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Can Low Doses Of SSRI Cause Irritability In A Bipolar Disorder Patient?
Question: Can low doses of SSRI cause irritability/anger that isn't there at higher, more therapeutic doses in people with bipolar or bipolar II?
Brief Answer:
yes it is possible
Detailed Answer:
Hello,
Thanks for using healthcaremagic.
SSRI during first week of treatment cause irritability which is common side effect but fortunately it remits when we increase the dose over time.
There is no link of this side effect with any disorder as it can occur in bipolar, unipolar, anxiety disorder etc.
Although it is not part of question but I must inform you that SSRI should not be used alone in bipolar disorder.
I hope this helps you.
If you have more questions feel free to write back to me.
Thanks and regards
yes it is possible
Detailed Answer:
Hello,
Thanks for using healthcaremagic.
SSRI during first week of treatment cause irritability which is common side effect but fortunately it remits when we increase the dose over time.
There is no link of this side effect with any disorder as it can occur in bipolar, unipolar, anxiety disorder etc.
Although it is not part of question but I must inform you that SSRI should not be used alone in bipolar disorder.
I hope this helps you.
If you have more questions feel free to write back to me.
Thanks and regards
Above answer was peer-reviewed by :
Dr. Prasad
The reason I ask is that Celexa seems to make me irritable at lower doses. Not so much at higher doses, but I am trying to manage side effects by staying low. A new doctor I am interviewing with claims the irritability at low doses is indicative of bipolar, which is in my family.
The first time I came off from a therapeutic dose of Celexa I became extremely irritable at around 20mgs.
Zoloft also makes me extremely irritable, but I've never gotten higher than 25-50 mgs.
The first time I came off from a therapeutic dose of Celexa I became extremely irritable at around 20mgs.
Zoloft also makes me extremely irritable, but I've never gotten higher than 25-50 mgs.
Brief Answer:
He is almost right
Detailed Answer:
Hello,
Thanks for reverting back to me.
It is right to say that irritability in younger age is indicative of bipolar disorder. This becomes more important in your case due to positive family history of bipolar disorder.
If you would have been my patient I should have suggested same thing about possibility of bipolar disorder.
Although I need to make it clear again that it is not something to do with a high or low dose of SSRI, but could be a coincidence with lower dosage or initial time (first week or so) at which irritability is more common with SSRI.
I hope this helps you.
If you have more questions feel free to write back to me.
If no please close the query and rate the answer.
Thanks and Regards.
Dr Ashok XXXXXXX
He is almost right
Detailed Answer:
Hello,
Thanks for reverting back to me.
It is right to say that irritability in younger age is indicative of bipolar disorder. This becomes more important in your case due to positive family history of bipolar disorder.
If you would have been my patient I should have suggested same thing about possibility of bipolar disorder.
Although I need to make it clear again that it is not something to do with a high or low dose of SSRI, but could be a coincidence with lower dosage or initial time (first week or so) at which irritability is more common with SSRI.
I hope this helps you.
If you have more questions feel free to write back to me.
If no please close the query and rate the answer.
Thanks and Regards.
Dr Ashok XXXXXXX
Above answer was peer-reviewed by :
Dr. Sonia Raina
Brief Answer:
you are tight
Detailed Answer:
Hello,
Thanks for reverting back to me.
In case of bipolar role of SSRI very limited. Even if used they should be with cover of mood stabilizer. Secondly they should be removed if the depression is no more. Thirfly possibility of rspid cycling should be kept in mind.
I think it will be ideal in your case to remove SSRI and other options should be explored including atypical anti psychotics or lithium. It is sldo advisable to try for lamictal alone . The reason fpr removing recommendations is side effects and questionable use.
I hope this helps you.
Thanks and regards.
you are tight
Detailed Answer:
Hello,
Thanks for reverting back to me.
In case of bipolar role of SSRI very limited. Even if used they should be with cover of mood stabilizer. Secondly they should be removed if the depression is no more. Thirfly possibility of rspid cycling should be kept in mind.
I think it will be ideal in your case to remove SSRI and other options should be explored including atypical anti psychotics or lithium. It is sldo advisable to try for lamictal alone . The reason fpr removing recommendations is side effects and questionable use.
I hope this helps you.
Thanks and regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
So jumping back to the original question...
trying to determine how I feel just taking celexa in the morning. I took 10 mg in the morning and held off on lamictal. felt a little low.
Took the lamictal 100 mg around noon and BAM! I am excited, dancing, kind of felt like I couldn't contain myself. Got to work and I really had to bite my tongue a lot. Then it switched quickly to open anger at everything. And a splitting headache (I get them every day since switching my lamictal manufacturer.)
What does this sound like to you? I would open a separate question but I wanted you to answer. I hope it isn't costing you money!
trying to determine how I feel just taking celexa in the morning. I took 10 mg in the morning and held off on lamictal. felt a little low.
Took the lamictal 100 mg around noon and BAM! I am excited, dancing, kind of felt like I couldn't contain myself. Got to work and I really had to bite my tongue a lot. Then it switched quickly to open anger at everything. And a splitting headache (I get them every day since switching my lamictal manufacturer.)
What does this sound like to you? I would open a separate question but I wanted you to answer. I hope it isn't costing you money!
Brief Answer:
It is again indicative of bipolarity
Detailed Answer:
Hello,
Thanks for follow up.
The pattern you described above is something unusual and again favors bipolarity. Kind of irritability, brain fog, difficulty in controlling yourself are other symptoms which are indicative of bipolar disorder.
The atypical pattern shows that lamictal is contributing if not causing all these symptomatically when the concentration is peaked which occurs after one hour of intake and stays there upto six hours. I personally feel the splitting the dose of lamictal can be useful in this scenario.
I hope this helps you.
Thanks and regards
It is again indicative of bipolarity
Detailed Answer:
Hello,
Thanks for follow up.
The pattern you described above is something unusual and again favors bipolarity. Kind of irritability, brain fog, difficulty in controlling yourself are other symptoms which are indicative of bipolar disorder.
The atypical pattern shows that lamictal is contributing if not causing all these symptomatically when the concentration is peaked which occurs after one hour of intake and stays there upto six hours. I personally feel the splitting the dose of lamictal can be useful in this scenario.
I hope this helps you.
Thanks and regards
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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