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Bipolar Disorder/BP d/o and Cymbalta

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Expert: - 11/21/2006


Question
Hi Dr. Goldberg-I was just diagnosed with BPD.  I have been taking Cymbalta for about 3 months and my depression has increased dramatically.  I have some brief periods of hypomania.  I was started on Lamictil yesterday.  I have also been taking hydrocodone but am no longer on that.  My question is : is the Cymbalta making things worse?  Is taking/abruptly stopping the Vicodin dangerous in BPD?  When will this horrific depression end?  Thank you for your time.

Answer
Hi, Jody . . .

People with bipolar disorder will often have hypomanic or even manic episodes if they take Cymbalta without a mood stabilizer such as Tegretol, lithium, Depakote or Trileptal.

Lamictal is an anticonvulsant with more antidepressant than antimanic activity. While it sometimes works well by itself, often it has to be combined with one of the other mood stabilizers.

Just about all narcotic analgesics can make depression worse.

Best regards . . .

Ivan
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Ivan Goldberg, M.D.

Expertise

I am a psychiatrist/psychopharmacologist with many years of expereince in treating individuals with depressions, manic-depression (Bipolar Disorder), other mood disorders,. I am especially interested in the psychopharmacologic treatment of individuals with so called "treatment-resistant" syndromes.

Experience

I have been on the staff of the National Institute of Mental Health, Columbia's College of Physicians and Surgeons, and the Columbia-Presbyterian Medical Center. I am currently in full-time private practice in New York City.

A.B. Johns Hopkins University
M.D. N.Y.U. College of Medicine

I am the creator of Depression Central:http://www.psycom.net/depression.central.html

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