Your experiences with antidepressants

I'm thinking about starting one, but there are just so many out there and then there's worry about mania/mixed mania. I think my current combo will keep me from getting manic. There are just so many antidepressants and I'm looking for experiences with particular ones.

For me personally ADs are evil meds. Even with mood stabilizers they throw me into a mixed episode. Without mood stabilizers they throw me into wicked mania. Even trazadone which some pdoc consider a sleep med and not an AD is off limits for me. My one hard fast rule regarding meds is NO ADs.

It depends I guess. I've had problems on some but I'm currently taking (Paxil) along with 2 APs and a moodstabilizer so I'm not having any issues

Ditto for me. They do nothing good for me at all. They always either make me manic , manic with mixed features, or some crazy form of ultraradian cycling. The last time I attempted to take an antidepressant, my psychiatrist himself warned against it (my stupid therapist at the time told me to ask for a particular one). Reluctantly, my psychiatrist prescribed it and it was a total mistake, indeed. Prior to that, some IP and IOP psychiatrists tried prescribing antidepressants WITH moodstablizers AND antipsychotics, and I ended up IP again and again. I only found longer-lasting stability when antidepressants were removed from my cocktail once and for all. I haven't taken an antidepressant for 8 years and I haven't been in the hospital for 8 years. That doesn't mean I haven't had manias since then, but they were easier to contain with medications like Seroquel XR and other antipsychotics. Frankly, depression hasn't been much of an issue for me since then, anyway.

Definitely, no ADs = no IP. Have been in PHP and IOP since stopping all ADs but no IPs.

I've been on ADs from all classes. I won't list them all because it would be huge. I'm not remembering everything but here's a sample list.

SSRIs are a sure trip to mania.

Wellbutrin made me sick and I lost 30 lbs in 6 weeks.

Remeron worked until it didn't but I think it had a stabilizing effect on me for at least a while.

Effexor was good but I never could reach a high enough dose before maxing out. It also increased my blood pressure.

Tricyclics have been mixed; two didn't work at doses I could tolerate. Imipramine did work for me for a while but only because it comes in 10 mg pills and we could adjust my dose up and down weekly if needed. I would range from 50-90 mg. Eventually that became impossible because I was needing more but not handling it well and that's when I went on the MAOI, Emsam.

I made a post about Emsam but I've been on it 10 years now and while we do have to adjust the dose sometimes it doesn't seem to cause mania. If I head up into hypo I have to watch and sometimes lower my dose briefly but it's easy to manage, especially with being on it and gaining experience for so long. It also is balanced by my AP.

If I ever have to stop Emsam I'd try another MAOI. I'm not sure if I would try other ADs; there are a bunch of new ones since I tried anything besides imimpramine or Emsam but the effects would be hard to predict.

Spikes, do you have any specific ones in mind? Or groups?

In November 2018 I was smashed by a severe depression that has followed a severe dysphoric mania. I was desperate and asked my pdoc for ECT. She agreed, but said before she scheduled that she wanted to try one med. The med was Pristiq, and it was extremely helpful for me, especially for making it through the winter.

My pdoc *claims* that Zoloft is an SSRI "that is least likely to trigger mania compared to other SSRIs." I don't know if there is any truth to that statement, but he said that. So I suppose if you are being pushed into taking an SSRI and given the choice of which one to take, I would probably ask for Zoloft to be on the safe side. But lots of people with bipolar have difficulties with SSRIs like BeyondTheRainbow implied, so even Zoloft may make you manic. So, I *personally* think SSRIs should be used as a last resort for people w/ bipolar even though some people (like myself) can tolerate them really well.

Also, my grandma had bipolar and became manic on both Trazodone (SARI) and Remeron (tetracyclic), FWIW. So really, YMMV even with non-SSRIs. She literally slept like 2 hrs in the span of 3 days while in IP on Trazodone. IP pdoc had to take her off it immediately because she was totally tripping out. She was initially given it to sleep because she was getting 4 hrs a night, but it just exacerbated the sleep issues and she started seeing weird sh_t.

But anyway, I know lots of people on this forum have had good luck with MAOIs, Emsam in particular. However, I know that Wildflowerchild25 was on Emsam for a while and then (if I'm remembering right) her insurance stopped covering it. I'm guessing that's because there is no generic yet and also likely because antidepressants technically aren't recommended for people w/ bipolar. (My insurance has rejected meds based on whether or not they are "approved" for treating bipolar.)

Bipolar II -

I had been on almost all AD meds,as well as combinations thereof, for years and years.
In time, I was diagnosed as BPII. My current pdoc claims that if a panel of experts gathered anywhere in the U.S., they would tell the practitioners that the goal with BPII clients is to eventually get onto a mood stabilizer only, preferably lamotrigine.

That said, sometimes people need AD meds. I had found Celexa was a good one for me. It really calmed agitation for me. However, my new pdoc felt it was keeping me from reaching maximum stability. We dropped it once I was on a good dose of lamotrigine.

Years ago I was only diagnosed with depression and anxiety (not bipolar) and Nortriptyline and Effexor both helped me. Since being diagnosed as being on the "bipolar spectrum" I have done well on Cymbalta combined with Zyprexa, Cymbalta combined with Geodon and am currently OK on Remeron with Geodon but not as good as I've been in the past, so my doctor is adding in Lamictal soon. (As an aside, I haven't been thrilled with my doctor lately so things are subject to change!)

Other antidepressants I've tried include Prozac, which was OK but not very effective and Wellbutrin which I had high hopes for and don't recall why it didn't work well for me.

I've been on a SSRI two months ago and it was quite a strange experience for me. I started feeling better after three days of taking it (which is strange) but I was still suicidal. After two weeks, I started to sleep quite badly and had racing thoughts. My doctor told me it was a mixed state and I got different medication.

Sertraline made me psychotic as well as partially catatonic (though some of that catatonia was preexisting). It's the only time I've ever been psychotic. I wasn't cognitively able to read - the symbols had no meaning. And I didn't speak for a week. And I believed my mother had been replaced by a robot and was dangerous. And a host of other crazy effects. Basically completely destroyed me. I am 100% sure it was the sertraline because I was on no meds before that and no other type of change.

Wellbutrin lifted me out of depression very quickly, like within two days, and then kept going and pushed me into hypomania. Pdoc stopped me from taking it at that point but I'm sure it would have taken me into mania. Also, it gave me a terrible headache.

Prozac made me hypomanic constantly even on a tiny dose.

I switched pdocs due to moving and my new pdoc said never take any antidepressant ever again, and list them as a drug allergy.

I have spent enormous amounts of time at the extreme end of the down pole. Have been on way too many antidepressants to even remember them all. The problem with traditional antidepressants in bipolar 1 is that we are trying to play this very delicate balancing game between depression and mania/psychosis. You're too low and it's awful and potentially dangerous. You're too high and it's a disaster and potentially dangerous. It's very, very hard to just dial it right in to somewhere nice in the middle. That said, I have had good luck with a few antidepressants (and not gotten manic) including Cymbalta, Wellbutrin, and Remeron. I had a bad reaction to Emsam and I don't think it really helped me very much, but others have had good experiences with it. I don't think lamictal did anything for me but lithium, contrary to the traditional teaching about it, is clearly helpful for my depression. No question about it.

There are a million options. Keep talking to your pdoc and I'm sure you guys will come up with a good plan. Just don't be surprised if you have to make some adjustments along the way. As this thread shows, everyone responds to a given antidepressant in his or her own way.