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antidepressants for bipolar?


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I take wellbutrin which is not an SSRI and effexor which is an SNRI (serotonin and norepinephrine reuptake inhibitor I believe). If I start to have manic signs I stop the provigil (not an AD) and decrease the effexor. So far so good with them and it's been a long time.

Oreo

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I take wellbutrin which is not an SSRI and effexor which is an SNRI (serotonin and norepinephrine reuptake inhibitor I believe). If I start to have manic signs I stop the provigil (not an AD) and decrease the effexor. So far so good with them and it's been a long time.

Oreo

The catch for Papertrees is that Abilify is metabolized through 2 versions of a common liver enzyme, one of which is strongly inhibited by Wellbutrin, Prozac, Paxil, and Cymbalta; the other can be inhibited by grapefruit juice and possibly Fluvox. Before CB went down, I'd also

found a reference to Lamictal and Zoloft not playing well together - again the issue is inhibition of a liver enzyme. (I've read that Lamictal, the Crazy Med it is, doesn't necessarily play well with med changes anyway.)

There's a limited potential for interaction with Abilify and Celexa/Lexapro, but with bipolar disorder in the mix, you probably won't want the mania risk of higher dosages anyway.

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then again, an AD will take at least a week for you to really notice, and 2 for it to work, and 4 to reach a very good level.

i take abilify, WB, and lamictal all together and this seems like a magic combo for me. my WB was just increased because i've been depressed, but i think the increase is kicking in because i'm starting to feel a bit better.

my pdoc started me on both lamictal and WB together during my 3rd hospitalization, so i suspect it is safe.

ask your pdoc all about it. i'm sure s/he knows all there is to know. all i know is what they've given me and what works in my body.

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  • 1 month later...

I've just been prescribed prozac for bipolar depression. Will this work? And is it true that it is metabolized in the same pathways as abilify? If so, what do I do??

This is from the Abilify article on Wikipedia:

Aripiprazole (aka Abilify) is metabolized by the Cytochrome P450 isoenzymes 3A4 and 2D6. Accordingly, coadministration of aripiprazole with medications that may inhibit (e.g. paroxetine, fluoxetine (aka Prozac) ) or induce (e.g. carbamazepine) these metabolic enzymes may increase or decrease, respectively, plasma concentrations of aripiprazole.

Basically, that means you can take the two together - but the Abilify will be a bit stronger in your system.. so you don't need to take as much.

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My gp. tried me on several ADs before he started to think maybe I had bipolar (I guess I should have told him about my previous two diagnoses as such, but I didn't believe it) and sent me off to another psychiatrist. Anyways, I tried a few SSRIs (Paxil, Zoloft, cant remember the others), a SNRI (effexor), a tricyclic (clomipramine)...I had issues with every single one of them (some degree of hypomania) finally he put me on Wellbutrin & low dose of Seroquel (to regulate my sleep, which I'd actually started with the clomipramine, cause I never said anything about the other hypo symptoms other than insomnia because i was adamant that I was not going to give him any reason to think I had bipolar cause as far I was concerned that was not a possability) which worked quite well. No hypo. Helped w/ the depression to a degree, Lamictal picked up the rest of the slack (although I know you said Lamictal isn't helping in that respect for you). So yeah, out of all the ADs I tried, Wellbutrin has been the ONLY one that I've been able to tolerate. But of course, that's me, and different people are going to react differently to different drugs.

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So it is not so rare to prescribe antidepressants for bipoplar folks? I was just started on Prozac two days ago.

to augment a mood stabilizer... no, it is not all that uncommon. of course, it all depends on the person and how one actually *reacts* to certain meds and med combos...

can't finish... late for class...

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all of my bp friends also have an AD wtih their mood stabilizer, so it seems like a common practice. i think the line of thought is that the mood stabilizer alone won't necessarily prevent depressive episodes, so we need the AD, but the AD by itself. i used to take paxil with lithium and now i take WB with lamictal.

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now i take WB with lamictal.

I take wellbutrin with lamictal as well... i mean, among other things also!

i think that some people have been able to get by with just lamictal due to the fact that it apparently has some antodepressent qualities or something. i guess it really depends on the person, how bad the depression is, etc., etc., etc......

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