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I know that a lot of bipolar folks take an SSRI as part of their daily regimen of meds and apparently it seems to help.  But there's some growing concern in the pdoc world now that SSRI's may be causing manic symptoms and even directly causing manic episodes.  I was on SSRI's for 10 years before quitting last October.  In chronological order:  Celexa, Zoloft, Celexa again, Lexapro, Zoloft again, Prozac, Zoloft again briefly, back to Prozac to close it out. 

For me, personally, after stopping them altogether, I was able to see what they were doing to my system.  I truly believe they made me much more unstable and greatly increased compulsiveness and just made a bad situation worse.  Switching from Lexapro to Zoloft sent me immediately full-on hypomanic for over a month in early 2015.  I was high as a kite and on top of the fucking world.  It was unreal and so obvious at the time. From the beginning of it, I was certain something unusual was going on. Now I wasn't diagnosed bipolar yet, just depressed, so I didn't even know what hypomania was then.  It fizzled out eventually (sigh) but I had at least two more, shorter, and less intense episodes late spring 2015.  I've not had anything quite as euphoric as those since.

My last pdoc expressed some concern about the prozac but wasn't very insistent on me stopping it, just that I would want to eventually.  I've since read that there is increasing concern in the pdoc community.  Yet a lot of bipolar people still take SSRI's and don't seem to have problems. 

Do SSRI's seem to help your causes?  Do you notice any unusual side effects?  Have any of you stopped taking SSRI's and noticed a change?  Other comments?   This could be interesting.

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I had to stop taking SSRI/SNRI medication because if they didn't cause balls-out mania, they caused something I hate even more:  Apathy.  Just this wet fucking blanket of apathy where I didn't want to do anything, didn't have the desire to enjoy myself, and because of the meds, was totally okay with not giving a fuck about anything I ever cared about.  I couldn't write, I couldn't play games, I didn't want to talk to my friends, I didn't want to discuss shit on the internet, I didn't want to take care of my own body or my household, and I was totally, absolutely okay with that.

Currently taking an atypical antipsychotic and a mood stabilizer and it seems to be working pretty well.  At least a little more shit is getting done.

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10 minutes ago, Bad Haiku said:

I had to stop taking SSRI/SNRI medication because if they didn't cause balls-out mania, they caused something I hate even more:  Apathy.  Just this wet fucking blanket of apathy where I didn't want to do anything, didn't have the desire to enjoy myself, and because of the meds, was totally okay with not giving a fuck about anything I ever cared about.  I couldn't write, I couldn't play games, I didn't want to talk to my friends, I didn't want to discuss shit on the internet, I didn't want to take care of my own body or my household, and I was totally, absolutely okay with that.

Currently taking an atypical antipsychotic and a mood stabilizer and it seems to be working pretty well.  At least a little more shit is getting done.

Yeah apathy is probably very common among us but is not discussed so much.  Some SSRI's caused serious apathy for me, while others did not.  Prozac was the worst but the best at keeping me from the deepest lows consistently.  Even when I stopped Prozac, I didn't care to do a damn thing.  I could sit on the computer but I didn't care about much at all.  I went back on Bupropion at 150 mg to quit smoking again and that snapped me out of it big time. I hadn't realized how bad I was until I got back to normal.  The bupropion is activating though and does not help my temper at all, but I'm paying that price at the moment.  I need to figure out soon if I want to stay on it.  I think it's keeping in semi-hypomanic mode nearly constantly.  I've definitely been less depressed.  And just like you put it "At least a little more shit is getting done."  I finally overhauled my garage after ingoring it for 2 1/2 years.  And I got on it a week into the bupropion.  Totally snapped my ass out of a big funk.

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1 minute ago, Distorted Me said:

Yeah apathy is probably very common among us but is not discussed so much.  Some SSRI's caused serious apathy for me, while others did not.  Prozac was the worst but the best at keeping me from the deepest lows consistently.  Even when I stopped Prozac, I didn't care to do a damn thing.  I could sit on the computer but I didn't care about much at all.  I went back on Bupropion at 150 mg to quit smoking again and that snapped me out of it big time. I hadn't realized how bad I was until I got back to normal.  The bupropion is activating though and does not help my temper at all, but I'm paying that price at the moment.  I need to figure out soon if I want to stay on it.  I think it's keeping in semi-hypomanic mode nearly constantly.  I've definitely been less depressed.  And just like you put it "At least a little more shit is getting done."  I finally overhauled my garage after ingoring it for 2 1/2 years.  And I got on it a week into the bupropion.  Totally snapped my ass out of a big funk.

I love Wellbutrin in small doses, but once I get to what the doctor considers a 'therapeutic dose' I start having these horrible fits of rage.  Maybe an increase in Lamictal would temper the anger a little. (Lol, puns.)  Maybe I'll try it again.

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I only recently heard the term "Wellbutrin Rage" so I didn't know it was so common.  I'm clearly affected by it even in low dosages.  I'd say 90% good but 10% bad.

In mid 2015 a pdoc wanted to try me on 450! mg of bupropion just to see what happened.  All fucking hell broke loose and I didn't know what hit me.  I got so unbelievably emotional.  I would have crying spells out of nowhere for 1/2 hour and I felt like I was wound up like a clock.  I'm at 100 mg on lamictal right now going up to prob 300 eventually.  I like it better than any other I've tried.  I have a feeling lamictal by itself is going to be 80% of what I need to be stable. 

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My current pdoc is pretty set against SSRIs for BP...especially BP1. Apparently some research has shown that even if it doesn't cause problems, the SSRI is less likely to be helpful than another mood stabilizer or AAP. This has been true for me will all antidepressants (either didn't help or caused manic/rage reactions). I'm of the mind that choosing to try a AAP or something like lamictal is definetly the safer choice and can definetly be more effective as well. However, clearly some people with BP do ok on SSRIs and other ADs...probably a good reminder that bipolar disorder is a diverse spectrum and not a black and white condition 

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13 hours ago, Iceberg said:

My current pdoc is pretty set against SSRIs for BP...especially BP1. Apparently some research has shown that even if it doesn't cause problems, the SSRI is less likely to be helpful than another mood stabilizer or AAP. This has been true for me will all antidepressants (either didn't help or caused manic/rage reactions). I'm of the mind that choosing to try a AAP or something like lamictal is definetly the safer choice and can definetly be more effective as well. However, clearly some people with BP do ok on SSRIs and other ADs...probably a good reminder that bipolar disorder is a diverse spectrum and not a black and white condition 

Great summary of what I think is basically the current situation.  Seems to be a definite shift occurring.  Some pdocs are still ok with SSRI's for BP, while others, probably a minority right now, are pretty strongly against it.  My personal experience is most are still ok or supportive of SSRI's for the antidepressant effect but only in conjunction with mood stabilizers or other psych meds.  They're just not ready for wholesale change yet. I guess the psych meds are keeping things in check, but I don't like this personally.  After I quit SSRI's completely in October it was so obvious how destabilizing they were for my system (but yes I never had psych meds with them).  I felt so much calmer, clear headed - like painfully obvious change there.  And then I looked back at the last 10 years on them and saw how much more emotional and compulsive they were making me - I'm BP you know I don't need any more of that.  Obviously I can't be 100% certain but I'm 99% and my gut agrees.  There were other weird things like getting frozen at my front door, unable to walk out and go to work.  I'd just sit there with my mind saying "get up and go" then "no don't go" with my ass glued down unable to move for an hour.  I can't say for sure that was SSRI related but I just don't feel like that's even possible now, you know?  You all know by now when you're on something new or stop a med when things are just very different.  You can't always describe it perfectly, but you know, no doubt whatsoever.  That's how it is for me with SSRI's.

I seem to be in the minority with my SSRI big hypomanic experience.  I actually think I was very, very close to full mania just that the euphoria was so awesome that's mostly what I remember.  Looking back, the intensity of the episode and how pronounced and obvious the symptoms were, I think I was close to going over especially in the first two weeks.  Maybe I crossed that line for a bit, I don't know but I never lost touch with reality, didn't overtalk anyone, and didn't hallucinate at all so I doubt it.  If I had all the BP knowledge I have now, I would know so much more, of course. Man, I would KILL to have that euphoria back!  SO MUCH BETTER than any drug, legal or not, ever created.  Unbelievable.

It would be very interesting to hear about other experiences anyone's had or knows others had that were similar. 

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Posted (edited)

Thanks eletricbamboo.  This is why I'm surprised they still prescribe SSRI's for BP at all.  Seems logical to assume they're still potentially harmful even with stabilizers.  There's something going on with the extra serotonin and BP systems.  I've tried 5-htp a few times and get really weird if I take even just a little too much, especially on an empty stomach.  I get like really paranoid but sort of like high and foggy headed at the same time. I know it sounds like being high on weed when I write it that way, but it's not that way at all - no fun whatsoever.

Edited by Distorted Me

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Every pdoc I’ve had, going back to 2000, has known that there’s a risk of mania with SSRIs, and has acted with appropriate caution when prescribing them to me. Celexa sent me utterly out of my mind, a long time ago, and after that it was about 13 years before I wanted anything to do with an antidepressant again. But since I’ve been on a combo of AAP, AED, and sleep med, I’ve taken small doses of several different SSRIs without problems. Well, without mania, anyway.

Until someone comes up with a better idea for treating anxiety, I’m going to keep taking them.

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It took me a second to realize that podcast was an autocorrect.

 

im not currently taking an SSRI, but I have taken them in the past.  They didn’t help me very much, so I stopped, but it didn’t cause mania or hypomania.  

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2 hours ago, Gearhead said:

Every podcast I’ve had, going back to 2000, has known that there’s a risk of mania with SSRIs, and has acted with appropriate caution when prescribing them to me. Celexa sent me utterly out of my mind, a long time ago, and after that it was about 13 years before I wanted anything to do with an antidepressant again. But since I’ve been on a combo of AAP, AED, and sleep med, I’ve taken small doses of several different SSRIs without problems. Well, without mania, anyway.

Until someone comes up with a better idea for treating anxiety, I’m going to keep taking them.

I think you've kind of hit the nail on the head here, Gearhead, with your last statement.  SSRI's are risky, more so in certain populations like BP and schizo.  But, I'm guessing anyway, that also SSRI's have been so widely prescribed for decades now that their efficacy and overall safety are pretty well established.  It's hard to think of any other class of drugs about which you can say the same.  In absence of better alternatives with similar track records, what else can they do? 

Celexa was my first SSRI back in 2006 trough 2009'ish.  I definitely felt a little lift at first, felt more normal I think.  But then I had no prior experience with any meds like this so what did I know?  It also made me SUPER sleepy, almost narcoleptic, between 9 a.m. and noon, every single day.  It was so bad I had to take daily naps at work and at home because I just couldn't go any farther without sleeping some. I just stopped Celexa myself in 2009, ended up on Zoloft for a few weeks but stopped that due to feeling too weird (without the extreme sleepiness).  It wasn't until I started Lexapro in 2012 or 2013 that I had that sleepiness come back again.  I can't say it was narcolepsy, I doubt it was quite that extreme.  But it was so powerful I literally could not stay awake at my desk no matter what I tried, even standing up.  After I switched to Zoloft again in early 2015, the magnitude of that effect really dawned on me.  Prozac also did that but not nearly as intensely.  This all should have been a big clue for me very early on but I just ignored everything and kept just following my doctors' advice without really speaking up enough.

I'm only at 100 mg of Lamictal now but I'm pretty stoked about how good I feel so far.  It's having a pretty tremendous effect on my anxiety.  Like so much I forget I'm not on anything else for that.  Sobriety is also helping immensely of course.  I'm now 27 days sober and the difference in my anxiety has been night and day.  The first two weeks weren't so great while the alcohol was still clearing my system but since it's been just awesome.  I really think the first thing these doctors need to do is get anyone with depression or any MI to stop consuming alcohol altogether.  It's effect on the nervous system is just devastating to anyone who's already challenged in that area.

 

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Posted (edited)

Almost every single SSRI I’ve tried has sent me up to either hypo or mania. Well, I should say is, almost every farking AD has, sans Cymbalta. Wait...Viibryd helped some also, but I sat on the toilet 12 hours a day. 

Edited by BipolarSpinster
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4 hours ago, dancesintherain said:

It took me a second to realize that podcast was an autocorrect.

Thanks for catching that. God, computers are morons.

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