Trouble with Sleep-Manic Episode?
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Q:  Trouble with Sleep-Manic Episode?

Hi, I have a question. I have been diagnosed with Bi polar mixed states. I am currently taking Trileptal, wellbutrin and trazadone for sleep. The thing is nothing is helping me sleep. I am exhausted. Do you think that I am having a terrible manic episode? please let me know what you think. thank you so much for your help


Dear Ms. V' -- 
When someone has a diagnosis of bipolar disorder and says "I'm having trouble with sleep", the very first thing I do is look at their medications to see if there's an antidepressant in there.  Now your doctor may have arrived at your current mix with great care and consideration and you could be an exception to the general rule, so you need to take my thoughts with that huge grain of salt.  I'll offer some general ideas. 

I think that mood experts have come to agree that antidepressants can induce manic-side symptoms with such frequency that if somebody's having difficulty sleeping, the antidepressant could be part of the problem.  Not the whole problem, but part of it.  

So, for you to discuss with your doctor:  maybe either less antidepressant or more mood stabilizer (I often try to "trade on for the other") would be useful.  

Dr. Phelps

Published September, 2002


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