My son was hospitalized this week for depression and feeling suicidal. He has schizoaffective disorder and is on Invega injection and depakote. (In addition to buspar and gabapentin). He has been depressed for awhile but also lives alone with no good friends. The social isolation has been hard on him. We have been asking both his own psychiatrist and the inpatient psych for an antidepressant but they refuse. The only Med change has been to increase the dose on Invega. We understand that serotonin can aggravate mania but he has been fairly stable on the mood stabilizer. (Although I find a few around his apartment.). Does anyone have a loved one who is schizoaffective on an antidepressant (SSRI)? Or is what we are asking for a crazy idea?
I’m diagnosed with SZA and at one point in a depressive period took an SSRI and an AP. I didn’t find it particularly helpful in my case, but it was at my Psychiatrist’s direction, I did not ask for it. In the end I think the depression was a combination of work-related situation issues, and changing to one of the early atypical AP medications. Part of my motivation for the switch was I was concerned that I’d plateaued in my recovery and it would limit me in my work environment.
I found my way out of the depression by changes in my work environment and a return (at the time) to typical AP medication. Some AP medications are used as adjunct therapy for antidepressants, and various AP medications are used in bipolar disorder patients seemily as adjunct mood stabilizers.
My father is presently prescribed an AP and an SSRI for psychiatric issues related to dementia, so I’m fairly certain combination therapy is mainstream where indicated. I’ve seen concerns by some advocates that combination therapies can cause neurotransmitter sensitivities and rebounds, but I haven’t experienced this first-hand. I’m a bit skeptical that these effects are widespread, and may be a result of cherry-picking information of studies, but by the same token some people are genetically sensitive to certain AP medication, because they metabolize them differently.
But to answer your question, yes this is a “thing” that I have experience with, but I feel only a Psychiatrist or Psychopharmacologist can say if it’s appropriate care for your situation.
Thank-you for you insight and knowledge. It sounds like you have a lot of knowledge and experience with these meds. We realize every individual and situation is unique but it’s helpful to have other insights. I hope we can help our son becomes more stable. One silver lining is he met a couple new friends while in the hospital. Hopefully they have no drug or alcohol problems which he is vulnerable for.
Has our son been diagnosed with Bipolar disorder?
If yes, then it’s my understanding that Antidepressants are NOT prescribed for Bipolar patients
Due to the very high potential of becoming manic.
How long has he been on Depakote?
And what is it given for?
Depakote made my son so suicidal and angry
How was he doing on the invega By itself?
I’m inclined to agree with @Mojoclay here, I didn’t notice he was also on depakote which is a mood stablizer. I have never been on a mood stablizer and an AP at the same time, nor has my father. I also have never taken injectable AP medication of any kind.
A little googling confirms general concern for SSRIs for people with bipolar disorders and their dubious value when a mood stablilizer is in play. The article also goes on to say that they still may be prescribed in some circumstance which confirms what I always say, laymen are not qualifiied to make these decisions.
Studies also have shown that they may not provide additional benefit for bipolar depression if they’re are taken along with a mood stabilizer such as lithium or Depakote. Nevertheless, your doctor may prescribe newer antidepressants known as SSRIs (selective serotonin reuptake inhibitors) for treating depression in bipolar disorder – along with lithium or other mood stabilizing drugs such as valproate, carbamazepine or an atypical antipsychotic.
I take an antidepressant and and antipsychotic
I have done for many years, I have schizophrenia
It has helped me with anxiety and mood. I really feel a lot worse if I don’t take them for a couple of weeks, so I keep taking them
It’s a big help
@three are you being treated for bipolar and or depression?
Depression is a recognised part of paranoid schizophrenia which is what I have
There is such an overlap
My depression is not deep, it has been called ‘lack of joy’
Without antidepressants I enjoy 1 in 7 days…
It’s a lifelong thing for me
He’s also on gabapentin
I see, although it’s not clear to me why. I had to look that one up. Might have come in handy when I had herpetic neuropathy due to shingles a while back. It’s usually used for neoropathies or to suppress seizures. Does he have diabetes or a history of seizures?
ouch, Shingles are no fun !
Gabapentin can also be used for Bipolar
With schizoaffective he has both schizophrenia and bipolar. He has been in Invega injection for 3 yrs and Depakote for one year. The depakote has really stabilized his mood but I will need to check into whether it is also adding to his depression.
He takes gabapentin for both anxiety and alcoholism. He has been good lately about staying clear of drugs and alcohol. He just needs to hang out with good people!
My daughter who has schizoaffective disorder takes a relatively low dose of wellbutrin.
My son was put on an anti depressant for a while, it did help and then he took himself off of it. He has lived at home, supportive family, good doctor and the right meds have made all the difference. It has taken 5 years but we are committed, can he move home for awhile. It is not ideal, but having family someone who loves him unconditionally. is so important.
In follow-up, we did convince his doctor to start very low dose antidepressant (lexapro) about a month ago and we are seeing improvements in his depression. It has also helped that he started back to very part time work and met some new friends who we think are safe people. He goes fishing with them.
I wondered the exact same thing about the gabapentin. Seizures? Painful nerve damage?The article in response was interesting and new to me.
Also, I know a couple of different folks who take Seroquel, though technically a second generation AP med, to manage symptoms of BP. One uses if for breakthrough manic episodes and the other uses it as a primary med for mood balancing, mostly to avoid minor depressive states.
This is excellent news!