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Suggest Medication For Bipolar Disorder And Manic Depression

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Posted on Sat, 7 Nov 2015
Question: I was diagnosed as bipolar in 2007, manic state. Since then I have been in the depressed phase with no letup in sight. I take 200 mg Cymbalta as an antidepressant. Many years ago I took Cymbalta and 200 mg Wellbutrin, which was the only time I felt more lighthearted, but definitely not manic. I was not taking Wellbutrin when I was diagnosed manic in 2007. Any suggestions?
doctor
Answered by Dr. Shubham Mehta (5 hours later)
Brief Answer:
Lithium, Thyroid function tests.

Detailed Answer:
Hello
Welcome to HCM.
I can understand your concerns.

8 years of depressive phase is quite long.

You are taking cymbalta 200mg for it and still there is depression.

In such case, my drug of choice would be to add lithium to cymbalta. It acts as a mood stabilizer and will lift your mood. The risk of switching to mania will also be reduced.

Other than this, I would suggest you to go for thyroid function tests. Impaired thyroid function can be a reason for such a long depressive phase.

Kindly discuss this with your doctor.
Hope this helps.

Feel free to ask further.
Take care.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shubham Mehta (18 hours later)
Lithium is a worrisome choice in my mind because a co-workers mother suffered from scirossis of the liver due to lithium. Why not combine Wellbutrin with the Cymbalta as was the case in 2004 with good results?
doctor
Answered by Dr. Shubham Mehta (9 hours later)
Brief Answer:
Lithium does not cause liver cirrhosis.

Detailed Answer:
Hi again.
Sorry for late response.

Cirrhosis of liver is not among the common side effects of liver. Rather I would say its very rare that lithium cause liver cirrhosis.
So, I would still recommend lithium for you.

Welbutrin and cymbalta can have significant drug interactions. Combination can lower seizure threshold. Significant monitoringof side effects will be needed if you take the combination.

Kindly discuss this with your doctor.

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

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Shubham Mehta

Psychiatrist

Practicing since :2008

Answered : 2145 Questions

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Suggest Medication For Bipolar Disorder And Manic Depression

Brief Answer: Lithium, Thyroid function tests. Detailed Answer: Hello Welcome to HCM. I can understand your concerns. 8 years of depressive phase is quite long. You are taking cymbalta 200mg for it and still there is depression. In such case, my drug of choice would be to add lithium to cymbalta. It acts as a mood stabilizer and will lift your mood. The risk of switching to mania will also be reduced. Other than this, I would suggest you to go for thyroid function tests. Impaired thyroid function can be a reason for such a long depressive phase. Kindly discuss this with your doctor. Hope this helps. Feel free to ask further. Take care.