Posted by Ron Hill on March 7, 2003, at 11:27:10
In reply to Please help, it's 5am-effexor mania, posted by KrissyP on March 7, 2003, at 7:27:34
Kristen,
> I took my Effexor-XR at 11pm last night, went to bed at about 12:50AM, and I am up and manic.
Sorry you’re having trouble, but hang in there, this can be fixed. I can not take Effexor or any of the SSRIs. They all push me into hypomania (initially). After that they cause a reduction in dopamine levels resulting in blunted emotions, lack of motivation, anergy, etc.
I subscribe to the position held by Dr. Phelps regarding the use of antidepressants for bipolar patients. He believes that bipolar patients should be treated with moodstabilizers first and foremost. If the depressive phase does not respond to the moodstabilizer (or combination of moodstabilizers) and it is decided that there is no other option but to add an AD, then MAOIs are best suited for the BP patient. Here is a link to his web site. His site is not very user-friendly, but if you click around you will find what I'm talking about. Click on "antidepressant controversy" or something like that. Click through the entire site if you have time.
http://www.psycheducation.com/
Also read the relevant portions of the American Psychiatric Association's document entitled; PRACTICE GUIDELINE FOR THE TREATMENT OF PATIENTS WITH BIPOLAR DISORDER (Revision). Here a link to it.
http://www.psych.org/clin_res/bipolar_revisebook_index.cfm
>I am thinking of just stopping the Effexor
If you do, reduce your dose VERY slowly to reduce the risk of severe withdrawal side effects (including severe dizziness, nausea, etc).
>I also took Lamictal 50mg, my usual 100mg Seroquel, 2mg Klonopin, my Stresstab, and Cal-Mag.
50 mg of Lamictal is nowhere near the therapeutic dose level. You currently have very little mood stabilization on board. Is your pdoc in the process of slowly ramping up the Lamictal?
Your dx is BP II, correct? What is you medication history; how long ago did you start taking meds, for what reason, which meds have you tried and how did each med make you feel?
-- Ron
poster:Ron Hill
thread:206768
URL: http://www.dr-bob.org/babble/20030306/msgs/206822.html