Skip to content
My WebMD Sign In, Sign Up

Announcements

Are you on Antidepressants and Frustrated that you can't Lose Weight?

Visit our Crisis Assistance Link for resources. For immediate help, get to the ER.

If you think you may have a Borderline Personality Disorder, please read this link shared here. Also, Topic Overview.

*No Dr Outside Contact Please*
Last Reply:
Includes Expert Content
Dr G. question
avatar
ttsmile posted:
I have been diagnosed as bipolar disorder mixed. Bipolar 2 fits me very well, especially the high activity levels and lack of need of sleep, followed by a crash completely into depression. The dr diagnosed me after becoming very agitated and a little agressive on a tricyclic antidepressant. He put me on another anti-depressant--celexa, which did nothing for the depression (a little for the anxiety) but made me wound-up followed by crashing really low rather quickly. Now I am on abilify, wonderful medicine. I have no depression, thought tend to be rather impulsive and am needing sleep less. No full on mania, though. My question is, Is the implusiveness getting worse something I should be concerned about, or just learn to manage?
2 Replies |Watch This Discussion | Report This| Share this:Dr G. questionI have been diagnosed as bipolar disorder mixed. Bipolar 2 fits me very well, especially the high activity levels and lack of need of sleep, followed by a crash completely into depression. The dr diagnosed me after becoming very agitated and a little agressive on a tricyclic antidepressant. He put me on another anti-depressant--celexa, which did nothing for the depression (a little for the anxiety) but made me wound-up followed by crashing really low rather quickly. Now I am on abilify, wonderful medicine. I have no depression, thought tend to be rather impulsive and am needing sleep less. No full on mania, though. My question is, Is the implusiveness getting worse something I should be concerned about, or just learn to manage?
Reply
 
avatar
Joseph F Goldberg, MD responded:
Dear ttsmile,

Not sleeping and uncharacteristic impulsive behaviors can be symptoms of residual or undertreated hypomania. Have you asked your doctor about giving you a mood stabilizer? Depakote is probably the best-studied mood stabilizer for the treatment of mixed episodes and, unlike Abilify, has been found to treat depression as well as hypomania. Studies also have shown that the combination of a mood stabilizer such as Depakote plus an antipsychotic such as Abilify may be more effective than 1 drug alone.

We tend to favor mood stabilizers over antipsychotics for the long-term since mood stabilizers are better studied and do not carry the risk for tardive dyskinesia, diabetes, or high cholesterol associated with atypical antipsychotics as a class; antipsychotics are more often short-term treatments, especially when psychosis is present (in contrast to bipolar II disorder, where by definition there is no psychosis during high periods) rather than preventatives against relapse after an acute episode has remitted.

Dr. G.
Report This| Share this:Dr G. questionDear ttsmile,<br /> <br />Not sleeping and uncharacteristic impulsive behaviors can be symptoms of residual or undertreated hypomania. Have you asked your doctor about giving you a mood stabilizer? Depakote is probably the best-studied mood stabilizer for the treatment of mixed episodes and, unlike Abilify, has been found to treat depression as well as hypomania. Studies also have shown that the combination of a mood stabilizer such as Depakote plus an antipsychotic such as Abilify may be more effective than 1 drug alone.<br /> <br />We tend to favor mood stabilizers over antipsychotics for the long-term since mood stabilizers are better studied and do not carry the risk for tardive dyskinesia, diabetes, or high cholesterol associated with atypical antipsychotics as a class; antipsychotics are more often short-term treatments, especially when psychosis is present (in contrast to bipolar II disorder, where by definition there is no psychosis during high periods) rather than preventatives against relapse after an acute episode has remitted.<br /> <br />Dr. G.
Reply
 
avatar
ttsmile replied to Joseph F Goldberg, MD's response:
Thank-you
Report This| Share this:Dr G. questionThank-you
Reply


Back to Top
Back to Top

See Related Mental Health Communities

See All Communities

Featuring Experts

There are no Expert stories for this community right now

Popular Discussions

Start a Discussion | See All

Helpful Tips

Screen out people who can't seem to "get it"....
There are some people who can't or won't understand at all. My wife is bipolar, and some people are more understanding than others. We ... More
Was this Helpful?
Yes No
31 of 37 found this helpful
Post a Tip | See All

Helpful Resources

Post a Resource | See All

Related News

Related Drug Reviews

  • Drug Name User Reviews
See More

Report Problems to the
Food and Drug Administration

FDAYou are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.