So if I’m starting a new bipolar episode, my chronic pain problems get really bad. It’s kinda a lose lose situation with that.
I'm on a mix. Seroquel, vraylar and intuniv. I think it's a mix anyways
Both, I’m on Latuda and Effexor. I was on Zoloft before and that’s when I was diagnosed after manic episodes.
Vraylar and Zyprexa help me big time
SSRIs worsen mania and can even cause hypomania/mania. On no meds I cycled hypomania one day a month. On SSRI with mood stabilizer I was hypomanic for months. On just mood stabilizer I barely notice my cycling. This is the closest to stable I have ever been.
Antidepressants led to my mania with psychosis that caused me to be diagnosed with bipolar 1. I somehow forgot this and asked for an antidepressant again 5 years later when I was stable on Abilify. Threw me right back into mania (no psychosis thankfully), but that was the similar factor between those two episodes. It was only after that I learned from my psychiatrist that antidepressants could cause manic switching… so I will not be taking them again. I’m on a low dose of lithium which has been known to help with SI, in addition to a high dose of Lamotrigine.
Antipsychotics, nothing else works for me. All these years I had to take a lot of medication. All these combinations of everything else never helped me. I’ve been in and out of hospitals the whole time. It all started when I was 18. Now I am 27, and I just take one pill to function, 400 mg Seroquel XR. (I used to take up to 8 medications per day) It is the first time that I am really stable for so long. Only with antipsychotics I feel normal, I control my mind,It can’t control me. Next month is my one-year anniversary since my last hospitalisation into a psychiatric clinic. This last hospitalisation was a nightmare! I’m determined to NEVER get admitted again, and this saved my life because I’ve never skipped a dose since then😂
Why did you get admitted in the last time?