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• Thursday, February 8, 2007 08:50 AM

  Please, get the meds checked, and get an MRI

  Two things sprang to mind reading this:

  One, sudden personality changes can result from injuries, small strokes, and tumors in the prefrontal cortex. So an MRI should be done.

  Two, adding my voice to mad cartoonist, bipolar disorder is frequently misdiagnosed, and this sounds classic. My husband was misdiagnosed as having chronic major depressive disorder with anxiety, and was put on Prozac and Wellbutrin for depression, Buspar and Klonopin for anxiety, and lithium to "enhance" the effectiveness of all these. Over time they tried Paxil and Celexa instead of Wellbutrin, and upped his Klonopin to 10-12 mgs daily (the maximum recommended dose for psychiatric purposes is 4). Throughout all of this he grappled with classic manic and hypomanic symptoms, as well as unusually severe depression.

  The problem is that SSRIs, and Prozac in particular, exacerbate the manic state. Sometimes the mania can persist long after the meds are out of the system; they serve as a trigger, throwing the mind out of balance and into a loop it can't escape by itself.

  In Type I, mania can take a very negative form, including psychotic symptoms and danger to self and others. In Type II negative symptoms can include irritation and sometimes rage attacks. For my husband, the fact that 10 mgs of Klonopin didn't even make him drowsy should have been a clue to his doctors; the Prozac was exacerbating the mania, and the Klonopin was barely keeping it under control.

  Type II is frequently underdiagnosed, and it's only in the past few years that better inventories for detection and treatment have appeared. For my husband, struggling with changing and over-prescribed meds for over two years as different doctors tried to treat him for depression, misdagnosis has been hellish. We had to move to find a doctor who could properly diagnose him, and he's in the process of adjusting his meds now.

  If you want to read the diagnostic criteria for bipolar and related disorders, try this as a starting point:

  http://en.wikipedia.org/wiki/Current_diagnostic_criteria_for_bipolar_disorder

  Good luck, LW!

  —Alex
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