Hi all,
Earlier on this year I was diagnosed with moderate depression and have been taking 20mg of first Fluoxetine (Prozac) and now Citalopram. I had to come off of the Fluoxetine because it made me hyper after about 3 weeks, but I’ve had no issues with the Citalopram.
I’m based in the UK and so was awaiting an NHS psychiatric assessment (there’s a long waiting list). I had that evaluation today, and the assessment results were that there was a good chance that I am cyclothymic or mildly bipolar.
The psychiatrist has asked me to come off of the citalopram and instead take 25-50mg doses of Chlorpromazine (I believe it’s called Thorazine in the US) whenever I feel a hypomanic episode coming on. However I’ve just read the wikipedia page on the medication and it’s making me a bit apprehensive. I was reluctant to start the anti-depressants in the first place, but they have definitely helped with my low moods. Chlorpromazine sounds like a whole different ballgame though.
Does anyone have any experiences they can share, or general advice on antipsychotics in relation to hypomania?
Thanks in advance,
Alan
Thorazine is very effective in thwarting mania and hypomania. However from my experience it’s not the first line of defense when dealing with bipolar episodes.
You may want to talk to your doctor about putting you on a Atypical Antipsychotic such as Risperadone, Saphris, Seroquel, or Zyprexa. Zyprexa is one I would recommend. But you have to be careful as it can cause you to gain weight (like most atypicals). Diet and exercise is key.
Personally I think your doctor is doing the right thing in instructing you to take the Thorazine only when you feel an episode coming on.
In my own experience I had a horrible time with Atypical Antipsychotics when I was taking them regularly.
I was diagnosed with bipolar because of a major manic episode that kept me in the psych ward for over a week. Depression has never been as bad as my manic episodes so doctors always prescribe AAs for me. I’ve tried Zypexa and Saphris. Both of them helped the mania but I had massive depression a few months into regular daily use of Zyprexa, so I stopped. And the depression cleared. I tried Saphris and the same thing happened. After a little research on the Saphris I discovered that it works by blocking seratonin receptors. Go figure. I’m not keen on taking an anti-depressant just to combat the side effect of an AA so I’m saving what I have left of the Saphris for a rainy hypo-manic day. Or when I feel like not being able to stand up without falling flat on my face.
I’m still hoping I can find a better solution someday, but this is it for now.
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@albatross Thanks for sharing. One thing to consider is if you are bipolar taking any SSRI or SNRI drug may induce mania. So using one of those to battle the depressive side of an AAP may require the use of a mood stabilizer (Lithium, Depakote, Lamictal, Carbamazepine). When my pdoc rx’d me Prozac I had to get on Carbamazepine to combat the hypomania that I was experiencing. In the end it was too much medication for me so I just stuck with Saphris and learned to cope with the flat/depressive feelings through therapy and CBT.
Thats quite true, and thanks for the tip about balancing it with mood stabilizers. My sibling is also bipolar, which was first misdiagnosed as simply depression. They decided she was bipolar after she reacted really badly to the depression meds they gave her.
Likewise, taking that many medications does not appeal to me at all. I’m hopeful I’ll find one or two things that can help.
Thanks for the info @shakycode and @albatross. Since posting my question I have started and stopped Chlorpromazine (Thorazin) and moved to Quetiapine (Seroquel). The Chlorpromazine worked well as long as a) I spotted a hypomanic episode in the early stages and b) I actually took it. I found that, from time to time, I would deliberately not take it as I could use the extra productivity and great mood that it would bring. I always ended up paying for it with a slump afterwards though of course.
Anyway, as my diagnosis was still fairly young at the time I wrote this post I had to have two subsequent six-monthly reviews to gauge how I was getting on and how I was responding to the meds. At the second review my psychiatrist took me off of Chlorpromazine and put me on Quetiapine. I now take 150mg of that daily at night before I go to bed and it slow releases over the next 24 hours. This has been brilliant. I still get mild to moderate hypos and depressions from time to time, but nowhere near like I did before. Together with the training I got through CBT and regular mindfulness exercises I’m pretty much on an even keel now. The only side effect I’m noticing is that I find it really hard to wake up in the morning (nothing an alarm clock and double espresso can’t resolve though ;)).
Thanks for taking the time to respond. I hope you both find the right balance for you too. <3