What Does It Mean If Discontinuation Of An Anti-depressant Makes You Hypomanic?
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This happens consistently when discontinuing either nortriptiline (pamelor) or venlafaxine (effexor) [I have taken both in past, but at different times.]: When I stop taking the anti-depressant, I get hypomanic. But shouldn't coming off an anti-depressant make you **depressed**? What does this mean?
Answer:
Several times I've noticed a real mood upturn as I went off an AD. (I'm not sure I would call them hypomania, tho doctors might!) It was pronounced enough that I have told others, had I still been on the AD, the docs would claim my improvement as proof the med was working. My theory is, these meds so fuck up my body, that as the poison leaves my system, I feel better. Since most meds make me very drowsy, and the rest give me insomnia so that I'm tired from lack of sleep, part of the improvement may just be feeling enough energy. Hypomanic - as in hypoactive thyroid- means simply down -- not active - which means you would feel very tired and sluggish. Hypermanic would be just the opposite. You would be feeling - overactive-- very high, like in a manic state. According to a local Prof of psychiatry, it is anecdotally well-known among psychiatrists that the sudden cessation of an anti-depressant can throw a bipolar into hypomania, and some even try this as a last resort to boot a bipolar out of a recalcitrant depression, but there are few if any published research papers to document this effect. Given similar published reports about the effects of sudden changes in mood controllers, I would suggest that it would be wise for bipolars to avoid any sudden change of psychotropic medication -- start them slowly, stop them slowly.
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