Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Suggest Medication For Persistent Bipolar Disorder And Severe Anxiety Leading To Manic State
Question: I have been diagnosed with Bipolar mixed severe. along with an anxiety disorder I have been on a myriad of medication to no avail. This year along I have been hospitalized due to a manic state. I few months later I Spent a week in the hospital for a manic episode and the a month later Ispent 3 days in the hospital for a suicide attempt. I am presently taking:i
lithium carb 600mg twice a day
gabapentin 300mg 4 time a day
Seroquel 400 mg at bedtime
hydroxyzine pamoate 50 mg at bedtime
klonopin 0.5 mg 3 times a day
My doctor is frustrated with me. Claims nothing she has prescribed has given long term relief.
She acts as if she is mad a me. The last view visits I have basically lied to her, stating that I feel fine.
Which is not the truth. But I am afraid to tell her the truth. Am I the only person in the world that has not been "cured" with this cocktail?
I am my wits end. I am very depressed and just want to accept that I have to live the constant mood swings or may be I should just end it all because this is no way to live. Bottom line she frustrated with me and blaming me for not getting better. What should I do. As you can see I have been up now for three days cant sleep, high energy along anxiety and I want I don't want to wait24 hours for a reponse
lithium carb 600mg twice a day
gabapentin 300mg 4 time a day
Seroquel 400 mg at bedtime
hydroxyzine pamoate 50 mg at bedtime
klonopin 0.5 mg 3 times a day
My doctor is frustrated with me. Claims nothing she has prescribed has given long term relief.
She acts as if she is mad a me. The last view visits I have basically lied to her, stating that I feel fine.
Which is not the truth. But I am afraid to tell her the truth. Am I the only person in the world that has not been "cured" with this cocktail?
I am my wits end. I am very depressed and just want to accept that I have to live the constant mood swings or may be I should just end it all because this is no way to live. Bottom line she frustrated with me and blaming me for not getting better. What should I do. As you can see I have been up now for three days cant sleep, high energy along anxiety and I want I don't want to wait24 hours for a reponse
Brief Answer:
you are not only one, many suffer from this
Detailed Answer:
Hello,
Thanks for writing us to back.
First of all I want to clarify that you are not only person in the world who is suffering even after taking multiple medicines. Almost 10-20% of the patients with bipolar illness may suffer from this.
From your history and symptoms I think you are still not given right medicines in optimum dose.
In your case my recommendations are as follows.
- As you are in mixed sever phase lamotrigine (lamictal) will be good option as it has proven drug for bipolar depression.
- Other option is olanzapine and fluoxetine combination as it is approved for mixed phase.
- Dose of seroquel can be increased up to 800 mg as it is effective as mood stabilizer.
- In my opinion gabapentin is not needed at all. It should be gradually omitted.
- 0.5 mg clonazepam and 50 g hydroxyzine are not sufficient for sleep in such cases. Dose of clonazepam can be increased up to 2 mg at night time for good sleep. Later on it can be reduced again.
You have narrated some problem with your doctor. Being a professional I think she should not be like that. You should tell your doctor what you actually feel. Do not give wrong information that you are fine. Try again to talk with her regarding your problems by getting specific appointment and discuss my recommendations for changing treatment and modify your prescription under her supervision.
However if you feel that your doctor is really not understanding you I suggest consulting another psychiatrist who can again take note of your problem in detail and modify treatment according to needs. You can share above recommendations to new doctor also if you consult someone else by chance.
Hope I have answered your query, I will be happy to help further.
Regards,
Dr.Chintan Solanki.
you are not only one, many suffer from this
Detailed Answer:
Hello,
Thanks for writing us to back.
First of all I want to clarify that you are not only person in the world who is suffering even after taking multiple medicines. Almost 10-20% of the patients with bipolar illness may suffer from this.
From your history and symptoms I think you are still not given right medicines in optimum dose.
In your case my recommendations are as follows.
- As you are in mixed sever phase lamotrigine (lamictal) will be good option as it has proven drug for bipolar depression.
- Other option is olanzapine and fluoxetine combination as it is approved for mixed phase.
- Dose of seroquel can be increased up to 800 mg as it is effective as mood stabilizer.
- In my opinion gabapentin is not needed at all. It should be gradually omitted.
- 0.5 mg clonazepam and 50 g hydroxyzine are not sufficient for sleep in such cases. Dose of clonazepam can be increased up to 2 mg at night time for good sleep. Later on it can be reduced again.
You have narrated some problem with your doctor. Being a professional I think she should not be like that. You should tell your doctor what you actually feel. Do not give wrong information that you are fine. Try again to talk with her regarding your problems by getting specific appointment and discuss my recommendations for changing treatment and modify your prescription under her supervision.
However if you feel that your doctor is really not understanding you I suggest consulting another psychiatrist who can again take note of your problem in detail and modify treatment according to needs. You can share above recommendations to new doctor also if you consult someone else by chance.
Hope I have answered your query, I will be happy to help further.
Regards,
Dr.Chintan Solanki.
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Prasad
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
