Depression and Bipolar Medications - Medications for Depression and Bipolar

Written by HealthyPlace.com Staff Writer

David: With wintertime coming on, I'm sure there are some people who are concerned about their depression levels increasing. They may suffer from seasonal affective disorder (SAD). What do you recommend for that?

Dr. Watkins: For winter depression, (seasonal affective disorder, SAD) I often prescribe a light box. You are better off using one from a legitimate company because you have to make sure that the light filters out any ultraviolet rays. Since the light is so bright, home made ones may have damaging bright spots. The reputable ones are fairly safe. It is better to use one under medical supervision. There is a clear dose/response curve depending on time and duration of light exposure. If you do not want to use the light, Prozac or another SSRI can work for SAD. I think that the lights have fewer side effects. It is just that some people do not have the patience to sit with one for 20 minutes a day.

David: One of our audience members would like to know if a tanning bed would be effective in treating seasonal affective disorder, SAD?

Dr. Watkins: Do not use a tanning bed. The UV rays could harm your eyes. The conventional light boxes have the light striking the open eyes. You do not want to look at the tanning lights. You also would not know the exact amount of light you were receiving.

Alohio: My mate is bipolar; how can I best help her?

Dr. Watkins: Educate yourself about the disorder. Some couples therapy can also be useful. You and your mate might make up an advance plan about how each of you will recognize and react to the beginning of a mania or a depression. You need to watch out for breakthroughs, but do not go too far and label each minor mood change as a mania.

jsbiggs: Recently, I experienced a violent reaction while making a transition from Epeval to Limictal and I have been without meds except for Omega 3. I feel the need to go back on a more conventional medication. Do you have any advice?

Dr. Watkins: I don't know what you have tried before. Some people use an Antipsychotic or a Benzodiazepine temporarily while waiting for a mood stabilizer (like Tegretol or Neuroltin) to take effect.

glow: What is normally the maximum dose of Effexor - XR?

Dr. Watkins: I usually do not go much beyond 300mg. I check blood pressure fairly often when I am using it in the higher range. You can go up to 375, but I am a bit cautious because I have had a few people have elevated blood pressure on higher doses.

karensue76: One of my diagnoses is major depression for which I take Prozac and Neurontin. Are these medications for clinical depression only, or can they be helpful in situational depression?

Dr. Watkins: If you have an adjustment disorder, minor depression, temporally related to a stress, we often don't medicate. If your symptoms are severe enough to merit the diagnosis of major depression, then medication could be helpful.

Maggie2: Can depression be treated with drugs only?

Dr. Watkins: In some cases, depression responds to medication alone. I like to use a combination, so that the person can develop the cognitive tools to cope better. However some people prefer not to use therapy and do well.

AMtDew4Me: A few months ago, I decided to use St. Johns Wort because I had taken so many quizzes for depression online and tested majorly depressed. I could tell the change in my moods and the way I acted and so could my friends. Recently my mom was diagnosed positive for depression and anxiety. I'm thinking of going back on St. Johns Wort now because my moods, and the way I'm acting, are starting to go crazy again . Do you think that I should consult a doctor first? Or should I trust my previous experience?

Dr. Watkins: There is the saying among doctors, "A doctor who treats himself has a fool for a patient." That may be a bit harsh, but there is a moral in it. Someone else can be more objective. If one of my children became depressed, I would not treat him myself. I could not be objective.

David: AMtDew4Me brings up an important thing here. The online tests for depression or any other mental health disorder are really just a very initial screening. We have them, but please don't take them and think you are getting a diagnosis. For a real diagnosis, please see your doctor or therapist.

breanne: Dr. Watkins, I was wondering if you could tell me whether the drug Topiramate will bring up the drug level of Desipramine. The reason I ask is because I am currently taking 150 mg of Desipramine with that drug and I want to increase it by 50 mg.

Dr. Watkins: A better way to increase the Desipramine level is to take more Desipramine. Have you and your doctor decided that 150 is the right level for you?

David: I know it's getting very late. Thank you, Dr. Watkins, for being our guest tonight and for sharing this information with us. And to those in the audience, thank you for coming and participating. I hope you found it helpful. Also, if you found our site beneficial, I hope you'll pass our URL around to your friends, mail list buddies, and others. http://www.healthyplace.com/.

Here's the link to the HealthyPlace.com Bipolar Community. You can click on this link, sign up for the mail list at the top of the page so you can keep up with events like this. The Depression Community link is here.

Also, Dr. Watkin's website is here.

Thank you again for coming tonight, Dr. Watkins.

Dr. Watkins: Thank you, it was a pleasure and thanks to everyone for the good questions.

David: Good night everyone, and I hope you have a pleasant weekend.

Disclaimer: That we are not recommending or endorsing any of the suggestions of our guest. In fact, we strongly encourage you to talk over any therapies, remedies or suggestions with your doctor BEFORE you implement them or make any changes in your treatment.

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