Noradrenaline & Rapid Cycling : Serotin Reuptake Inhibitors
[Home] [Bipolar News] [Bipolar Disorder] [Medications] [Treatments] [Bipolar Disorder/Job/School] [Disabilities] [Ask the Doctor] [Ask David] [Self-Injury] [Personal Stories] [Graham's Column] [Steven's Column] [Storm's Column] [Columnist Archives] [Suicide] [Community Support] [Family Members] [Expressions] [Greeting Cards] [Books] [Awards] [Links & Rings] [About Us] [Contact Us]

 


Q:  Noradrenaline & Rapid Cycling : Serotonin Reuptake Inhibitors


Dear Dr. Phelps:

This is a long due thank you for all the help I have got from your psycheducation site and, now that I can, to ask you about some things that I have noticed and have not found in it.

First, I have read elsewhere that after a long, years long, treatment with antidepressants and after a mood stabilizer is established, the usual residual depression goes away after the takeaway of the antidepressants. And my experience says  so.

Then, I have found that noradrenaline increase causes rapid cycling, actually an acceleration. It has happened to me with imipramine and, to a lesser extent, venlafaxine, but I have found no reference to it, anywhere.

Third, I suspect that increase in serotonine does have an effect that I have found, again, never noticed, actually I have found no name for it, which is that it decreases sensations: hunger, sleepiness, even boredom (it does only increase thirst ;-). May that be so?

Thank you again,



Dear G. --

Taking your thoughts in turn: 
1. Glad to hear that your experience is consistent with my working clinical impression that things can go better when antidepressant is removed.

2. Suspecting venlafaxine (Effexor) as capable of inducing rapid cycling is indeed consistent with a recent study comparing venlafaxine with two other antidepressants. Venlafaxine seemed to be associated with a much higher rate of switching into mania than the other two. One of the comparison medications was sertraline (Zoloft), an SRI. Interestingly, the other one was bupropion (Wellbutrin), which has long been suspected as less likely to induce instability -- even though it affects noradrenaline (norepinephrine). I don't think we quite know enough to know precisely which neurotransmitters do exactly what.

3. Serotonin reuptake inhibitors have been recognized to decrease appetite, perhaps particularly Prozac, sometimes others, but quite often they increase appetite after awhile and can be associated with weight gain. They can all induce insomnia, but sometimes they make people sleepy, so that reaction is also hard to predict. As for decreasing boredom, that is trickier, as boredom is a complex phenomenon and probably means quite different things to different people. Interesting to hear that you thought an SRI might decrease it.

Thank you for your questions --

Dr. Phelps



Published September, 2007
 
 

Bipolar World   1998, 1999, 2000, 2001, 2002, 2003, 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014
Owners: 
Allie Bloom, David Schafer, M.Ed. (Blackdog)
Partners:  John Haeckel, Judith (Duff) 
Founder:  Colleen Sullivan
 

Email Us at Bipolar World

 

About Us  Add a Link  Advance Directives  Alternative Treatments  Ask the Doctor   Ask Dr. Plyler about Bipolar Disorder   Ask The Doctor/ Topic Archives  Awards  Benny the Bipolar Puppy  Bipolar Chat  Bipolar Children  Bipolar Disorder News  Bipolar Help Contract  Bipolar World Forums  Book Reviews  Bookstore  BP & Other mental Illness   Clinical Research Trials & FDA Drug Approval   Community Support   Contact Us  The Continuum of Mania and Depression   Coping   Criteria    Criteria and Diagnosis  Criteria-World Health Disabilities,  DSMV-IV   Dual Diagnosis  eGroups  Expressions (Poetry, Inspiration, Humor, Art Gallery, Memorials  Family Members   Getting Help for a Loved One who Refuses Treatment  Greeting Cards  History of Mental Illness  Indigo  Job and School  Links  Manage Your Medications  Medications   Medication and Weight Gain    News of the Day  Parent Chat  Pay for Meds  Personal Stories  Self Help  Self Injury  Significant Others  Stigma and Mental Health Law  Storm's Column  Suicide!!!  The Suicide Wall  Table of Contents   Treatments  Treatment Compliance  US Disability  Veteran's Chat  What's New?