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Q: ADs w/ Low Risk of Inducing Mania?
I have been diagnosed with Bipolar II and GAD. We seem to have the Anxiety
under control with a combo of Klonopin & BuSpar. However, I
came in 6 weeks ago in a deep depression...so my doctor first prescribed
Wellbutrin. I've been on it 6 weeks now, with now relief. Are there
any other safer anti-depressants that you would suggest that have a low risk of
inducing mania?
Thanks!
Dear Jessica --
As you may have heard, Wellbutrin is one of the least likely to induce mania,
based on lots of clinical experience -- but not based on any "head to
head" studies of antidepressants in this role. There are a few such
studies but they don't really generate the data we'd need to comment further on
your question.
As you may also have learned, theoretically if you
really have bipolar disorder, then you're on an antidepressant without a mood
stabilizer, and that is not generally thought wise in people who truly have
bipolar disorder. If things are going well, most doc's wouldn't change
anything. But if depressions return despite being on Wellbutrin; or
if you see other evidence of "cycling", then you'd have to think (and
discuss with your doc') about getting on a mood stabilizer (Klonopin has some
possible value in this respect but is not in the "big leagues" in this
department).
Dr. Phelps
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