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Paxil triggered a major manic episode for me. It also saved my life by doing so. I would have killed myself but my mania pulled me up (so weird, huh?).

I dumped the Paxil because it was a double-edged sword. It increased mania and made it hard to stay balanced, but decreased the TERRIBLE anxiety and depressive states. It also (I think as a result of lowering anxiety) lowered the mixed states.

So what I had to tolerate a bit of mania?

Now I'm on what you read in my signature below. I am in a horrible mixed state. I haven't been seen by a psychiatrist for 3 months because she keeps cancelling on me (she is "sick"- more like sicker in the head than me if you ask me).

I'm really asking- do you think I should go attempt to get a phone conversation with her to RX an SSRI? I really don't think anything else will help. Abilify can kiss my ass.

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Paxil gave me one manic episode that I still don't want to believe was manic. It was a long time ago long before I knew anything about bipolar. I felt really good for 2-3 days. Didn't feel hyper, anxious or any bad stuff.  Was the only SSRI to do that. Then right after that I was back to depression although it was an improvement over Zoloft.

Don't mean to talk about myself but I've read your message a couple times and I can't help thinking this wouldn't be the med for you if you're BP I. But that's just my wild uneducated guess. Why not look at other mood stabilizers? Can't remember if you've tried Lithium. And I know you're concerned about the stupid drugs because of your job. But long term I can't imagine a drug that can easily cause mania to be what you need.

Said out of love concern and hypomania.

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Greenyflower--> Paxil made me as manic as all hell, but without a mood stabilizer. I take a lot of Lamictal now.

lemonflavor--->I've been through all the mood stabilizers and AAPs. I've done well with ADs and Lamictal in the past. That's why I'm risking it a bit now. Lithium is good but makes me stupid, and that would make me homeless, which would make it all worse.

penny---> i've tried every atypical. this is the second time i've used abilify. it amplifies the mixed situation. i've taken it for a month and for two months.

ncc- i was released from the hospital on all 5 occasions with an AD and a shitload of mood stabilizers and an AAP. Now I'm down to just Lamictal.

I'm hoping it holds. Mania is worse than depression for the career and life. If I start to sound manic, let me know!!!

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Soapbox here... (I'm short anyways, so let me stand on it, damn you)

I'm glad Paxil got you out of that depressed state.  Had my old pdoc in Indianapolis recognized that the Trazodone (antidepressant and not sleep dose!) and Cymbalta pulled me from torpid depression into hypomania, and tried to cut me off from one or the other, let's just say there'd be revolting.  When I'd get transient paranoia and rage together, he'd given me Abilify to take, it started out as PRN but then he wanted me to take them every day.  I respectfully declined, given my Z experience. =)  Something about silly pdocs wanting to avoid the liability of having a manic around in society. =D

I'm just a little wary of Paxil, though - it's the strongest of SSRIs, even given the 'equivalence dosage' paradigm.  Have you ever tried to cross-titrate to say, Lexapro (which is a very 'clean' drug that is also approved for GAD)?

Really, it's frightening when you know more about clinical psychopharmacology than the top-rated psychiatrist in Indiana does...

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