Antidepressants-What Do I Do
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Q:  Antidepressants-What Do I Do

Help! I truely believe I have Bipolar II but my Pyschiatrist keeps on trying antidepressants!

I have had many occurances of depression and have always responded well to an antidepressant almost immediately until now. After the birth of our third son, my regular antidepressant, Zoloft no longer worked. I started cycling. Up for a week obsessing like crazy on something and then down . . . So I realized I may be Bipolar II (episodes in the past also point to this>) So I went to this dr. and he prescribed Wellbrutrin. This started me on a weekly cycle for 2 months straight. Most weekends suicidal. When I went back to him he only increased it to full dose. After this I had the worst depressive episode ever and almost didn't make it.

I just went back to him after this episode and he wants to put me on yet another antidepressant. I do not agree with him and am afraid this will really put me under. I can not find another dr. right away so I need to stay on the Wellbrutrin (was 450 mg) , change to the other antidepressant, or quit altogether in the meantime. What do you suggest?

I think I should just take a small dose of the Wellbrutrin until I can find another dr.??

Dear Ms. B' -- 
You're in a tough spot.  What would the doctor say if you said you thought you had bipolar II and that antidepressants can make that cycle?  (you probably already did this?...)  If you said you'd tried numerous antidepressants and wanted to try a mood stabilizer; or if you said you'd like to try augmenting the Wellbutrin with lithium -- would he go for that?  

In general in this circumstance most doctors would want the "patient" to speak out about their concerns and their wishes; maybe there's information he's not aware of so far that would help him recognize a possible bipolar component.  For example, you could complete the Mood Disorders Questionnaire and bring that in to him?  Would he respond to this kind of thing?  I am aware that there are doctors out there who would not respond constructively, so I don't make these suggestions expecting that will work out every time.  

In other words, I'm trying to help you work with this guy so you have somebody to work with while you're hunting up somebody else.  As for what to stay on while you're looking, well, I wouldn't want to try to stand in and be the interim doc' at a distance, so I really shouldn't tell you what to do at all.  There is no clear widely accepted view on what to do in your circumstance, I can tell you that.  Most important is  just what you've done so far, which is try to make something work out (fairly quickly now) so that you're under a doctor's care and she/he has a diagnosis and treatment plan you understand and feel okay trying to pursue.  Good luck getting that together.  

Dr. Phelps


Published February, 2002


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