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Default Jan 01, 2020 at 05:23 PM
  #1
Hello,

I've been feeling depressed and have a lot of anxiety and my psychiatrist suggested taking an SSRI with my meds (Latuda, Lamitcal) like Prozac or Zoloft. I have read that it can cause mania....I really want to lift my mood but I don't know if the benefit is worth the risk of mania/psychosis. I would like a "balanced/normal" state. What is your experience of taking an SSRI? Did it push you into mania/psychosis? I have to admit, I would love to a have a little boost/ or high in my mood but just the right amount.

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Default Jan 01, 2020 at 08:57 PM
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Originally Posted by Jennyanydots View Post
Hello,

I've been feeling depressed and have a lot of anxiety and my psychiatrist suggested taking an SSRI with my meds (Latuda, Lamitcal) like Prozac or Zoloft. I have read that it can cause mania....I really want to lift my mood but I don't know if the benefit is worth the risk of mania/psychosis. I would like a "balanced/normal" state. What is your experience of taking an SSRI? Did it push you into mania/psychosis? I have to admit, I would love to a have a little boost/ or high in my mood but just the right amount.
I have been on a few and none did diddly for my bipolar depression, but that doesn't really mean much, as we are all as different as a thousand snowflakes. There is no question that some people can become too activated and manic on some doses of some of these meds. So, beware.

That said, I have a belief that way too many psychiatrists in the US take mania incredibly seriously--as we all should--and don't really give a flip about maximally treating depression. Sorry, I know this may offend some--I apologize. It's just been my experience with more than one shrink that there is this attitude of sort of, as long as he's not manic, we're good. I hate that, because it says you don't care about the overall quality of my life, you really only want to make sure I don't think I'm Jesus or running naked down Broadway. Which is a noble goal, but should not be the only goal.

So anyway, if you decide to do it, have a big-time plan in place to identify and act, should you start getting hypo. It is essential.

I really feel for you. As you can tell, one of my major gripes about my lifetime of bipolar care has been the incredible lack of urgency by various pdocs about the misery caused by my depression. It makes me sad to think about it. Needless suffering, in my view. I hope you feel better really, really soon.

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Default Jan 01, 2020 at 10:10 PM
  #3
When I was younger SSRI's were very helpful. I have been on each one of them at one time or another.


As I've become older I have found that the SSRI's are not helpful, but I'm on an SNRI (Pristiq) and that has really helped me.

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Default Jan 01, 2020 at 10:58 PM
  #4
I was on Prozac @ 20mgs (was once the standard dose, I think...) and it was pure gold at first. fewer ruminations, calmer, mood lifted a bit, and...wow. its like it ****ed my neurons in all the right places. and then...

tremor, because it boosted Abilify blood levels. shrinky shrink reduced Abilify. more and more apathy. laziness. excessive sleeping, with...nightmares, bu I was kind of apathetic about the nightmares...

so I dropped it. good thing: Prozac has a long, long half life. dropping suddenly....not a big deal, it seems to have self-tapered. another bonus: i doubt shrinky shrink would have reduced Abilify, otherwise. so, now I'm on a lower (but still effective) dose of tranq.

in -general- , a lot of people find ssri drugs apathy-making. not trying to scare you, its just...it is what it is, basically. and sexual dysfunction is kind of a big thing, and some people say that can persist after discontinuation (I'm thinking that'd be long, long term use?). and...because I'm in it to win it with Abilify (not a huge fan, just..I can actually tolerate it, that's all), I did a little bit of research on antidepressants+tranqs, and...it seems that the TD risk -might- go up, which makes sense, because....

now, there are emerging cases of TD coming from the antidepressants (ssris, in particular), without the additional use of neuroleptics or anti-nausea drugs, (both those categories of drugs are known to cause TD on a fairly regular basis).

and...again, not to scare you, but...there's -some- data/research that would seem to indicate that in -some- people -some- times, ssri drugs buy short term relief, but over the long haul, make depression more severe, more frequent, more disabling, and eventually..."treatment-resistant."

blah. i dunno. oh, and drug induced psychosis, agitation, mixed states, mania...those happen, too, to get back to your concerns, finally. how often? good question. some "critical psychiatrists" obviously have their own agenda to push in demonizing the drugs, I'd argue that most work a day shrinky shrinks have a vested interest in deliberately ignoring evidence of drug-induced harm, so...

ugh. have you tried Wellbutrin?
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Default Jan 03, 2020 at 09:44 AM
  #5
I was already on Abilify. My new pdoc suggested Welbutrin and lamictal. It pulled me out of a long and deep depression. So far, no bad side effects. Only been on this for a couple of months. Hopefully, the good results will continue.

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Default Jan 08, 2020 at 07:44 PM
  #6
lexapro was the worst thing I have ever taken . . . can we say ip . . . prozac did nothing . . . just started Viibryd . . . little dizzyness but going to give it a few more weeks . . . took doxipen for years but really was just so so . . .

as said above I believe pdoc's want us all depressed . . . . JMO . . .

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Default Jan 09, 2020 at 09:42 AM
  #7
Lexapro made me manic, same thing with zoloft. I take paxil and wellbutrin now in addition to my other meds and have had no issues

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Default Jan 10, 2020 at 10:32 AM
  #8
I have been on Zoloft for many years, and it does help; WITH the addition of mood stabilizers. When I was initially seen by my primary physician many years ago, I was put on Zoloft. It perked me up. Too up. I started seeing a Pdoc shortly after, and we added Lithium and Depakote. Lithium is great. Depakote did nothing for me.

Years later, when it seemed like Zoloft was petering out, we tried a switch to Wellbutrin. Instant Manic. Irrational, rage, seeing things. I obviously switched back to Zoloft. I tried Effexor, with about the same result as Wellbutrin with the addition of sexual side-effects.

As you know, meds affect all of us differently. For me, Zoloft has been a great med overall. I have been taking Zoloft, Lithium and Lamictal for quite a while now and it's the best combo I've found. For Me.

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Default Jan 10, 2020 at 11:50 AM
  #9
I wouldn't but that's me. I can't take any AD with or without mood stabilizer and or APs. But many bp2s do take an AD and it works for them

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Default Jan 21, 2020 at 06:48 PM
  #10
When I started SSRI's, they initially had a positive outcome. After several months, I felt very tired all day, and even though my mood improved, I was kind of upset that I had no energy to do anything.

I was advised by my pdoc to take them before bed instead of in the morning to wear out the sleepy side effects, which did work at first.

Being bipolar 2, I did notice through the SSRI's and talk therapy, my thoughts began to slow down (I guess from being tired all the time) and I was able to handle my racing thoughts better.
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Default Jan 21, 2020 at 11:06 PM
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Originally Posted by bpcyclist View Post
....
That said, I have a belief that way too many psychiatrists in the US take mania incredibly seriously--as we all should--and don't really give a flip about maximally treating depression. Sorry, I know this may offend some--I apologize. It's just been my experience with more than one shrink that there is this attitude of sort of, as long as he's not manic, we're good. I hate that, because it says you don't care about the overall quality of my life, you really only want to make sure I don't think I'm Jesus or running naked down Broadway. Which is a noble goal, but should not be the only goal.
....

Yes, yes!!! I could not agree more. In fact, I find it frustrating that I have to entirely give up mania, but still have an ongoing struggle with depression, anxiety, and obsessive rumination. I mean, if I'm stuck with a chronic mild depression and crappy anxiety- why can't I have a mild hypomania?

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Default Jan 22, 2020 at 02:07 PM
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Just sharing my recent, good experience with Prozac.

I was hospitalized in August (I think) for a psychotic/manic episode, then again in September/October for a mixed episode. The manic part was treated with loads of haldol and risperdal and left me in a suicidal depression, for which they started prozac. My IP doc said he wasn't worried about mania because I was already in the hospital so it wasn't so risky. It worked pretty well (combined with risperdal), and within a couple weeks I was out of the hospital ready to tackle life again. I recently came off of it with the okay from my outpatient provider to start it again if I begin to swing low. I've had a couple of days of minor hypomania, but nothing too out of control.
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Default Jan 22, 2020 at 05:07 PM
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SSRIs have pushed me into mania/psychosis even with a mood stabilizer. I started thinking the FBI was after me and wrote letters to my former employer, who I thought was against me and going to do something bad to me. This is only my experience, so I just figured I'd share and encourage anyone with Bipolar to be cautious and mindful of any "warning signs," if you start an SSRI.

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Default Jan 22, 2020 at 08:16 PM
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Just sharing my recent, good experience with Prozac.

I was hospitalized in August (I think) for a psychotic/manic episode, then again in September/October for a mixed episode. The manic part was treated with loads of haldol and risperdal and left me in a suicidal depression, for which they started prozac. My IP doc said he wasn't worried about mania because I was already in the hospital so it wasn't so risky. It worked pretty well (combined with risperdal), and within a couple weeks I was out of the hospital ready to tackle life again. I recently came off of it with the okay from my outpatient provider to start it again if I begin to swing low. I've had a couple of days of minor hypomania, but nothing too out of control.
I am so sorry you have had such a rough go of it. I am glad you seem to feel a bit better now and hope it continues to look up.

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Default Jan 23, 2020 at 04:12 AM
  #15
I know SSRI's are popular antidepressants and often prescribed to people with bipolar. IMO they should not be the first choice. I have no science to back this up but I believe people with bipolar do better with SNRI's like cymbalta. Or even tricyclics like wellbutrin.

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Default Mar 10, 2020 at 06:58 AM
  #16
From what I know of the research, SSRIs don't usually push people into mania, but they do lower the threshold for mania. So, it's related, but not a definite. When I've been on SSRIs in the past they haven't pushed me to the manic side. Sometimes they help with the depression, and in one case it made me more depressed. I'm on Lamictal and Latuda as well. The Latuda seems to act as my antidepressant. I was on Wellbutrin mostly for focus issues, but then I changed to a different medication. In general, though, I'd think it's safe to be on an SSRI, especially in conjunction with a mood stabilizer and an antipsychotic. Obviously, though, talk with your doctor about your anxieties and concerns.
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