ADs w/Low Risk of Inducing Mania?
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Q:  ADs w/ Low Risk of Inducing Mania?

I have been diagnosed with Bipolar II and GAD.  We seem to have the Anxiety under control with a combo of Klonopin & BuSpar.  However, I came in 6 weeks ago in a deep my doctor first prescribed Wellbutrin.  I've been on it 6 weeks now, with now relief.  Are there any other safer anti-depressants that you would suggest that have a low risk of inducing mania?

Dear Jessica -- 
As you may have heard, Wellbutrin is one of the least likely to induce mania, based on lots of clinical experience -- but not based on any "head to head" studies of antidepressants in this role.  There are a few such studies but they don't really generate the data we'd need to comment further on your question.  

As you may also have learned, theoretically if you really have bipolar disorder, then you're on an antidepressant without a mood stabilizer, and that is not generally thought wise in people who truly have bipolar disorder.  If things are going well, most doc's wouldn't change anything.   But if depressions return despite being on Wellbutrin; or if you see other evidence of "cycling", then you'd have to think (and discuss with your doc') about getting on a mood stabilizer (Klonopin has some possible value in this respect but is not in the "big leagues" in this department).  

Dr. Phelps


Published July, 2002


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