Thursday, May 15, 2008 DeeDee asks

Q: Could wrong medications cause bipolar symptoms in a recurrent major depressive without true bipolar?

I have fought recurrent depresssions since adolesence. About 18 months ago I was diagnosed as BPII and put on mood stabilizers, antidepressants and amphetamines (for assumed co-morbid ADHD). We tried several different drug combinations, but the depressions would eventually return. This past Fall (around November, after continuing to struggle with the depressions), my doctor switched me to the following mix: Topomax, Cymbalta, Dextrostat and d-amphetatmines. By the end of January, I was truly manic (when I had NEVER been manic before, even despite thinking that perhaps I had experienced HYPOmanic symptoms in the past); and I ultimately became psychotic, paranoid, and delusional before having a complete nervous breakdown at the end of February -- which cost me my career, among other things!! I was also prescribed Prednisone and cough syprup with codeine (both twice for a serious respiratory infection), plus Oxycodone twice, for pain after minor abdominal surgery -- all between Thanksgiving and early January (while on the mix of psych drugs listed above).

Is it POSSIBLE that all of these medications worked together to create the BP-like mania and psychosis, etc? Ive been weaned off the amphetatimes and taken off the Topomax and feel completel different! I was hospitalized three weeks into my amphetamine withdrawal with serious (and first-time) suicidal ideation; and the Topomax was removed from my drug regimen then, because it was apparently having no positive effect on my moods whatsoever. My Cymbalta dosage was cut in half too and the anti-anxiety drug Seroquel was added, 25mg 3X/day. The hospital staff and doctors are questioning the BPII diagnosis completely. Is it possible I was wrongly diagnosed and therefore overly-medicated ... meaning did my meds cause me to become Manic/Psychotic, etc., when otherwise I would NOT HAVE? Can this happen? I look forward to responses to this question. It has been a hell of a ride!

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Answers (5)

John McManamy, Health Guide

5/20/08 10:36pm

Hi, DeeDee. There is a good chance that the meds you were on did flip you and destabilize you. We're all different and we respond to meds in different ways. Many people with bipolar do very well on ADD meds. Some also do well on antidepressants. Obviously, you didn't.

There are likely to be trust issues with your current doc. You may want to consider another one. I won't hazard a guess as to the meds you should be on, but the first priority is making sure your mood is stable. That would suggest a mood stablizer - just a mood stabilizer.

Later, when your stability is assured and when your doctor has a more precise diagnostic read on you, there may be justification for adding more meds. But obviously you need to proceed with caution and your doctor needs to understand that, too. Don't be afraid to stand up for yourself.

John McManamy, Health Guide

5/20/08 10:44pm

Hi, DeeDee. Forgot to address the query in the caption. There is a strong body of expert opinion that recurrent depression is so closely related to bipolar that it may be advisable to treat both with mood stablizers rather than antidepressants. Basically, whether you have recurrent depression or bipolar II, you are cycling. You may not be as cycling high up, but you are still cycling. And now that various meds destabilized you, you may be truly bipolar anyway. But the important thing right now is to treat the cycle, and you need a mood stabilizer (such as lithium or depakote) for that.

Disclaimer: I'm not a clinician. Please discuss this with your doctor.

Chrispy

6/14/08 9:04pm

Antidepressants can cause bipolar people (or people who APPEAR to have MDD) to become manic. It might have been the Cymbalta that made you manic. Celexa (another antidepressant) is what made me manic.

I used to take Topamax too. What I found was that it landed me in the hospital and caused me to try and kill myself. Maybe it was the Topamax that made your depression worse.

Hope that helped. Take care,

- Chris

Sherrie M

10/26/08 11:02am

Prednisone can cause mania. I went completely manic with psychosis after taking Prednisone. I've lost my job and my independence. I've been on a mood stablizer (depakote) and Lorazepam (anti-anxiety medication) for over a year now. Depakote has made me gain over 100 lbs and causes me to be mildy depressed and tired all the time. Please if you can stay away from Prednisone.

It's Me

8/27/09 11:52am

Before I take prednisone, I discuss it with my Pdoc so that he knows the dosage and the length of time. We discuss when to call and what I need to do to try to avert mania. For me, if I get good sleep, eat properly, and exercise, I can avoid manic tendencies while on prednisone. If not, then I will become manic.

Also, my husband, also bipolar, was on a stimulant that caused a mania that last 5 months because doctors didn't believe that was the cause. It started with the med, and when they finally took him off of it and added Lithium, it went away.

So, yes, a combo of meds could very well have caused the mania. But it really isn't anyone's fault because drugs react differently for each person. There are some medications that work great for me but cause problems for my husband and visa versa. Really, for all medications, even those for other diseases, we are just in an experiment to see how our bodies react.

Q: Could wrong medications cause bipolar symptoms in a recurrent major depressive without true bipolar?

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