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Old 08-23-2007, 07:16 PM   #1 (permalink)
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Antidepressants vs mood stabilizers

I am trying to learn more about the differences and benefits/side affects of the mood stabilizers.
I have tried several antidepressents but I always feel WORSE than ever. I cry I feel more depressed, anxious, and it's just awful.

I got a message from another member on the subject and want to explore the possibliity of a mood stabilizer for my self.

Can you tell me your diagnoses and experience with this medicine?
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Old 08-23-2007, 08:24 PM   #2 (permalink)
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If you have tried several antidepressants and things have continued to get worse then I'd suggest continuing to try a few other antidepressants.

Have you tried Welbutrin yet? Many do well on it.

But more importantly, if you are seeing a general physician then please see a psychiatrist as depression and mental health is what they do....general docs often make things worse for not understanding mental health issues and meds enough.

If you are seeing a psychiatrist then have they tried higher doses of the same anti-depressants?

Mood stabalizers are most often prescribed for mood disorders like bipolar disorder. Their primary function is stabalizing mood swings. You may very well have experienced one or more manic or hypomanic periods and were not aware. Most people only become aware of the depressions. I was hypomanic for at least 6 months in college without knowing anything was going on at all....then i hit my first major depression which caused me to have to drop out of college for a semester...as i couldn't do much but sleep and be physically sick all the time.

it wasn't until 7 years and many more hypomanic episodes, that i crashed into my second major depression....that ended in me discovering my bipolar diagnosis.

BUT there are many other diagnosis out ther that cause mood swings besides bipolar...and you many not have swings at all.

Although....depression is usually a symptom of something more (rather than the sole problem as most of society thinks).

Mood stabalizers are harder to get right in individuals and there are as wide a range of experineces with the different ones as there are people who are prescribed it.

So...in summery...go see a pdoc for the depression (not a general physician), think back on how things were going the year before your depression started, and i'd also suggest making an appointment with a clinical psychologist for full testing to see if there may be an underlying diagnosis you may not be aware of yet. When i did mine...it was about a 3 hour set of tests and talking with the psychologist about my history...and it only cost me the same as a regular co-pay for a regular doc visit.

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Old 08-24-2007, 06:38 AM   #3 (permalink)
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I have been on several antidepressants and every time, without fail, there is a period of "getting used" to them about one week into it that is almost unbearable--terrible anxiety, crying for long periods of time, insomnia....generally, just feeling totally crazy and awful. This has lasted anywhere from one to two weeks. Each time I want to quit, and have on a few occasions, because I couldn't stand it. But usually, if I just hang in there, those awful feelings go away. Another thing that helps A LOT is if your doctor can give you like two weeks worth of a benzo (ativan or klonopin have worked for me) and this takes the edge off and helps with the anxiety and insomnia.
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Old 08-24-2007, 09:59 AM   #4 (permalink)
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and QU31 brings up a good point about the time factor with anti-d's. most take an average of 6 weeks to start workinging completely in the system. so frustration and my not knowing that had me quitting several anti-d's during my first depressions.

i don't know that i agree with the benzo to take the edge off for the first 2 weeks of taking a new anti-d. Benzo's are addictive pure and simple...especially Xanax and should (in my opinion) ONLY be prescribed as a last resort for serious anxiety issues and a few others. Too many fall into the addictive trap of benzo's like Zanax and then become dependant on them...and at an unnecessary cost.

There are lots of NON-prescription techniques and things that work well to help if experiencing slight-moderate anxiety and insomnia issues. Those are free, non-habit forming and healthy for you both short and long term.

just my 2-cents.
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Old 08-24-2007, 12:12 PM   #5 (permalink)
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I agree that one must be careful with benzos. However, the anxiety I experience when starting an SSRI is so intense (it made me realize why some people are at risk for suicide when they start taking them) that taking a benzo is the only way I can get through it. I guess it's a situation of outweighing the pros and cons of taking any type of medication.

There's another thread going on this forum on Topomax. I have no experience with it, but they're making it sound like it's some kind of miracle drug!
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Old 08-24-2007, 12:31 PM   #6 (permalink)
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I have been on several anti-depressants over the years, starting about 15 years ago. I started with Paxil, went through several others, and am now on Cymbalta. For many years I was diagnosed as having a depressive/anxiety disorder. Anti-depressants would work somewhat for a period of time. By somewhat I mean they at least controlled the suicidal thoughts I was having.
About 3 years ago my Dr. reassessed my depression and asked me some more in depth questions. They related to my sleep patterns, energy patterns, spending patterns, interests in activities, mood as well as several other things. The diagnosis was Bi Polar type II with PTSD Since then I have been treated with not just the anti-depressant, which keeps my depression at bay, but also a mood stabilizer. The mood stabilizer keeps me from having drastic changes. I think of it like a pendulum swinging. Before the mood stabilizer the pendulum made big arcs now it still makes arcs but not as dramatic. It does not make me feel high, drunk, or stoned. I did have to try several of them to find the one that works for me. I started on Lithium and now take Lamictal. Lithium left me feeling zombie like and drugged as well as causing a significant weight gain. The only thing I notice with the Lamictal is I can tell when I miss a dose as I get the urge to spend money.
You might try taking the test at this link http://psychcentral.com/quizzes/bipolarquiz.htm it might help answer some of your questions.
Do remember that many mental illnesses can be treated quite effectively but we have to do our part by advocating for ourselves with our MD's. The MD is only as good as the information we give them. Good luck.
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Old 08-24-2007, 07:54 PM   #7 (permalink)
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Thanks nandm, I scored a 50. Good grief, I do need to see a pdoc Shutterbug!

Wow, what a lot of info.
I truly appreciate the eye opening from you all.
I have tried Welbutrin, and get so anxiety prone that I can not live with myself.
I also have been taking ativan for sleep every night for 6 years. Then, I only take a half a pill.
It totally changed my life for the better. I can sleep which in turn makes me able to work during the day without crashing due to no sleep!

I took it with the Welbutrin and still had the same horrid experiences. The Ativan didn't even touch the anxiety. If I am addicted, well, at least I get to sleep at night and sleep well all night and feel rested when I wake up. I don't take more than one half a pill per day. I can understand where you're coming from Shutterbug though.
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Old 08-24-2007, 09:24 PM   #8 (permalink)
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Glad you were able to find some use from my post, Wabbit. I too had extreme anxiety while on Welbutrin. It seems it is a common side effect. You might consider talking to your Dr. about a different anti-depressant as there are plenty out there and one is right for you. Good luck. Keep us posted.
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Old 08-24-2007, 10:00 PM   #9 (permalink)
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just remember...seeing a pdoc for depression is no different than seeing a dentist for a toothache.

QU31... i've yet to read any data from studies (or even from doctors or patients relaying their own opionins) about suicide becoming a greater risk for some who are just starting on anti-d's. it is simply not true. And such a statement can scare people into not seeking proper treatment for their depressions....especially if they are already dealing with suicidal thoughts and issues.

i know of NO anti-d that makes a person become more suicidal. period.

Is it possible that the info read was talking about anti-depressants pushing some into states of mania??? If an undiagnosed (or diagnosed) bipolar is placed on significant doses of anti-d's without the presence of a mood stabalizer then a drug-induced mania can occur. Even so...that is not as common as people realize.

Also.....the thing i worry about with things like the benzos is that not everyone has severe anxiety issues to need scripts like xanax, but people looking for quick fixes or clutching for anything that will possible help them right now....may think that if they are having ANY kind of discomforts from starting an anti-depressant then they should ask for a benzo script. Plus, as nandm pointed out, some anti-d's cause anxiety in those taking them. Rather than add a second med to 'fix' the first...it'd be much better to find just 1 med that works without the axiety side affects. Agree?

i live in a state where docs hand them out like candy. my aunt died a pre-mature death from RX addiction and among her favorites was the zanax. She left behind 2 young daughters...one with no father either.

Benzo's ...should be the exception...not the rule.

Sorry to disagree.

nandm....welcome to SR and to the mental health forum. quick mention tho that PTSD is a completely seperate illness than bipolar disorder. i say this because so many people come here to learn...A person can have 'bipolar I with psychotic features' or 'bipolar II with rapid cycling'. i just want those who read this to know that PTSD is not a feature of bipolar disorder, but seperate disorder. i'm sure that's what you meant....i just wanted to make sure no one got confused.

Guys i really am sorry for disagreeing so much...for some reason i just felt a need to say something.

hugs,
jenna
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Old 08-24-2007, 10:48 PM   #10 (permalink)
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Thanks Shutterbug. Yes, I did mean two different disorders but in reviewing my post it is easy to see someone may have seen it different. Thanks for the clarification.

You brought up some good points. I have read articles in the past few years that the main time their is an increased risk of suicide with starting an anti-depressant is mainly in children and teenagers. I wonder though how much of it has to do with the medication and how much has to do with the chemicals in the brain already being so low before the meds were started that suicide was already such a high probability that the meds do not have enough time to catch up the chemicals before the attempt is made.

I did have my daughter when she was 16 become manic when she started on Zoloft but she was also mixing it with alcohol and pot. I think the combination was probably more the cause than the drug alone. Glad she no longer uses alcohol or drugs. Do think she still could use an anti-depressant though but she is 22 so it is up to her.

Thanks again for the information and the welcome
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Old 08-24-2007, 11:12 PM   #11 (permalink)
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thanks nandm...i haven't read much on children or teenagers on anti-ds, so possibly why i haven't ever heard of anything like that. Even so, i agree with your questioning of the circumstances. Also, possibly for teenagers...just the thought of them needing pills for mental health issues, may provide enough stigma-related anxieties that some may think it better off not here than to have to live life only being happy on pills???? don't know...just trying to put my thoughts in there shoes for a moment. children and teens are so delicate...they really are. it's a good point you've made. thanks
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Old 08-25-2007, 05:53 PM   #12 (permalink)
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Shutterbug, I had a cousin who committed suicide 2 years ago while on anti depressants. He shot himself. He had just graduated college with a job waiting. No one knows why he did it, and no note was left behind. He was 24.
I am not sure how long he was on this medication either, or exactly what the name of it was.

I have to agree with the Q on suicidal thoughts because of the extreme anxiety I experienced. I was sobbing and crying and feeling useless. I obviously didn't do it though.

I am learning a lot here. It's amazing what people have been through and are able to share their experience.
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Old 08-25-2007, 07:09 PM   #13 (permalink)
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If you go to the drug company sites like Pfizer, who makes Prozac and Eli Lily, who makes Zoloft, the first thing that pops up now is a disclaimer that taking these medications may increase suicidal thoughts during the first few months of taking them. HOWEVER, the studies did not detect an increase in suicidal thoughts for people over the age of 24.

I just know, for me, they're hard to get used to. But it is worth it in the end.
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Old 08-25-2007, 07:47 PM   #14 (permalink)
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Yeah, on the note about being suicidal, I took Effexor XR for awhile during my last year of college, and I had severe suicidal thoughts, to the point where I stopped taking the medicine and sent myself into an even deeper low because I did it without the help of a doctor. I was 22 at the time, though... I'm 24 now and on Lexapro, and so far I haven't had those thoughts, but then again, it's only been a week, so we'll see!
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Old 08-25-2007, 08:19 PM   #15 (permalink)
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wow....okay....this is all totally new news to me!!!!!!!!!!!!!!

I'm sorry for disagreeing previously when i obviously didn't know what it was talking about. (hugs)

I only just now connected that it was shortly after the addition of the mood stabalizer another anti-d and an increase in the one i was already on....did i actually become truely suicidal during my "breakdown" 3 years ago. I had just thought it was because of the major depression and having to go into the hospital and having to accept my bipolar diagnosis...and having to miss work...and having to worry about loosing the job...and being lonely........and on and on...

It was a very rough time. So....guess this is one of those "chicken or egg" questions. LOL

I'm glad to know about this...(((((((thanks Wabbit, QU31 and ladyamalthea)))))))
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Old 08-25-2007, 08:44 PM   #16 (permalink)
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Thank you shutterbug and Q
lady, I have been reading the askapatient.com about every antidepressant (and every single other med I take) I can find. It's an amazing site. Seems like lots of folks had the same problems I had I went trough on certian meds.
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Old 08-25-2007, 08:48 PM   #17 (permalink)
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interesting. I'll have to try that.
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Old 08-27-2007, 01:50 PM   #18 (permalink)
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Hi, I am new here. I am a part of a different forum for alcohol problems. I was searching around and found this one which offers a lot more than just the alcohol problem part of it.

I have been recently diagnosed with bi-polar and anxiety disorder. I am 35 and have been on almost every SSRI out there for 'depression'. It never helped me and a few of them made me feel so 'out of it/high' that I drank more to bring me down.

I am currently on Epival and Tradezone. The combination of the mood stablizer and the anti depressant (not an SSRI) is working very well for me. I am on Epival 250mg x3 a day and Tradezone 50mg x1 a day before bed.

Just thought I would share with you my medication experience.
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Old 08-27-2007, 06:30 PM   #19 (permalink)
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Originally Posted by QU31 View Post
I have been on several antidepressants and every time, without fail, there is a period of "getting used" to them about one week into it that is almost unbearable--terrible anxiety, crying for long periods of time, insomnia....generally, just feeling totally crazy and awful. This has lasted anywhere from one to two weeks. Each time I want to quit, and have on a few occasions, because I couldn't stand it. But usually, if I just hang in there, those awful feelings go away. Another thing that helps A LOT is if your doctor can give you like two weeks worth of a benzo (ativan or klonopin have worked for me) and this takes the edge off and helps with the anxiety and insomnia.
A cross taper can work well with a Benzo + SSRI. There are certain benzos that are probably preferable because of dependancy issues, though each prescriber has their preferences. At a few weeks, it probably isnt' that bad, but people who stay on for months on end....they are most likely in for a world of hurt if they try and stop too quickly.

-p
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Old 08-27-2007, 10:21 PM   #20 (permalink)
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QU31... i've yet to read any data from studies (or even from doctors or patients relaying their own opionins) about suicide becoming a greater risk for some who are just starting on anti-d's. it is simply not true. And such a statement can scare people into not seeking proper treatment for their depressions....especially if they are already dealing with suicidal thoughts and issues.

i know of NO anti-d that makes a person become more suicidal. period.
True. The unfortunate result of the black box warnings on the SSRIs was an INCREASE in total suicide attempts and suicides during the following year, NOT a decrease....mainly attributed to people avoiding the use of SSRIs.

From what I remember, the original research found that suicidal IDEATIONS increased (2x), though there was no increase in actual suicide attempts. There were some issues with how each study classified ideations, behavior, suicide risk, etc; the researchers did their best to quantify the different categories.

*edit*

I think this is the study, I'm still picking through it, it has been a couple of years since I've read it. It doesn't pull any punches at 130 pages, but for those curious, here is the study:

http://www.fda.gov/ohrms/dockets/ac/...ads-Review.pdf

Outcome 3 (definitive suicidal behavior/ideation) was the part that caused all of the uproar. It is talked about frequently throughout the study, since it speaks to definitive risk. This is where that ~2x number comes in (1.78x average increase)

Here are some of the most important conclusions they found in their study

Quote:
".....among the events considered representative of suicidality in these 25 pediatric antidepressant trials, there were no completed suicides."
The news reports ignored this fact.

Quote:
"No individual trial showed a statistically significant signal for suicidality. However, many had a RR of 2 or more and some of the overall estimates, across various trial groupings, were statistically significant."
In English, there was a meaningful finding that there was an average increase of suicidal ideations 1.78x, compared to the placebo group, though that increase did not result in more suicide attempts.

Quote:
"Most of the events occurred in trials with the highest proportion of patients with a history of suicide attempt or ideation at baseline."
The ones with the most history of attempts, reported the most issues. They also were the most likely to have issues once they stopped treatment. This reiterates the importance of med compliance, and the real suicide risks for those most in need.

-p
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