Discussion in 'General Parenting' started by Kit_Kat_MI, Feb 15, 2007.
There are a number of other types of antidepressants and some that don't fit any types. Here's a list: http://www.healthyplace.com/communities/depression/treatment/antidepressants/antidepressant_list.asp
There are tricyclics. They are more effective but more dangerous than SSRIs with all the same possible side effects and more. The suicidal ideation is an issue because those drugs can be easily used to commit suicide while the SSRIs are very difficult to use that way. The initial studies on antidepressants triggering rapid cycling and the identification of antidepressant induced bipolar came through use of tricyclics, not SSRIs.
The SNRI and SNRI/SSRI combos -- Effexor, Cymbalta, Strattera.
MAOIs -- there are lots of conflicts with other drugs and a foods with that class of drugs.
Abilify isn't a mood stabilizer. None of the antipsychotics are approved for stand alone long term maintenance for bipolar.
Antidepressants can be used with Abilify but no antipsychotic or mood stabilizer will control the psychiatric adverse reactions to antidepressants.
In Europe, the most common treatment for adult type bipolar is lithium and an antidepressant. However, they are much less likely to diagnose bipolar in children and are far less likely to prescribe antidepressant for children period.
I've tried SSRIs: Prozac, Zoloft, Paxil and tricyclics: amitryptilene, tofrinil, nortryptelene (all spelled wrong) and this is what I found. Sadly, I know about patient response to medications based on being in the hospital myself three times, at one time for ten weeks when insurance actually covered your stay. The tricyclics, in my opinion, work LESS well than the SSRIs for depression. I found the side effects horrible, including psychosis. The only one I could tolerate was nortryptylene, and that maybe helped me only 50%. I was still not functioning well. Then the SSRI's came out and I had hideous side effects to both Prozac and especially Zoloft. But, again while in the hospital, the patients seemed to do better on the SSRI's than when there were only tricyclics. Paxil works well for me. I have no idea why. It's been eleven great years. Effexor is an SNRI. Straterra is an SNRI. Wellbutrin is different--not sure what. My hub, who has no disorder and is usually calm, took it to stop smoking and it didn't help him stop (he since stopped on his own). It did make him so nervous that he tossed it in the trash. There are no medication guarantees and for kids none are really that great, in my opinion--I'd watch any child on any sort of antidepressant. There are also withdrawal effects. I had them from tricyclics as well as SSRIs and they aren't fun. The worst withdrawal I had was from tofrinal. I ended up back in the hospital because I started acting bizarre and suicidal. I deliberately crashed our car into the cement wall of the garage and I *knew* I wasn't "right" but couldn't help it. It took a while each time to get the drugs out of my system, and I've been tempted to try quitting, but each time I do, even after the darn drug wears off, I fall into a deep depression. Sometimes you have no choice.
With all due respect, why are you interested in an antidepressant when your difficult child might have bipolar disorder? If she's not on a mood stabilizer, that's the first medication to consider before anything else. by the way, the mood stabilizer Lamictal works well for bipolar depression.
If your daughter is bipolar and not on a mood stabilizer, putting her on an anti-depressant could very easily throw her into full blown mania. For bipolar she needs to be on a mood stabilizer first and then, after it's determined that the mood stabilizer is effective, they will sometimes add an antidepressant if it's needed.
That is one of the reasons I refused medications for my daughter for so long. Everyone wanted to do an antidepressant, but she had enough symptomology that matched bipolar I wasn't putting her on an antidepressant until we ruled bipolar out. Even then, her psychiatrist warned us to keep our eyes open because something like 30% of kids with depression go on to develop bipolar disorder.
From our experience, difficult child 2 went from bad to worse when an SSRI anti-D (Zoloft) was thrown in the mix with just his ADHD stimulant (became manic, even though he doesn't have BiPolar (BP) diagnosis, and ended up dropping the Zoloft and adding Risperdal). So if your difficult child is BiPolar (BP), I'd tread very carefully with that.
I have taken both an SSRI and a tricyclic and the latter worked much better for my depression (although one of the side-effects bothers me: increased heartrate).
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