Overview of Lithium SSRI
Over the last few years the Lithium SSRI combination has been accepted by the medical community for treatment of Bipolar Type II Depression, also called BD II and Type II Depression, but with reservations due to problems with SSRI's. BD II is one of the less severe forms of Bipolar Disorder. Symptoms are more likely to be anxiety or irritability than actual mania. BD II is, however, very capable of interfering with a person's ability to live a normal life.
Lithium is a mood stabilizing drug often used to treat mania and less frequently to treat depression. SSRIs are a class of anti-depressants that are, among other things, also used to treat depression and anxiety.
The most current research suggests that SSRIs, on their own, do little to help with MD II, and one study even compares them to sugar pills. Use of SSRIs by themselves, in this context, can even be dangerous. It can lead to increased manic episodes and in extreme cases suicide, especially when used over long periods. SSRIs can also cause the manic/depression cycle to accelerate.
The preferred treatment for MDII is Lithium or a similar mood stabilizing drug. It takes time for the medicine to work. A couple weeks is common. Then the dosing must be adjusted, possibly several times. With some trial and error it will usually work.
When it does not, in some cases, the addition of an SSRI will help. The SSRI supports what the Lithium is already doing by attacking the same problem from a slightly different direction.
Lithium does not negate the risks that come with the use of SSRIs alone. It does allow the SSRIs to be used in lower dosage, which minimizes the danger. Unfortunately, periodic treatment with SSRIs does not work. Giving SSRIs to a patient currently in a depressed state will not alleviate their immediate problem.
The answer generally recognized is to give the SSRI only when it is clear Lithium alone will not end a person's cycle of moods. When taken its use must be regular, but it is temporary. Once the patient's moods are stabilized the SSRI is discontinued.
Lithium and SSR's are both strong and dangerous drugs that should only be taken under supervision of a doctor. In addition to the problems already mentioned, each has powerful potential side effects of its own.
Some of the side effects of either Lithium or SSRIs may be more annoying than problematic. Others are serious and require immediate medical attention. Be sure to get, and study, a full list of side effects from your doctor.
Summary of Lithium SSRI