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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Bipolar Disorder And Insomnia

Hello. I am typing at 3:41AM my time with insomnia. I m diagnosed with occasional hypomanic episodes treated with valproic acid. Today I had an L4-5 epidural steroid injection for severe stenosis and now I m having a doozy of an episode. For me these episodes are not, contrary to the report of many, fun, creative, energetic, productive, witty, nor do I feel eloquent or engaging. I am miserable with them. As my mind races faster I tend to get angrier. I just want to rest. I have been given, as prep for the injection (this has happened the first 3 times I was injected- this is the 4th) a coarse of Seroquel (to be weaned from later) as well as the valproic acid upped to 2000mg. at bedtime. I really don t feel depressed except about being this elevated. Also about taking so many meds for it and they re not working so well. My psychiatrist says my extreme reaction is unusual for an epidural. I need to just wait it out, I suppose- this historically clears up in about 2 weeks starting out with 2 hours sleep a day for a few, then to 4 and 6 hours over time. I don t have any harmful thoughts or actions in mind. Guess I m just venting yet still will appreciate any feedback offered. Thank you for your time. Sincerely, Arthur Flowers, Verona, VA
Tue, 1 Aug 2017
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Psychiatrist 's  Response
continue valproate .continue seroquel as your sleep is reduced.can add 5mg nitrazepam to ur medications.consider slow tapering of nitrazepam and seroquel once ur symptoms stabilize with valproate
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Suggest Treatment For Bipolar Disorder And Insomnia

continue valproate .continue seroquel as your sleep is reduced.can add 5mg nitrazepam to ur medications.consider slow tapering of nitrazepam and seroquel once ur symptoms stabilize with valproate