Robert D. McMullen, MD about Medications for Depression & Bipolar
Medications for treatment of Depression & Bipolar disorders
Major depressive disorder is also known as major depression, clinical depression, or unipolar depression. The term unipolar refers to the presence of one pole, or one extreme of mood- depressed mood. This may be compared with bipolar depression which has the two poles of depressed mood and mania (i.e., euphoria, heightened emotion and activity).
Bipolar disorder (also known as manic depression) causes serious shifts in mood, energy, thinking, and behavior—from the highs of mania on one extreme, to the lows of depression on the other
These are of 2 types
• Bipolar I disorder involves periods of severe mood episodes from mania to depression. The highs may even require hospitalization of the person.
• Bipolar II disorder is a milder form of mood elevation, involving milder episodes of hypomania that alternate with periods of severe depression
The depression that people with bipolar disorder experience is generally of a melancholic or psychotic type and therefore more biological in its nature. The depression found in these bipolar patients can be difficult to treat than unipolar depression as the antidepressants can cause them to have greater mood swings. These patients need to be on mood-stabilizing drugs. The antidepressants alone can actually increase the manic episodes and worsen the disorder.
Antidepressants: divided into three main classes:
• Selective serotonin reuptake inhibitors (SSRIs) - were developed in the 1980's and are the most common prescribed today. They are sold under brand names such as Prozac, Paxil, Prozac, Luvox, Zoloft, Celexa
• Monoamine oxidase inhibitors (MAOIs) There are three types of MAOIs, phenelzine,(Nardil) isocarboxazid and tranylcypromine, ( Parnate) and moclobemide.)
• Tricyclic drugs (TCAs). (sold as Amitriptyline, Imipramine)
For effective control and to limit the side effects a combination can be used such as Wellbutrin (or bupropion). Mechanisms of action are different hence lower doses of both help control side effects. The combination of Zoloft and wellbutruim earned the popular name Welloft.
The MAO inhibitors are more effective than the SSRI drugs. But can cause severe weight gain and therefore patients need to work on diet control, else the spike in blood pressure can be dangerous. They are contraindicated with drugs that work on serotonin.
Lamictal (or Lamotrigine) was FDA approved for treating depression in 2003.The main advantage being, no sexual dysfunction, no sexual side effects and no weight gain. There is no sedative effect and dosage is generally much less than used for seizures.
If any of the above mentioned combinations are ineffective in controlling depression, the thyroid hormone replacement drug Cytopan or Cytomel or Synthroid can be added to any of the above drug.
Atypical anti-psychotics such as low doses of Zyprexa, or Abilify, or Seroquel, and the latest Quetiapine can also be prescribed. 150 mg of Lithium, normally prescribe for Bipolar at much higher doses, can be used safely without having to get regular blood checks.
Address: #2, 171 W 79th St, New York, NY 10024
Phone: (212) 362-9635
please please listen to me i have to say just for leagal reasons it is in my opinion that your better off without the medications any that are for bipolar.. If you want to go threw life having every doctor saying that you have A.L.S. then take the meds. I took the medication for pain because I didn't want narcotics. when I got off 3 years later I could no longer keeps my body from tremoring. i almost lost my voice. i have to drink for breakfast lunch and dinner. I have met many many people at the MDA that did the same as I did. if you think im ok because there's nothing going on now, just get off the meds and you will see in a couple of months. PLEASE SAVE YOURSELVES from this. I owned my business grossing over 3 million a year. now im living off of social security. DONT LET THIS HAPPEN TO YOU PLEASE! for the love of everything HOLY dont do it please. Doc warn your patients. I find all of you doctors are just worried about getting that kickback from prescribing.
shrinks = pseudo-science + big pharma scams. These charletons will prescribe dangerous meds after just 15 mins to make a diag. They now have over %10 of the population on psyche meds. The drugs only work on schizoprenic patients, the rest is just bull shit and actually cause more mental illness than they cure. Don't buy into it. They also like to prescribe highly addictive benzos for sleep and anxiety. Seems lots of people who uses benzos wake up in jail after blacking out in car accidents or just other bizarre behavior. These clowns make $250K a year just writing scripts and sitting on there ass, while telling their golf buddies how they are saving crazy people. I'm a former victim and it just makes me sick !
TMS and ECT also bullshit, do your reseach before letting some quack attach electric shock to your brain. My god people are gulliable.
These doctors are the only ones who treat a body organ that they can’t see It is all guess work Dr I know you mean well but this profession has had no major medical breakthrough Dr the new wave is diet plant based More and more Dr are backing such approach We need to fix the cause not just treat the symptom
Dr..have you have found any link between severe depression and auto immune disease? I became so depressed after being diagnosed with active epstein barr and have went down hill for 8 months..I cannot function due to a mind numbing depressive state..I have terrible mouth, teeth and gum pain (no dental issue found), digestion has slowed to a crawl and bloated with weight gain, no appetite (have to force myself to eat 1x per day (usually soup or salad) dry skin that burns, eyes blurry and become very bloodshot, (ALL mucous membranes affected) muscles are weak and toes on one foot have gone numb and I now limp along with several other issues.I have a positive ANA and it seems as if my body is attacking itself (tsh in normal range)..I so apologize for this long disorganized post! My main questions are 1) Are these common issues of severe depression? 2) Have you seen people improve by taking plaquenil or a biologic drug for systemic auto immune disease? Thank you
Doctor, would you please make a video about insomnia, especially as it occurs in depression and bipolar disorder? It's got to be the worst part of depression because of the continual exhaustion and the inability of the brain to get the rest it needs to replenish neurotransmitters and function properly.
Dr. I have watched many of your YouTube clips and let me start by saying you are very helpful, knowledgeable and informative and I am sure you have helped many people through YouTube. I have suffered life long depression and anxiety to varying degrees which is obviously worse in times of angst. I have seen about 4 psychiatrists over the years and I wish even one of them was as knowledgeable as yourself.
A couple of things I would like to ask is regarding your thoughts on RIMA medications ie moclobemide etc.
Also the long term effects of TMS in relation to cancer of the brain? Even though scientists haven't proven a correlation between cell phone use and brain cancer with the electro magnetic radiation that is emitted by cell phone use, the jury is still out. Therefore, what are the risks of the electro magnetic field emissions from TMS as a risk factor even though I realise it is only used for a short period of time compared to cell phone use cumulative over years.
Greetings from Australia.
It would not be appropriate for me to suggest any medication for you to take as I do not know anything about you. You should set up an appointment with a psychiatrist who can interview you, gather some history, spend time with you and develop a treatment plan. Be well!
It would not be prudent for me to comment as I do not know the specifics of your condition. Contact my office if you are interested in seeing me 212 362-9635 or speak with your psychiatrist about this in detail.
MAOI's are considered. They can be very good for some patients with depression. Of course there are a few dietary restrictions, but often the benefit of the medication is well worth having to watch you diet. Be well! Office phone is 212 362-9635
I have been on Wellbutrin for a little under a year. It worked alright but the last few months my depression has gotten progressively worse. I seen my PCP yesterday and she prescribed me Zoloft to take along with my Wellbutrin. I took my first pill yesterday and as soon as I did I felt as if I couldn't focus, I was extremely hyper, shaking, my brain feels like it's just pinging in a million directions. I took it at 3 yesterday and still feel the same as I did right after I took it. I didn't sleep at all last night. I did some research online and read alot of things about hypomania and bipolar episodes. I have not been diagnosed with bioplar, but it runs in the family my father has it, his father etc etc. I have an appointment to see a therapist next month, I put a call into my doctor because I just don't feel right and she's not in today. Can you give me any idea of what I should do?
As I am not your physician I would not give you advice on how to manage your medications -it is just not the right thing to do. You have a call into your physician and I would wait for him/her to call you back. If you encounter problems with your medications always communicate with your physician even if it means having to leave several messages with the reception desk or answering service. If it is an emergency and you do not receive a call with in an hour call again. All the best. Be well!
I have been on lamital for years on and off but now a full year and I google reviews from people and they say the same thing. It does affect my sex drive and causes weight gain slowly but it does. I don't get it? How much does it cost to call you and will I get you directly?
dear, respected doctor, i have O.C.D, and i know it, 2 weeks ago i saw a doctor for psychotherapy , but instead they gave some medication and told that i am suffering from anxiety, i agreed cause i knew that i have anxiety issues and i well be all right if take medications, but after a use of 5 days, my anxiety got worse and some time a had very bad anxiety attacks,
when i searched the medication, i a was stunned to see that they were for bipolar disorder, and after that i visited the doctor to confirm they also admitted....
my whole condition is alot more worse... the medication i am using are lithium carbonate, olenzopine+fluxtien, and kempro an anti parkinson drug, i know i do not have any bipolar disorder,
now all i want is to withdraw the medication safely, plz help me out, i am afraid to cold turkey, plz tell how to come off these medication, note i have use them only 15 days,
My hands are tied here as I am not sure of the particulars od your case. If you are not confident in your physician's assessment and treatment seek another opinion. Always be willing to ask questions and listen to the feedback. Be well!
There are a few ideas to try
Find the reasons why you are shy - the first step in solving an issue is to understand why it is there.
Be comfortable with yourself - this makes it less difficult
Challenge youself - you will feel better by taking action - especially by doing things that push your boundaries.
(I read these and more tips from Martos magic method site )
Antidepressants are medications that can help relieve symptoms of depression, social anxiety disorder, anxiety disorders, seasonal affective disorder, and dysthymia, or mild chronic depression, as well as other conditions.
They aim to correct chemical imbalances of neurotransmitters in the brain that are believed to be responsible for changes in mood and behavior.
Depression Medications (Antidepressants)
These are the most commonly prescribed type of antidepressant.
Serotonin and noradrenaline reuptake inhibitors (SNRIs) are used to treat major depression, mood disorders, and possibly but less commonly attention deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), anxiety disorders, menopausal symptoms, fibromyalgia, and chronic neuropathic pain.
SNRIs raise levels of serotonin and norepinephrine, two neurotransmitters in the brain that play a key role in stabilizing mood.
Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed antidepressants. They are effective in treating depression, and they have fewer side effects than the other antidepressants.
SSRIs block the reuptake, or absorption, of serotonin in the brain. This makes it easier for the brain cells to receive and send messages, resulting in better and more stable moods.
They are called "selective" because they mainly seem to affect serotonin, and not the other neurotransmitters.