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Suggest Treatment For Bipolar Disorder

Posted on Wed, 7 Oct 2015

Question: I have been diagnosed with severe bipolar 1 disorder. I have been on a multitude of medications over many years and I cant seem to find long term results. Even taking lithum carb,gabapentin and Seroquel I still have periods of depression, aniexty and manic episodes. I have read numerous studies that state that medication cures all.......why don't I have those results. In the last 3 months I have been hospitalized for panic attacks, manic episodes and a suicide attempts
I also experience crying episodes and multiple side effects from the medication I am taking. I hallucinate, at times I have fainted and lose my ability to walk and feel like I live in a fog
Also I have no desire to do anything. Most days I stay in my room. I experience very low energy and have even lost my desire to live. I haven't experience any happiness in years. At times when I feel totally out of control and have lost my ability to handle my symptoms I have turned to alcohol for relief. I now its wrong but when my life is out of control I'am desperate for some relief

Answered by Dr. Chintan Solanki (31 minutes later)

Brief Answer:
please mention the dose you are taking,

Detailed Answer:
Hello,

Thanks for writing to us.

From your history it seems that you are suffering from Bipolar Disorder Rapid cycler category. It is difficult to manage. You have also mixed features. In my opinion optimum dose of lithium, Lamotrigine and SSRI with or without valproate would be the best combination. If severity is more anti psychotic medicine like olanzapine or quetiapine can also be added for short time.
ECT - Electro convulsive therapy is the best treatment to treat severe episode and also for suicidal ideas.

Let me know current medicines with dose and duration you are taking as well as your body weight so I can give further comments.Also mention if you have taken ECT or not.

Hope I have answered your query, I will be happy to help further.

Regards,
Dr.Chintan Solanki.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Chintan Solanki (1 hour later)

lithium carb 600mg twice a day
Seroquel 400mg 1 at bedtime
gabapentin 300mg 4 times a day
hydroxyzine pamoate 50mg 1 at bedtime
clonazepam 5mg 3 times a day

why do I still experience mood swings, depression, severe anxiety, and manic episodes
I weigh 136
and I've never taken ect

Answered by Dr. Chintan Solanki (7 hours later)

Brief Answer:
ECT is the best option,still need of adding some medicines

Detailed Answer:
Hi,

Thanks for information.

Lithium 1200 mg per day is quite ok. But there is need of adding valrpoate or lamotrigine with some SSRI. In this much severe disorder 2-3 mood stabilizer is used frequently.
I hope it is 0.5 mg clonazepam not 5 mg.
Gabapentine is not likely helpful in my opinion in your problem.
Hydroxyzine is only for sleep.

I am surprised that why you have been not given ECT yet. It is highly recommended for such severe bipolar disorder.

This high severity is likely due to multiple neurochemical disturbances.

Please discuss my view with your treating doctor and start ECT treatment. It will help.

Take care and feel free to discuss further.

Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar