risks of ADD meds with bipolar disorder?? - Bipolar Disorder Message Board

4support · 03-11-2007, 08:47 PM

Hi friends,

My husband who has BP/ADD and is medicated with lithium, began taking (not sure why the forum won't let me post the medicine name, same as slow release Ritalin) for ADD 2 weeks ago. The first week he seemed to be fine, however over the past week he has slipped into a MAJOR depression. I honestly have never seen him this down, he tells me he is having serious feelings of hopelessness, sadness and overall depression. He says he has never felt this badly, feels empty and overwhelmed, and just sits around staring ahead and looking very out of it and sad.

We have an appt with his pdoc in 2 days. In the meantime, we decided he should probably discontinue the med until he sees him.

Is anyone on this forum familiar with the risks of mixing ADD medications with bipolar mood stabilizers? On the med leaflet, it states that major mental/mood changes which can include anxiety, irritability and depression can be a side effect and to discontinue use. Has anyone had experience with mixing these meds and if so, what has and hasn't worked to manage the moods/depression AND the ADD? Also, I've read that anti-depressants can push someone with BP into a manic episode. Can the BPers out there share their success/non-success stories with me please.

I am very worried about my husband and just keep trying to reassure him that we will continue to go the pdoc regularly until he finds the right med combo to really HELP him and make him FEEL BETTER. It's a helpless feeling for me, as I know there is really nothing I can do to pull him out of this.

Thank you for all of your help!
4support

Paige1989 · 03-11-2007, 09:19 PM

My psychiatrist (pdoc) told me most ADD/ADHD meds are stimulants, like a higher dose of caffeine, and that can throw you into either state. So talk to his pdoc (or have him talk to the pdoc) about Stratterra, which is the only non-stimulant ADD med.

Hope this helps,
Paige

tsohl · 03-11-2007, 09:31 PM

Hello 4support,

Sorry you are already having problems with meds after things were going so well for a few days! I am not really responding directly to your post because I don't know about those ADD drugs...but I wanted to pass along something else. I would first want to get the bipolarity medicated before trying to do much with the ADD. Often it is found that when a person is properly medicated and are episode-free (in the nice even "stable" state), there is little need for all these additional, add-on drugs. Often what was thought to be ADD was really symptoms caused by hypomania. The newer trend among more recently trained pdocs is to treat the diagnosis of bipolar rather than trying to treat each of the symptoms separately. Often more than one mood stabilizer is necessary...because one works better on symptoms of depression, another works better on symptoms of mania, etc. My son was on lithium and then the pdoc would try something else almost every month, to go with the lithium. When he switched pdocs, the new one added tegretol which made him "better" but not quite 100%...so in awhile he added lamictal...and that's what he takes now...all 3 at tolerable doses!

I personally would be really cautious taking an anti-depressant until your husband is stabilized...but obviously your pdoc should be able to help you here. I would call the office first thing in the morning and ask if he should discontinue the med for ADD...and explain what is happening. No reason to wait two more days to find that out.

Hang in there. Keep reassuring your husband that it is common to have to go through a period of trial and error until you find the right meds, but that this WILL happen.

Tsohl

Llama · 03-12-2007, 12:23 AM

Hi 4support,

You might want to ask your husband's pdoc about lamictal. It is a mood stabilizer that is supposed to work well for depressive episodes in bp. It also should have a lower risk of sending someone with bp into a manic state (as opposed to the antidepressants).

I'm sorry to hear that the add meds have made your husband feel worse. I don't know what to think now considering my pdoc prob wants to start me on some kind of add med too!

marshmallow · 03-12-2007, 08:08 AM

4support I am sorry your husband is feeling so badly and problems with the meds. I cannot help with any of that but wanted to say I hope things get better for both of you real soon.