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520191 tn?1355635402

Bipolar Depression Medication

Do anyone know of any good anti depressants that don't make you manic but good for bipolar depression? that are less likely to cause mania or psychosis? Or other medications that have been helpful for depression. My pdoc wants to put me on Effexor but my therapist doesn't think that's a good idea as can cause Mixed, mania, and psychosis in someone with those issues. So for the moment i said no. but can feel myself sinking into depression again.

What do you think? What are you on if any?

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585414 tn?1288941302
    Some mood stabilizers have a greater anti-depressent effect than others. Ask your psychiatrist which medications they would be willing to prescribe as some mood stabilizers that are fda approved medications used off label to treat bipolar are not in use by all psychiatrists. Then from there ask about the specific side effect profile and efficacy of each one as regards its effect on depression and you could also look up the medication website. From what I am reading Amisulpride like Seroquel does have a mood stabilization effect and actually has shown efficacy on depresion though only a psychiatrist would understand this in full. I have found Lovaza which is used off label as a mood stabilizer to be effective on both mania and depression but it would depend on whether a psychiatrist was familiar with its use but more are. Best to research and find out and discuss this with your psychiatrist.
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520191 tn?1355635402
I forgot to add, I am on a mood stabilizer. I am on Lithium, Amisulpride, and quietapine.
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574118 tn?1305135284
>>>My pdoc wants to put me on Effexor but my therapist doesn't think that's a good idea

strange that your therapist understand psychiatry more than your pdoc. INDEED any AD will cause mania after a while (can take months, weeks or even a few years, the longer it takes to produce mania the more difficult to extinguish it).

This question I asked here long time ago whether there exists an AD that doesn't drive you manic. Nobody came up with an answer simply because it doesn't exist. Had it existed then BP would have been cured. WHY ? because any AD that doesn't drive you manic will not get you depressed either. SO you are cured since no Bi-polar i.e. the 2 poles won't occur. Unfortunately I tried all of them except effexor or prozac but I dare not to; coz i know the consequences. Of course some will tell you try lamictal (AC) or abilify (AP) as they are activating but still you won't get the NICE feeling of an antidepressant.

sorry, you have to find other ways. If you live in the USA or any western country then you are lucky coz they have some nutrients on the market rich of tryptophan (precursor of seretonin), 5-HTP, glutamate etc... omega-3, etc... i haven't tried St John's wort though they say it gives mania.

Your question may seem simple to you but in fact the most difficult one, coz as i said if such AD exists then bye bye to BP.

My question though can be slightly different taking a different turn: BP is mainly a fluctuation in the dopamine and a deficiency in GABA. a higher dopamine makes you manic and a lower one lowers your mood and with a lack of energy. Now BP is mainly a mood disorder and not an energy disorder, why ? coz it has 3 phases:

1. mania (higher energy, higher mood)
2. depression (lower energy, lower mood)
3. mixed states (lower mood, higher energy)
4. rare case (high mood, low energy)

so if you can boost your mood you delete 2 and 3. For 1 people only know the AD"s to do it, but unfortunately somehow increasing your mood will automatically give you energy thus --> manic. So the question is whether one can increase the seretonin without touching upon the dopamine is the trick. People say use something which doesn't reduce dopamine but kills the irritability, anxiety and so forth. What is that, I don't know yet, or whether it exists for start.

finally, there are two ways to fight mania: the rude one - just killing dopamine not bothering at all that mood and motivation will be killed too (by using antipsychotics which i do) . And the gentle one - calming down amygdala and other problem brain areas with GABA, without touching the dopamine level, thus preserving mood, energy and motivation. It's up to you, which way to choose. BUT surely stay away from any AD by all means.

good luck
i don't know Amisulpride but seroquel/quetiapine is good for the mood. Sorry but this is all i know. OF COURSE because had i known an answer i would have not posted here and lived in peace ever after. Patients across the continent don't have an easy answer to any of the questions raised here, neither i think their pdocs
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574118 tn?1305135284
i forgot to tell you that AD's not cause mania but worse mixed states, & rapid cycling
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Avatar universal
I use seroquill xr. It works great. At first there were some side effects, but ten months and none. I take seroquill around eight o'clock pm. Just once a day. It also helps me wake about eight hours later. Used to be up until 4-5 am. I have angry manics mainly and those have been way in check for ten months due to seroquillxr.

keep seeking answers,
zzzmykids

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574118 tn?1305135284
sorry for iterating. But your question i shall put differently because PERHAPS someone knows anything

Does anyone know of ANYTHING ( BUT NOT an antidepressant) that elevates the mood but does not make you manic

please answer if you know or according to your experience
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Avatar universal
Lamictal is a mood stabilizer with AD traits. For many people you can take an AD if you are also taking enough of a mood stabilizer but there is no guarantee.
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520191 tn?1355635402
Thank you for all your comments, I will talk to my pdoc next time i see her about it.
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574118 tn?1305135284
thank you i am aware of that as i wrote above, but this i wasn't asking for. as to increasing the MS with an AD is the majority of the cases. but isn't a good solution because you cover something by increasing the side effect of another
thanks anyway. in any case it proves my point that there is no such thing yet, i.e. that regulates the mood without an AD.
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574118 tn?1305135284
this Amisulpride is completely new to me. i shall look it up. about lovaza this is omega-3 strange it's potent thanks
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Avatar universal
First of all, I have taken many antidepressants without getting manic -- but I have been on mood stabilizers at the same time. Wellbutrin and Effexor are supposed to have low switch rates. I take Cymbalta with no switching.

Ziprasidone has properties of serotonin and norepinphrine re-uptake, which thus has antidepressant properties, and is also a mood stabilizer. It is sometimes necessary to start at a fairly high dose because it can cause anxiety at lower doses. The downside are some irritating side effects, which can be bothersome, but this doesn't mean it would affect you this same way.
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