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- Newsgroups: sci.med
- Path: sparky!uunet!psinntp!newstand.syr.edu!rodan.acs.syr.edu!mdkline
- From: mdkline@rodan.acs.syr.edu (Mark D. Kline)
- Subject: Re: post-Prozac reactions
- Message-ID: <1992Dec23.085430.17591@newstand.syr.edu>
- Organization: Syracuse University, Syracuse, NY
- References: <1992Dec14.133117.20486@u.washington.edu> <1992Dec20.133028.10836@newstand.syr.edu> <1992Dec21.194052.1328@cbfsb.cb.att.com>
- Date: Wed, 23 Dec 92 08:54:29 EST
- Lines: 47
-
- In article <1992Dec21.194052.1328@cbfsb.cb.att.com> kja@cbnewsf.cb.att.com (krista.j.anderson) writes:
- >In _The Good News about Depression_, Dr. Gold says that he believes
- >that a certain percentage of people diagnosed with depression also
- >have some phases of hypomania, and that is why, he thinks, some
- >people have adverse reactions to Prozac or other antidepressants.
- >He thinks that it may produce hypomania in some.
- >
- >So, I'm wondering, what effect would antidepressants have on people
- >who are known to be bipolar or cyclothymic?
- >Do people ever commit suicide during manic phases? For example if
- >they were afraid of going mad?
- >Is rage indicative of mania or hypomania? I read in one book that
- >raging at someone is abusive and I could see their point, when I
- >thought about it.
-
- No question that some people who get depressed also have a tendency
- toward mania - either mild hypomanic intervals, as in cyclothymic
- disorder, or the full-blown, buy-the-brooklyn-bridge delusional mania
- of bipolar (manic-depressive) disorder. Yes people do committ suicide
- during manic episodes; this is rare in comparison to depressive suicide.
- In mania, suicide is usually associated with paranoid delusions, e.g.,
- "they're going to kill me or my family if I don't kill myself first."
- Yes rage (or irritability) can be a symptom of mania or hypomania.
- People can and do "switch" suddenly from a depressive to a manic or
- hypomanic state while taking antidepressants - the traditional teaching
- has been that all antidepressants can induce such a switch in susceptible
- people. There is some talk now that perhaps its just chance, that
- perhaps the antidepressants aren't causing the switch (its the post hoc
- ergo propter hoc problem again...)
-
- >Is Prozac ever prescribed for children? It seems that it would be
- >safer than a tricyclic like Imipramine.
-
- Yes, prozac is prescribed for children, but is not FDA approved
- for any indication in children. Prozac has a different spectrum
- of action than a tricyclic like imipramine, which is prescribed
- for urologic problems (bed-wetting and trigonitis) as well as
- childhood depression, panic-separation-overanxious problems,
- etc. Prozac is coming into use in childhood for obsessional
- problems (OCD, trichitillomania (compulsive hair pulling))
- and depression (especially in adolescents).
-
-
- =================================================================
- mark kline mdkline@rodan.acs.syr.edu
- suny health science center, syracuse voice: (315) 422-1050
- ================ courtesy of syracuse university ================
-