Since people with Bipolar II disorder have far more depressive episodes than hypomanic, it stands to reason that there would be a lot of effort put into finding out which medications are particularly good for Bipolar II depression, which includes mixed episodes where some hypomanic characteristics intrude. But in fact, researchers Holly A. Swartz, MD, and Michael E. Thase, MD, found that the opposite is true. They reviewed literature from relevant clinical trials and found that there's only enough information for a few drugs to say they have been shown effective for depression in Bipolar II disorder.
Topping the list of effective medications in this review is quetiapine (brand name Seroquel). Although quetiapine is an atypical antipsychotic drug, it was judged as having "compelling evidence supporting its efficacy." Of the other drugs tested enough to include (and there weren't many), Lamictal (generic lamotrigine) and Lithium could be considered as second-line options, SSRI antidepressants did better on their own than in combination with other drugs but weren't as effective as the first three, and a drug for Parkinson's disease, Mirapex (generic pramipexole), could have some effectiveness in combination with other drugs.
Topping the list of effective medications in this review is quetiapine (brand name Seroquel). Although quetiapine is an atypical antipsychotic drug, it was judged as having "compelling evidence supporting its efficacy." Of the other drugs tested enough to include (and there weren't many), Lamictal (generic lamotrigine) and Lithium could be considered as second-line options, SSRI antidepressants did better on their own than in combination with other drugs but weren't as effective as the first three, and a drug for Parkinson's disease, Mirapex (generic pramipexole), could have some effectiveness in combination with other drugs.
If you might be interested in contributing to the research on medications for Bipolar II depression, check out this clinical trial currently recruiting participants: Bipolar II Depression: Lithium, SSRI, or the Combination.
Source: Swartz, HA and Thase, ME. "Pharmacotherapy for the Treatment of Acute Bipolar II Depression: Current Evidence." Journal of Clinical Psychiatry. 2011;72(3):356-366.
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I’m having amazing success with Deplin. You might want to look into it.
Caustion should be used when prescribing SSRI & SNRI antidepressants to bipolar patients.
The Physicians Desk Reference states that SSRI antidepressants and all antidepressants can cause mania, psychosis, abnormal thinking, paranoia, hostility, agitation, etc. These side effects can also appear during withdrawal. Also, these adverse reactions are not listed as Rare but are listed as either Frequent or Infrequent.
Go to http://www.SSRIstories.com where there are over 4,600 cases, with the full media article available, involving bizarre murders, suicides, school shootings/incidents [65 of these] and murder-suicides – all of which involve SSRI antidepressants like Prozac, Zoloft, Paxil, etc, . The media article usually tells which SSRI antidepressant the perpetrator was taking or had been using but sometimes the media article just says “antidepressant” or “medication for depression”.
On December 15, 2010, PLoS Medicine released a study which showed that, in regard to prescription medications and violence, the FDA had received the most reports of violence from the SSRI & SNRI antidepressants (except for Chantix, the smoking cessation drug.) The evidence of an association with violence was weaker and mixed for antipsychotic drugs and absent for all but one of the mood stabilizers. Yet, the antipsychotics and mood stabilizers, given for the most serious mental illnesses, bipolar disorder and schizophrenia, would be the most likely culprit involved in violence but, instead, it was the antidepressants which had the most reports of violence. They were given to patients that traditionally were the least likely to commit violence, the depressed and the anxious. See:
http://www.ssristories.com/show.php?item=4701
Watch out for Seroquel! I took it for 2 months and it left me with a permanent tremor in my left (dominant) hand.
It is very embarassing. I have even had clients remark on it.
One said I look like I needed a drink!
By the way…. the Seroquel is a marvelous drug! I wish I could have stayed on it.
I developed cataracks in both eyes which required surgery on this drug. It is a KNOWN side effect but the doctor never stopped me taking it. It knocked me out too much so it was supposed to be for sleep, but I used it for calmdowns when needed too. But the last straw was when I would simply pass out. The first time I made the connection I got rid of it all. Thanks to the non-informed attitude of the doctor, I am a ‘bad patient’ because I question ALL possible side effects before I take meds as I react strongly to all drugs.
Presently, having moved away from my triggers, I am off meds by my own choice. Get sad and very occasionally hyper but I am not fainting or developing medical problems from them.
ALWAYS do your own research on meds and the situations which are stated you should not take them because pdocs do not ask all the questions about you medical health they should and sometimes just don’t do any research at all.
American Journal of Physiological endocrinology and metabolism; April 2011 medical research study: “Atypical antipsychotic drugs perturb AMPK- dependent regulation of hepatic lipid metabolism” – excerpts from the study: “Taken together, these data suggest that AAPD_stimulated hepatic dysregulation of lipid metabolism could result from the inhibition of AMPK activity, and pharmaceutical means to potentiate AMPK activity would contribute to restore hepatic lipid homeostasis”….earlier in the article…..”AAPD decreased transcriptional activity of PPAR@, a critical transcriptional regulator for controlling hepatic fatty acid oxidation, via an AMPK dependent manner.” end quote.
Forever my Dr.’s tried successfully to medicate away mania (which I seldom had) and depression which it seemed I always had.
The only trouble is…they also successfully medicated all the joy, wit and wonder out of life!
Mania isn’t bad. It’s the uncontrolled behavior that is.
For me learning to control my behavior has been much better than controlling mania or depression.
What if you get out of control? You could die! I’ll risk it.
I’ve tried the not living thing already. No fun.