Thanks for your query.
I appreciate your efforts for medical consultation in so much distress.
Important aspects of your query are:
• 30 year old male
• Known case of Bipolar disorder
(as appear from history)
• Currently on: Divox 750, Oxene 300-2tab
• Complaints of: dizziness
, drowsy, nausea, hair loss, hand trembling, blur vision, headache, loss of concentration, weight gain etc for last 4 months.
From the treatment history it appear that you have bipolar disorder. Bipolar disorder is a chronic illness and in most of the cases patient need treatment for years or lifelong.
In Bipolar disorder patient has both manic and depression
episode. In depression most common symptoms are: low mood, decrease energy and negative thinking. In contrast, in Manic episode common symptoms are: over cheerfulness, anger, irritability, increase energy and decrease need for sleep.
Following medicines are well researched and found to effective for Bipolar disorder: Lithium (intalith/litholentzelith), Valproate (Divox/dicorate-er/valance-od), Lamotrigine
(Lamitor-OD) and Carbamazepine
(oxene). These medicines also called as mood stabilizers and given for for long term to stabilise mood. They prevent both depressive and manic episode. Even if patient become ill while on medicine, illness is less severe and last for short period.
Out of these medicines patients got stabilised on one or combination of two medicines. Choice of medicine is depend on patient illness state (which can be assessed on interview only), side effect profile of medicine, and duration of illness, weight, age and sex of the patient. Sometime other antimanic agent (ooz/rionforte) needs to be added depending on the severity of episode and anti depressants need to be added during depressive episode..
Overall your treatment appear ok to me. Although it is not good to change treatment so frequently, but as treatment is highly individualised, changes might be needed according to your condition. To suggest any treatment or treatment change, in person mental status examination
(interview) of patient is must.
For side effects (dizziness, drowsy, nausea, hair loss, hand trembling, blur vision, headache, loss of concentration, weight gain) following steps will be helpful:
-Most of the side effects subside after few days of continuation of medicine.
-For weight gain: Start diet/weight monitoring, restrict fat and sweet intake, exercise regularly.
-For hair loss: It usually occur with valproate. Multivitamins preparation with selenium (like Cobadex CZS
once in a day) will help.
I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow ups.
Wish you good health.
Dr Ashish XXXXXXX Mittal