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Escitalopram/Lexapro and Bipolar 2


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Starting Lexapro tonight after 4 weeks of severe anxiety and panic. Currently stable on Lamictal and Depakote ER as mood stabilizers, Intuniv for attention and focus, and low-dose Seroquel for sleep (Seroquel has never helped my anxiety, just my mood). Tried increasing Depakote and Seroquel to no avail. Tried scheduled Klonopin around the clock, which certainly took the edge off but not by much.

I'm basically writing to find out if anyone in the boards has experience with SSRIs in paired with mood stabilizers and a Dx of Bipolar type 2. I'm starting at 5 mg for four days and then increasing (and staying) at 10 mg. It has, in the past, helped the severe anxiety and panic attacks I used to get back in my early 20's (I'm 26 now). 

Any input is appreciated! 

 

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I'm not bipolar II, but I figured I'd throw in my two cents and hope they help.

I was able to tolerate a very small dose of zoloft while taking lithium. At the higher doses I started to become agitated and had difficulty sleeping, and soon after I tapered off the drug all together I had a manic episode. 

I think the most important thing is to go slow and be cautious. Look out for signs of agitation or lack or sleep, stuff like that.

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16 hours ago, aura said:

I'm not bipolar II, but I figured I'd throw in my two cents and hope they help.

I was able to tolerate a very small dose of zoloft while taking lithium. At the higher doses I started to become agitated and had difficulty sleeping, and soon after I tapered off the drug all together I had a manic episode. 

I think the most important thing is to go slow and be cautious. Look out for signs of agitation or lack or sleep, stuff like that.

I shouldn't have emphasized the BP2 as much as I did. I think that as far as the bipolar spectrum is concerned, we're all unique while at the same time we share many of the same characteristics of the disease, just in different capacities/severities. Thanks for your input, Aura. I've read/heard from many that Zoloft is a tricky one, with is small action on dopamine in addition to serotonin reuptake. I'll definitely be going slow and frequently checking in with myself. Thanks for the reply!

1 hour ago, sbdivemaster said:

I'll be following this.  My quack has recommended adding escitalopram to my lamotrigine, and I'm concerned, among other things, about a flip into mania.

I'll keep y'all updated. Today is day two at 5 mg. I plan another two days of 5 mg and then I'll be bumping it up, as planned, to 10 mg. In the past, I was on 20 mg for OCD/GAD, but it didn't touch my depression. Moreover, I switched for a time to Prozac, which was grand for depression, but not so good for OCD/GAD. This was all before the bipolar Dx came along, so I'm unsure what will happen this time around. But I'm hopeful that this works, because nothing in my current cocktail is a first-line treatment for anxiety disorders, and my anxiety is just so out of control and crippling at this point. So I'm willing to take the slight risk. Hopefully with Lamictal and Depakote, it'll keep things stable.

Edited by mjs190
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I did very well on Lexapro for a long time, and I'm BPl. Didn't make me manic, worked like a charm on my anxiety and intrusive thoughts.

I had tried SSRI's in the past with disasterous results, but never when I had been stable on a mood stablizer-AAP combo, and with a sleep med that worked.

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