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MN Psychiatrist
MN Psychiatrist, Psychiatrist
Category: Mental Health
Satisfied Customers: 792
Experience:  Physician for 17 years, adult psychiatrist for 13 years working with a wide variety of patients.
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How would I know if the celexa caused the manic or if I had

Resolved Question:

How would I know if the celexa caused the manic or if I had an underlying bipolar
?
Submitted: 2 years ago.
Category: Mental Health
Expert:  MN Psychiatrist replied 2 years ago.
Hello, I am a psychiatrist.

This can be a tough question and it may take time for the answer to be revealed.

What I mean is that Celexa can induce mania that looks like bipolar disorder (but isn't); in other words, it can cause mania as a side effect in some people. However, if someone has bipolar disorder, it may also unmask it and be the cause of his/her first-ever manic episode. This is how some patients with bipolar disorder are diagnosed.

Since there are no blood/laboratory tests for bipolar disorder, the only thing to do is discontinue the Celexa and see what happens. If the mania stops pretty quickly, it's suggestive that it was caused by the Celexa rather than due to bipolar disorder. However, even in untreated bipolar disorder, mania will eventually stop on its own. As such, it may just take the passage of time to see what happens. If it goes away when the Celexa is stopped, you could try restarting it, to see if the mania returns but this is extremely risky, because of the behaviors associated with mania (gambling, promiscuity, grandiosity of all sorts, etc). However, if you do this, and the mania returns, and then stops again when you stop the Celexa, it's even more suggestive of the mania being a side effect, rather than due to underlying bipolar disorder. Then the thing to do is to try another antidepressant and see what happens. Truth be told, I'm a bit squeamish about asking patients to do this or expecting them; my preference is to stop the medicine in question, and adopt an attitude of patience to see what happens to them mood-wise without having them try it again.

Does this make sense?
Customer: replied 2 years ago.
When I was put on 40 mg of celexa I became manic. It didn't happen with the lower doses of celexa.
I continued to be manic until I stopped taking the celexa. They tried to put me on a mood stabilizer but I didn't take them and the manic was out of control. I spent $60,000 in 2 months , was stripping, forging my dads signature on checks, speeding tickets and more. Once I stopped the celexa the manic went away but I went into a severe depression. They put me back on a low dose of celexa and the depression continued to get worse until I attempted suicide and was put into a mental health centre. There I was told I was bipolar and taken off celexa and put on effexor and lithium. Since then I have never had a mania. I only had mania one time in my life and that was when I was on the 40 mg of celexa. So I don't know if it was a side effect of the celexa or if I do have bipolar ?????
Expert:  MN Psychiatrist replied 2 years ago.
To be truthful I cannot answer this question, and nobody else can either, because there's just no way at all to know the answer without trying something along the lines of what I previously suggested. I know that's not a particularly helpful answer, to you but it's the truth; such is the limitation of psychiatry as a field of medicine at this point in time, and that's why I advocate a patient "wait and see" perspective regarding what time shows you your diagnosis to be. You're welcome to ask someone else, but please be very, very, VERY skeptical of anyone who tells you that you can be definitively told if you have bipolar disorder or not (based on the same information you've shared with me).
Customer: replied 2 years ago.
At what point should someone who is manic be put in the hospital?
Expert:  MN Psychiatrist replied 2 years ago.
This is a great question. Generally speaking, it is at the point when their thinking stops being rational and starts getting irrational. Without the ability to think rationally, people are unable to make good decisions and end up making the decisions that put them at risk or otherwise hurt them.
Customer: replied 2 years ago.
So if I was spending tons of money and stripping and stealing money and not sleeping are things like that a reason to be hospitalalized.
Expert:  MN Psychiatrist replied 2 years ago.
Absolutely.
MN Psychiatrist, Psychiatrist
Category: Mental Health
Satisfied Customers: 792
Experience: Physician for 17 years, adult psychiatrist for 13 years working with a wide variety of patients.
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