Are you bipolar and on an anti depressant?

[Ballerina123]

I know some bipolars are but my psych won't let me be even though I know metazipine or trazadone will help with my sleep problems.
I have been on anti depressants before (with other psychiatrists) and as long as I'm on a mood stabiliser (which I am, lithium) then I haven't got manic.

I'm currently on also aripiprizol and can change my anti psychotic because of side effects to others.

How can I get my psych to put me on a anti depressant?

[Cedrus]

Could you ask them to start you off on lower than the recommended starting dose and to increase it very slowly? And maybe also discuss early warning signs so you can show you will be monitoring your mood? I understand how frustrating it can be, for quite a while my old psych refused to prescribe an anti-depressant.

Hope it works out for you!

[sherlock holmes]

I'm on both mirtazapine and trazodone.

I was on carbamazepine as a mood stabliser but it made me very anxious and I had to stop it.

[Ktulu]

Have they said why they don't want to put you on antidepressant? I'm not on one and my psych also won't put me on one because I've become manic on just 20mg of Prozac even while on lithium. I've taken quetiapine for depression before and found it very helpful, I had to get up 900mg/day for it work though which is above the max daily dose iirc.

Edit: just seen that you need help with sleep, could you try a sedating anti psychotic (like quetiapine), I find it brilliant for sleep at about 100-200mg. Would a short term course of sleepers not be an option? Zopiclone or zolpidem? Or triazolam or flurazepam if really necessary?

[Ballerina123]

He won't put me on another sedative anti psychotic either because I'm on one anti psych and I have heart problems.

He just thinks I'm gonna go manic on an anti depressant without even trying one.

Does anyone know what the nice guidelines say about bipolar and anti depressants?

[Ktulu]

Have a read of it here. Pages 24-27. As I read it, it basically says antidepressants should only be used short term and with an anti manic agent. Lithium, valproate etc should be used long term instead. That's it in a nutshell as I read it.

[Ballerina123]

Thanks ktulu

[Copernicus]

The other thing the NICE guidelines say is not to use anti-depressants in anyone with rapid cycling bipolar (unless prescribed by an expert in bipolar). How fast do you cycle -could that be why he won't use it?

[Ballerina123]

Quote:

Originally Posted by Copernicus

The other thing the NICE guidelines say is not to use anti-depressants in anyone with rapid cycling bipolar (unless prescribed by an expert in bipolar). How fast do you cycle -could that be why he won't use it?

This could be a reason. I'm diagnosed rapid cycling.

[Wellingtons]

I'm bipolar I and on an antidepressant alongside a mood stabiliser/anti psychotic.

[DannieGirl]

I don't know if you've tried it but lamotrigine is supposed to be good for the lows of bipolar. It didn't touch me...but we're all different. I can't touch anti depressants..

[giese9881]

I'm ok 2 antidepressants and a mood stabilizer.

[~SuNsHiNe~]

I'm on fluoxetine and sodium valproate for bipolar 2 which I find helpful. Sounds like if your rapid cycling that might be why they're reluctant to prescribe - can you ask if that's why?

[ShadoWalkr17]

I'm bipolar n.o.s.. with s.a.d. and rapid cycling ect..
I am on a mood stabilizer and anti psychotic but not a anti depressant.
Anti depressants don't work well for me.