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Suggest treatment for depression and bipolar disorder

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Posted on Wed, 30 Jul 2014
Question: I need psychiatric help concerning my current state and medications.
Of course, I have been on different medications since 1976. I am depressed more than usual because of my mom's death; I was her primary caregiver and lived with her. I was prescribed Cymbalta 10 yrs. ago due to arthritis, and Ritalin about 6 yrs. ago to help with fatigue. Would another antidepressant like Wellbutrin give me some energy to at least function...I can't even muster the energy right now to take a bath, care for my dogs, get groceries, etc. I am so distraught...was so close to mom...constant crying spells, etc.
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Answered by Dr. Sunil Gupta (35 minutes later)
Brief Answer:
Please see details below.

Detailed Answer:
Hi.

I am sorry to hear about your mother and offer my sincere condolences. Your being depressed is highly understandable.

You have mentioned that you have been suffering from bipolar depression. I would have liked to know the details and frequency of the manic and depressive episodes that you have had till now.

Regarding your current state, I am not sure that ritalin would have helped with the depressive symptoms anyway. It might help with fatigue and lethargy, but not with pure depressive symptoms like feeling low and crying spells.

You are already on cymbalta (duloxetine) 90 mg/day. At this stage there are two options. If you have had past manic episodes and a true case of bipolar disorder, addition of a mood stabiliser like lithium or lamotrigine would be appropriate. Addition of another anti-depressant can precipitate a manic episode. In case you haven't have nay manic episode in the past, and it is just depression that you have suffered from, addition of another anti-depressant would help. Wellbutin (Bupropion) would be good choice as it will help combat your depressive symptoms as well take care of the fatigue part too.

I do hope that I was able to help with your query. Please do let me know in case you have nay further question. I will be glad to help.

Best wishes for a speedy recovery,

Dr. Sunil Gupta




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

Psychiatrist

Practicing since :2005

Answered : 637 Questions

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Suggest treatment for depression and bipolar disorder

Brief Answer: Please see details below. Detailed Answer: Hi. I am sorry to hear about your mother and offer my sincere condolences. Your being depressed is highly understandable. You have mentioned that you have been suffering from bipolar depression. I would have liked to know the details and frequency of the manic and depressive episodes that you have had till now. Regarding your current state, I am not sure that ritalin would have helped with the depressive symptoms anyway. It might help with fatigue and lethargy, but not with pure depressive symptoms like feeling low and crying spells. You are already on cymbalta (duloxetine) 90 mg/day. At this stage there are two options. If you have had past manic episodes and a true case of bipolar disorder, addition of a mood stabiliser like lithium or lamotrigine would be appropriate. Addition of another anti-depressant can precipitate a manic episode. In case you haven't have nay manic episode in the past, and it is just depression that you have suffered from, addition of another anti-depressant would help. Wellbutin (Bupropion) would be good choice as it will help combat your depressive symptoms as well take care of the fatigue part too. I do hope that I was able to help with your query. Please do let me know in case you have nay further question. I will be glad to help. Best wishes for a speedy recovery, Dr. Sunil Gupta