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Suffering from bipolar and on medication. Lacking motivation and anxiety. Having chest pain and taking effexor. Suggest the cure?

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Practicing since : 2000
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I am on 10 mg abilify, with 120 of cymbalta and vairiably 100-200mg thorazine a day, and down to 1 to 2 mg ativan, also 200 mg topamax. I also incedenally use the fentanyl 75mcg/72hr patch.

I am bipolar over the last 30 years, diagnosed in 1983. My question: I find an increasing lack of motivation, but no depression, and find it anxiety-provoking to leave the house, to the point where I have my groceries delivered. I have no neuroses, I hae abstained from alcohol for 8 years by choice, quit smoking but occasionally use a piece of nicotine gum (3/day). I was a public health nurse when I did work, and I have been on disability for bipolar for the last ten years.

Do some chronically ill bipolars have a hard time leaving the house?

I have a hard time making myself take a bath, it's a motivation thing. My father has Parkinson's--could my motivation failure be the beginning of Parkinson's? I have no focal deficits or tremors. Or could it be the side effect of the thorazine?

Some are saying that for long-term low grade depression that strattera is a good thing. I don't know much about this. I already think fast, but have a hard time getting going. I just sit and sit, can't get down to actually doing anything.

I was on effexor for a while, and it helped me, and we switched to cymbalta when it seemed to no longer seemed to be working. I at the same time was having bigeminy and trigeminy and chest pain. Can effexor cause this? Because If it doesn't I was thinking of going back on it.
Posted Sat, 21 Sep 2013 in Mental Health
Answered by Dr. Payman Hajiazim 30 hours later
Brief Answer:
Anxiety is common in bipolar mood disorder.

Detailed Answer:
Hi there, thanks for asking. general anxiety is pretty common in bipolar mood disorder. It can be managed with mood medications for bipolar issues.
Lack of motivation mostly backs to depression and as you mentioned Effexor is a good medication for depression. Effexor does not have any side effects on the heart such as rhythm irregularities. However, many medications have this potential. The low dose is safe and also is better for depression in bipolarity.
People who will develop Parkinson, have restless legs at night up to 10 years before the onset of Parkinson. You can ask your wife to watch this issue to see.
Let me know if I have not answered any point.
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