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I have been in a depressive episode for 2.5 years, which is crazy for me. For my first 8 years of being diagnosed, my normal state was hypomania, with mania with psychosis thrown in. 
 

I got an amazing new psych. He put me on requip, and I finally felt good again. But the effect wore off after 4-6 weeks. Upped it to 4mg and nothing. 
 

I’m also on lamictal 400mg, topomax 150mg, vraylar 3mg, trazodone 150 mg and adderall 40mg. He took me off Wellbutrin because he said it’s the worst med for bipolar. 
 

I don’t understand why this has happened. I’ve had like 4 depressive episodes in ten years, each lasting no longer than a couple months. 
 

I feel like my brain broke. Could I just be stuck this way? Has anyone else experienced such a dramatic change in the way your bipolar manifests? 

 

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10 minutes ago, iLove said:

I have been in a depressive episode for 2.5 years, which is crazy for me. For my first 8 years of being diagnosed, my normal state was hypomania, with mania with psychosis thrown in. 
 

I got an amazing new psych. He put me on requip, and I finally felt good again. But the effect wore off after 4-6 weeks. Upped it to 4mg and nothing. 
 

I’m also on lamictal 400mg, topomax 150mg, vraylar 3mg, trazodone 150 mg and adderall 40mg. He took me off Wellbutrin because he said it’s the worst med for bipolar. 
 

I don’t understand why this has happened. I’ve had like 4 depressive episodes in ten years, each lasting no longer than a couple months. 
 

I feel like my brain broke. Could I just be stuck this way? Has anyone else experienced such a dramatic change in the way your bipolar manifests? 

 

hey- i think you posted somewhere else, but i forget what does your med history look like? what are the major symptoms of this current episode? some off the top of my head ideas- remeron is supposed to be more bipolar friendly than other antidepressants. what about the other usual suspects for BP depression? latuda, abilify, rexulti or the second line options (for depression, not overall, i know lithium isnt always a second line option) like lithium or maybe zyprexa ? I guess theoretically you could switch to mirapex another dopamine agonist- but that is pretty far out in the realm of unknown. Also- have you tried cytomel? its a T3 booster but also lesser known BP depression treatment.

Unfortunately, bipolar can evolve across the lifespan, and i think the ratio of depressive episodes gets higher as people age (but id have to check the stats on that) 

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5 hours ago, Iceberg said:

hey- i think you posted somewhere else, but i forget what does your med history look like? what are the major symptoms of this current episode? some off the top of my head ideas- remeron is supposed to be more bipolar friendly than other antidepressants. what about the other usual suspects for BP depression? latuda, abilify, rexulti or the second line options (for depression, not overall, i know lithium isnt always a second line option) like lithium or maybe zyprexa ? I guess theoretically you could switch to mirapex another dopamine agonist- but that is pretty far out in the realm of unknown. Also- have you tried cytomel? its a T3 booster but also lesser known BP depression treatment.

Unfortunately, bipolar can evolve across the lifespan, and i think the ratio of depressive episodes gets higher as people age (but id have to check the stats on that) 

That IS unfortunate if depressive episodes increase over time!

Yes, I posted this a year and a half ago. Great memory! At the time, I wrote “I’m currently taking lithium, adderall, trazadone, Effexor, Wellbutrin, and latuda, which she switched to abilify today.”

I’ve also taken depakote, Seroquel, and some others I’m forgetting. I’ve gained 100 pounds in the past few years, so I can’t do zyprexa. 
 

I’m thinking of switching back to abilify. Is rexulti an AP?

At this point, I’m considering asking about tms. My sister did ect and while it helped her, she doesn’t recommend it due to the memory loss. 
 

The requip worked wonders at first. I was myself again. But now I’m back to sitting on the couch playing on fb all day, not wanting to socialize, not talking much, and just feeling overall blah. No sadness or crying though. I guess it’s mostly anhedonia. 
 

I did the Hamilton depression scale today and it said severe depression. I’m so lost and starting to feel hopeless, which is really unusual for me. 
 

I really appreciate your response and trying to help me. 

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2 hours ago, iLove said:

That IS unfortunate if depressive episodes increase over time!

Yes, I posted this a year and a half ago. Great memory! At the time, I wrote “I’m currently taking lithium, adderall, trazadone, Effexor, Wellbutrin, and latuda, which she switched to abilify today.”

I’ve also taken depakote, Seroquel, and some others I’m forgetting. I’ve gained 100 pounds in the past few years, so I can’t do zyprexa. 
 

I’m thinking of switching back to abilify. Is rexulti an AP?

At this point, I’m considering asking about tms. My sister did ect and while it helped her, she doesn’t recommend it due to the memory loss. 
 

The requip worked wonders at first. I was myself again. But now I’m back to sitting on the couch playing on fb all day, not wanting to socialize, not talking much, and just feeling overall blah. No sadness or crying though. I guess it’s mostly anhedonia. 
 

I did the Hamilton depression scale today and it said severe depression. I’m so lost and starting to feel hopeless, which is really unusual for me. 
 

I really appreciate your response and trying to help me. 

For what it’s worth the memory loss was annoying but bearable for me from ECT. If start with “low dose” unilateral treatments and they work without going to bilateral (big if), some people have minimal cognitive issues.

Rexulti is an AP- it’s is theoretically very similar to abilify, but some people find the effects very different. Some people with bipolar find it helpful for depression, not so much for maina 

There is also a very new AP called caplyta which has shown some promise with BP depression. Being new many docs still don’t use and many insurers still don’t cover it 

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2 hours ago, Iceberg said:

For what it’s worth the memory loss was annoying but bearable for me from ECT. If start with “low dose” unilateral treatments and they work without going to bilateral (big if), some people have minimal cognitive issues.

Rexulti is an AP- it’s is theoretically very similar to abilify, but some people find the effects very different. Some people with bipolar find it helpful for depression, not so much for maina 

There is also a very new AP called caplyta which has shown some promise with BP depression. Being new many docs still don’t use and many insurers still don’t cover it 

Ok, thank you for the info about ect. I won’t be freaked out about it if it does come up. 
 

I’m gonna ask about switching to rexulti 

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On 7/14/2021 at 12:32 AM, iLove said:

That IS unfortunate if depressive episodes increase over time!

 But now I’m back to sitting on the couch playing on fb all day, not wanting to socialize, not talking much, and just feeling overall blah. No sadness or crying though. I guess it’s mostly anhedonia. 
 

I did the Hamilton depression scale today and it said severe depression. I’m so lost and starting to feel hopeless, which is really unusual for me. 
I really appreciate your response and trying to help me. 

I'm not BP, but I can vouch for (at least in my experience) Depressive episodes are muuuuuch longer as I age. (neverending to be honest). The difference is there is less severe lability / dysphoria (probably due to both maturity & meds), but the lack of interest in absolutely everything, no motivation, wasting time, anhedonia will not go away. Stimulants helped with this initially and now i seem to have become tolerant to the uplifting effect.

And yep, even though I am much more stable compared to my 20's, i still score "severe depression" on Hamilton scales. Good luck with your med changes.

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  • 2 weeks later...

Starting in my early/mid 30s, my depressive episodes suddenly started lasting much longer, always about 9 months or more, and one time over 4 years. As I have gotten older, my remissions have become fewer and and father between. I think it’s pretty common for people to experience worse and longer MI episodes as they age, although some people seem to get better later in life, instead.  

I was on Abilify and doxepin during my previous remission, which ended just over 5 years ago, so you might try one or both of those. Unless it was just a fluke, doxepin is the only AD that ever worked for me, and I have tried most everything outside of the MAOIs. Abilify is known to help with depression, too. It didn’t do anything for me until I hit 15 mg, though. And doxepin didn’t start working until I was at 250 mg for a few weeks, which took 4.5 months to get to. I think there is a new version of Abilify (Rexulti?) that you might also try. Best of luck!   

P.S. One word of warning: once I discontinued doxepin and Abilify (at which point I almost immediately went cuckoo), neither ever worked for me again, and I have tried both again on multiple occasions. The last time, I couldn’t even tolerate either of them, because the side effects were suddenly so much worse than in the past, and so I had to stop both very early on. I’ve talked to many people over the years who have had similar experiences, so don’t go off meds that work unless you have to. 

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