Are antidepressants off-limits?

As some of you may (or may not) know, I am in the process of coming off of my anti-psychotic. I am done with them forever. I plan to take only Lamotrigine (and perhaps raise the dose back up to 400 mg) but I'm not sure if this is enough to combat my depression. I could care less if I get manic, but I don't want the depression to come back.

A little back-story: I have been on 2 antidepressants in the past. 1) Wellbutrin. This med make me paranoid and delusional beyond belief. I thought I was constantly being followed and people were trying to mug me or kill me. I was afraid to leave the house. 2) Prozac. I went flying straight into a terribly dangerous mixed (mostly manic) episode that landed me in the hospital.

Now, my NP has said she won't prescribe me an antidepressant, but I really don't want the depression to come back. So is it possible there is an antidepressant that won't cause mania, that I can convince my NP to let me take (if I get depressed)? I know little to nothing about antidepressants.

My mom has cyclothymia and she takes Lexapro and said there are no side-effects, so maybe this would work for me? I dunno. I have an NP appointment on the 14th and I'll ask her then, but in the meantime, any suggestions??

In general, pdocs won't give a bipolar diagnosis an antidepressant unless it's in correlation with an antipsychotic. The reason being that the antipsychotic is stabilizing the mania, so you're less likely to tailspin into an episode.

I've been trying for years to get another antidep after my brief stint on Effexor, but they just won't do it, and I refuse to take what they'll give me (lots of antipsychotics).

So... outlook not good.

I was on Abilify and Depakote when I got manic from Prozac, so in my case, I guess even with an antipsychotic, I still get manic. Ugh, this is just not fair. I guess I will have to live with the depression, then. If I can live with it.

Since I had a sertraline-induced hypomania a few months back, the only things they prescribe me are antipsychotics or "mild" antidepressants like sulpiride (which is officially an antipsychotic but works as antidepressant in low doses). But my crisis wasn't even very severe.
From what I know, pretty much all antidepressant can cause mania, some more than others certainly. The only way to know is to ask someone who really knows about the subject. I will also ask my psychiatrist (in the end of the month) if there's any antidepressant I can take, because I suspect I will crash on sulpiride only, after September when stress increases, and I won't take any more zyprexa and such unless there's no other choice.

Until I read that Sulpiride is an anti-psychotic I was feeling hopeful. I am just not taking any more of these awful drugs (the 60 lb weight gain has caused enough health problems for me, and I'm NOT gaining any more med-related weight). I guess it's hopeless then. Thanks for your input.

My psychiatrist told me that Valdoxan (agomelatine) is relatively safer mania-wise. Have you talked about that one to yours?

I am very susceptible to medication-induced mania and that one didn't trigger it in me. I don't know, I'm not a doctor, but it could be worth mentioning.

Ooh, thanks Bui, I'll bring this one up. I like that it doesn't cause weight gain. I'll definitely mention this one, thank you so much!

I take Sertraline which is an anti depressant and Abilify maintena injections which act as an anti manic agent. This combo works like a dream for me.

I have been on Abilify before, and it didn't work for me. I was still depressed. But I'll bring up the Sertraline, thank you. I like that weight loss is a side effect.

I have been diagnosed with BP type 1 and my docs have always included an SSRI in my drug cocktail. I have read that this is not standard practice, so perhaps I have bad docs or they have a good reason.

I suspect it's because I have severe anxiety problems which has landed me in the ER half a dozen times over the years. It's essentially panic disorder and it became so debilitating that I think the docs wanted to try an SSRI instead of possibly getting me addicted to benzos. (SSRI's are prescribed for anxiety as much as depression). So they put me on the max dose of zoloft which made me utterly crazy for a couple of weeks. I stuck it out (after going to the ER thinking I was going crazy) and now I almost never have panic attacks. So the zoloft does seem to work on that front. However, it doesn't seem to do a whole lot for my depression.

It's my understanding that the only "mood stabalizer" that has been proven to work for depression is Lithium. None of the others have been shown in randomized trials to actually do anything for depression (but they are good for mania). Lithium does both. So unless you're on lithium, your docs might prescribe an SSRI if they think your depression is severe enough.