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Dr. Andrew Rynne
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Was diagnosed with Bipolar. Unable to focus on work, depressed a lot. On Cymalta, Imipramine and lyrica. Suggest?

Answered by
Dr. Srikanth Reddy


Practicing since :2007

Answered : 2770 Questions

Posted on Thu, 25 Jul 2013 in Mental Health
Question: I need to find a local psychiatrist, I think. I was diagnosed with bipolar II about 5 yrs ago. I have been having performance issues at work-ie not focusing and unable to concentrate. Someone has accused me of being ADD-I'm wondering if maybe my problems are related to ADD instead of bipolar (I'm hardly ever manic-just depressed a lot and I am on Cymalta, Imipramine and Lyrica (fibromyalgia,also)
Answered by Dr. Srikanth Reddy 27 minutes later
Thanks for choosing health care magic for posting your query.
I have gone through your question in detail.
ADD or attention deficit disorder or more popularly ADHD (Attention deficit hyperactivity disorder) has a strong association with bipolar mood disorder. Many people who have ADHD tend to have mood disorder as well. So it is still possible for you to have ADHD along with your mood disorder.
Secondly for you to have ADHD at this age it is mostly essential that you should have had ADHD in childhood as well and this can be confirmed from your parents. You generally do not develop a de no vo disorder of ADD in adulthood.
You have mentioned your medications in your question and unfortunately, if your psychiatrist considers you as bipolar then there are two probelms with your prescription:
1) There is no mood stabilizer in the prescription which is a must if you are bipolar.
2) Imipramine should preferable be avoided for the risk of switching you to mania.

Valproate, lithium, lamotrigine are some of the mood stabilizers you should be on along with antidepressants such as bupropion or venlafaxine.
Moreover for you to be considered as bipolar, you need not have a full blown mania. Instead even if you have a hypomania (Pathological euphoria), then also you will be considered bipolar mood disorder.

May be you should consider getting a second opinion about your illness from a different psychiatrist around your area.
Hope I am able to answer your concerns.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.
In future if you wish to contact me directly, you can use the below mentioned link:

Wish you good health,
Dr. Srikanth Reddy M.D.

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

The User accepted the expert's answer

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