Bipolar, SSRIs and Suicide

FDA, SSRIs & Suicide: Problems do exist
December 13, 2006
Bipolar SSRIs and the Brain
December 16, 2006
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Bipolar Brains run more fast and hot with SSRIs. Bipolar Brains are fragile, already hypermetabolic, and react very poorly to any stimulation such as adding an SSRI or stimulants for ADD. Individuals with Bipolar can emotionally become unraveled quickly because their internal brain physiology is moving way too fast. Instead of idling at a reasonable 20Bipolar_300 RPM, they are idling at 10,000 RPM.

No wonder they burn rubber at the smallest stimulation.

Take a look under the hood at this guys brain, no wonder he
did not do well with multiple SSRI interventions:

SSRIs added to this frothy mix, this solid fuel intensity, can send
judgment out the window. Areas of the brain that usually
settle down thinking [temporal], and coordinate thoughts
[prefrontal]- as well as delay action are all somewhat impaired.

SSRIs can make you more impaired – can
make you feel like you are indeed loosing your mind. But why suicide…?

The answer is simple: Some want to turn off their out-of-control mind, and are frustrated the interventions may be making thinking and feeling worse.

But every person who has a reaction [suicidal, irrational, depressed, confused] to an SSRI is not necessarily Bipolar.

In this particular SPECT scan we can see that this person has depression, has temporal lobe and prefrontal cortical dysregulation, so we may need to use several different meds in careful sequential doses to correct this complex set of findings.

Using one med for one diagnosis is often not the answer. Most who present with complex problems have more than one core problem, be it brain or body.

If we use specific meds to address each of the too hot or too cold parts of the brain, and use those meds in the correct sequence, then success is more likely. In summary

  • Right [Entire] Diagnosis: Brain and Body
  • Right Meds, Supplements
  • Right Titration for meds and supplements, and
  • Right sequencing.

Right sequencing: Start with a mood stabilizer for the temporal lobe dysregulation, then go to the antidepressant, then… they may still need a stimulant. Yes ADD and Bipolar does coexist.  See the next post. This latter point may seem out of the standard of care to some, but there is an increasing body of literature agreeing with the phenomenon we have seen for many years now.

Main point on sequencing is simple: build the entire foundation before you start framing the house.

However, in closing, don't forget this core thought: The gut, the adrenals, the thyroid, are sitting down there, and may be sick. The patient could be depressed from hypovitaminosis  D, [D3 to be exact, D2 will not be helpful, and D3 levels are measurable].

More later on D and Iodine, two very hot topics in this series about the limitations of SSRIs.

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6 Comments

  1. Carlos says:
    December 18, 2014 at 9:34 AM

    I am working with my doc on getting my medication regime squared away. I have read your book and have the trifecta of ADHD+Depression+Bipolar.
    Looking at medications I am taking Effexor and short acting AMP which I have dialled in but which medcications do you normally run with : mood stabilizer or antipsychotic?

    I am looking at any additional underlying Biomedical problems that could contribute (Mineral Hair and IgG) but this advice would help me in the short term.

    Merry Xmas

  2. Craig R says:
    June 1, 2014 at 7:38 AM

    Hi Doc,

    I am a type 2 diabetic who needs to take insulin –> I also have the trifecta of Bipolar, Depression and ADHD.

    I am struggling with my doctor to find the best mood stabilizer and SSRI or SNRI. I have found Lithium and Sertraline cause significant Insulin Resistance.

    Are there any Mood Stabilizers or SNRI’s that might be cleaner on causing Insulin Resistance so to speak?

    Craig

    • Dr Charles Parker says:
      June 1, 2014 at 7:47 AM

      Craig,
      Do work on identifying the underlying problems that caused the diabetes, as they are likely related to mood dysregulation. See this videos for some additional info: http://bit.ly/mindgut Read on IgG and insulin resistance anywhere on the Internet… serious connections.

      RE: the mood stabilizer: consider w your doc Lamictal or Trileptal, perhaps not as good as lithium – it’s important to customize for each individual.
      cp

  3. Gina Pera says:
    February 9, 2012 at 2:17 AM

    Brilliant. Thank you for this, Dr. P.

    I am stunned and saddened at how often I need this information — and how absolutely reckless so many physicians are about giving SSRIs to kids without a clue about ADHD/bipolar+ risk.

    If I hear of one more suicide that happened right after a kid was given SSRIs…….

    • Dr Charles Parker says:
      February 12, 2012 at 5:13 PM

      Gina,
      This problem, as you well know, is the single biggest problem [because of the inherent danger] present with ADHD non recognition today – and it is nothing less than pervasive!

      Thanks for weighing in, always appreciate hearing from the voice of ADHD relationship management – who also, quite unexpectedly for the uninformed, has the biomedical details in her hip pocket after years of hearing the pain… and paying attention to the details.
      Thanks,c
      cp