bipolar pt. not manic on ad´s?

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I have this patient we have been treating with highdose ad´s for about a month(ltc) ..do to depression. Now a familymember said this patient was diagnosed bp years ago ( didnt want treament for years though)..

but aren´t all bipolar patients suppose to go manic when only on an antidepressant? The patient is doing fine ( no mania or depression). Should I bring this up to the doc ( pt. on Citalopram 40 mgs and Endronax 12 mgs) do all bipolar patients have an reaction to only being on an ad?

Specializes in behavioral health.

bipolar is extremely seasonal!!!! both of my past psych docs have thought so. i was doing great this winter (but not 'too' good ;) ) and my psych doc kept annoying me warning me of an impending mood swing that i did not feel coming on. and there is a lot of daylight in arizona =p.

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allways crashed around January/Febuary for the last ten years..I should pretty much just book an appointment with pdoc in advance;-) Going hyper in the spring ...love it and never get to book it ...cause I am neeever going to get depressed again ...denial is so fasinating lol... After getting dxéd I began to see things a bit clearer ...the right meds help alot to;-) ( never been on Lacmital as you asked about, but Lithium is great)

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thanks for letting me know it´s okey for me to " let him hand out the flowers" by the way...;-) It´s difficult when you can see the " tell tell signs" and the doctor doesn´t ( cause the are counting on me to fill them in) think my pdoc is doing the same with me ..unless quite manic !..;-) Point is I respect her for that and thats why we have a great relasionship and I fully trust her for when things get out of hand... so I guess the point is..it´s all so individual..still hate as a "young nurse" and a "psych patient" to feel I should be able to help these patients the right way.. cause I know the pain/suffering/ denial and JOY ..geuss (sp,)thats why I not in pych lol...traference and so on...but do admire nurses who are dedicated to the field

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Specializes in behavioral health.

Mish56, i do take lamictal =) and it was prescribed for me as a 'soft' bipolar deal. My psych doc wasnt sure what my mood disturbance was, but ADs were all failing. I think I was in a mixed episode at the time of titrating. It worked for me almost immediately. I stopped having panic attacks at 50mg lamictal. Eventually, i got up to 200mg. The mood stabilization isnt quite strong enough for me, so trileptal is added on. I was on geodon last year. Basically, lamictal is my basic med and i plan to make seasonal changes. I hope to get off the trileptal when im more stable. I see how many meds my patients are on and don't want to go that route. Sometimes i already feel like i cant think clearly!!! Although with nightshift, my hopes of stable mood are fading =(.

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sometimes if the patient becomes manic and on anti-dep the doctor tapered it gradually and we also give anti-psychotic and anxiolytic meds to make the patient calm.since the patient is on manic stage anti-dep could elevate the mood of the patient.so what we do is gradually decrease it or discontinue it.we seldom used litium and most of the drugs given is atypical one coz it is more effective and less EPS.but the meds are way so expensive.....

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