Hi there, thanks for asking. As you mentioned he is showing some irritable attitude and it is well known that using lorazepam more than needed can lead to irritable behavior. It would be appropriate if you tell his doctor about this problem and he will know how to manage the dose and gradually adjust it. In many cases lithium alone would be sufficient for the the regulation of mood in bipolar disorder. Appetite will increase in many cases with improving the depression and lithium adjustment alone can also regulate it. Then even cyproheptadine may not be necessary. I wish for you and the family a good health.

Hello and welcome to Healthcare Magic. Thanks for your query.

taking multiple benzodiazepines, especiall in high doses such as 8mg of lorazepam is definitely not good. It is likely that he has become dependent on benzodiazepines. I would advise you to discuss with his doctor regarding a gradual tapering of the unecessary drugs.

Regarding his "mood disorder", it is difficult to say which medication would be appropriate for him without knowing a detailed history and doing a proper psychological assessment. So, please discuss about is medication with the treating psychiatrist. If Topiramate is causing side effects like loss of appetite, you can report this to his doctor, so that necessary alterations can be made in his medication regimen.

Wish you all the best.

Regards,
Dr. Jonas Sundarakumar
Consultant Psychiatrist