Hi, everyone. I am hoping you will understand if I jump right in without reading the archives first--I'll be working through them as I go.

My daughter is 21 and in college. I know there's a "parents with bipolar children" subforum, but since my daughter's 21, I thought I should be here. Please redirect me if I'm wrong.

My daughter has been having symptoms for over two years which have recently finally been tentatively diagnosed as ultra-rapid-cycling bipolar. She cycles between euphoric episodes that escalate into anxiety and finally full-blown panic attacks, and episodes of what she calls "depression." The reason I put it in quotes is not that it's not severe--it's plenty severe--but that she tells me "I was depressed for 45 minutes today" or sometimes even "in small spurts of ten seconds." So it's not what most people mean by "depression." Or maybe it is, I don't know. She cycles through these states all within the same day.

She's on lithium. It seems to help a lot. She's had no panic attacks for over two weeks, which is wonderful, because before the lithium she was having them daily. She was on Celexa but just went off it cold-turkey because it seemed to be causing suicidal thoughts.

I am asking for suggestions to help her manage the Celexa withdrawal, which is causing her flu-like symptoms, and the condition itself (exercise seems to help most). I'm also asking whether what I describe is familiar to anyone here, or whether we should question the diagnosis.

Thanks, all. It is good to be in a place where I know everyone understands what we're going through.

Abby

Hi, Abby,

She cannot go off Celexa cold turkey. That withdrawal is awful. How long ago did she stop it? Did the psychaitrist tell her to do or did she go off it by herself? Perhaps the pharmacist or psychiatrist would tell her to get back on a small dose of it.

How long has see been on the Lithium? It is good that it has helped with the panic attacks but it does not seem to be helping with the cyclilng.

The symptoms and the diagnosis sounds about right. But she should not have been on anti-depresant and she might need to be on a different mood stabilizer.

The short answer to your question about the withdrawl effects is that there is not much she can do. At one point, some psychiatrists would prescribe Prozac because it is longer acting. I do not know if that worked for everyone or if the pdocs (psyhciatrists) are still doing that. She really needs to get in touch with her pdoc and stay in touch.

M

Hi Abby

And welcome to the room.

I'm not sure how low a dosage there is of celexa. But I'm on 20 mg of it.
And I know that I believe my doctor would have me reduce mine by
going on to a maybe 1/2 pill if its possible to split it. I would have
to do some research to see if its okay to split it.

I am not sure if there is a smaller amount of the celexa than the 20mg.

I would also think that going to every other day would be someting that
he would suggest too.

Then I'm not sure what ese he would suggest.

Donna

Yes, Donna,

Also, your doctor can switch you to a similar antidepressant that comes in a liquid form because the liquid can let you go down in dose a drop or two a day.

M

Thanks, everyone. Her psychiatric-nurse-practitioner-therapist told her to quit cold-turkey. I think the reason may be that she was only on it for about three weeks. Her practitioner thought that the lithium would be enough to stabilize her so that the Celexa wouldn't cause her to cycle.

She is still cycling, but not with the extremes that she had before. So she gets a bit anxious, but not to the point of a panic attack. No hypomania, either, I don't think. And while she has spells of depression, they're not as severe or long-lasting (she roller-skates them away). We think the lithium has done her a lot of good, especially since it's only been three weeks.

My daughter has been having these cycles for two years now, with a six-month respite that began last spring and lasted through the summer (is it usual to have a remission like that?). We were trying to get a diagnosis for her the whole time. There's a lot of Graves disease (hyperthyroidism) in the family*, so when she first described her symptoms, I was sure it was that. Tests came back normal--and then weird for a while (contradictory)--and then normal normal normal normal again. It took me two years (including the remission) to be convinced that she didn't have a thyroid condition. So we're still getting used to the idea that this is bipolar.

Thanks for the welcome, and the help.

Abby
*yes, I know lithium can mess up the thyroid...

Hi, Abby

As you know three weeks is not enough time to tell if something is working. Three weeks on the lithium does provide some indication if it helps. The Nurse Practitioner will probably order lithium blood work at 6 weeks to check levels.

My own experience is that the side effects can kick in within three days but the benefits can take a month or two or even three.

For some sensitive people, three weeks is long enough to do careful tapering.

Some people can have remissions. Sometimes the light in the spring /summer can make people more up. Less often, people can become up in the winter months.

Maybe in your daughter's case the discontinuation syndrome will be mild because she was only on the anti-depressant for three weeks.

It is o.k. to call any pharmacist with these types of med questions --- especially about stopping a medication.
It is very much o.k. to call the person prescribing the medication. People who practice psychiatry expect telephone calls (or texts or emails) from us.

Mari

Hi,

This is some info from the NIMH
http://www.nimh.nih.gov/health/publi...te-index.shtml

M