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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest treatments for Bipolar disorder

Hi, My son is 27 years old still living with us and he was just diagnosed with Bipolar disorder. He has his ups and downs , not able to keep a job or stay in school. What ca we do as parents to help him Thank you for taking the time to give us some advice
Mon, 18 Aug 2014
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Psychiatrist 's  Response
In my opinion if your son is getting repeated episodes of ups and down then he need long term treatment. You need to persuade him to take treatment. As parents, you need to encourage him to have regular sleep wake cycle, have some kind of relaxation exercises or yoga, helping him deal with stressful situation and teaching him better coping skills and avoiding any kind of substance use if he takes any.
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Psychiatrist Dr. Ravi Soni's  Response
hello,,Mr.. i can understand your concern..actually bipolar disorder is a kind of mental illness in which person has mood swing and they are at extremes like severe depression and severe euphoria and mania. they can not remain continuous for long but illness is episodic and there are relapses and recurrence. that is why regular consultation to psychiatrist and evaluation is very necessary.
usually this illness is treated and controlled with mood stabilizers, the drugs are sodium valproate [depakote], lithium, carbamazepine, lamotrigine, combination of fluoxetine and planzapine, and some antipsychotic medications [quetiapine].

because i dont know about the symptoms and its severity, i can just suggest drus blindly but that will be surely helpful.

if your son is remain happy and restless and asking money, making big talks, talkative then u shud go for following drugs:
1. tablet depakote xr 500 mg thrice daily
2. tablet olanzapine 5 mg twice daily

there is a possibility that he might have excessive sleep and sedation for first few days. u can reduce the dose of olanzapine as per his severity of symptoms. u can increase the dose of depakote as per 20-30mg/kg body weight. go for regular consultation and advice.

if your son remains depressed most of the time and his manisc symptoms are not very much severe then u can go for any of the following medication:
1.quetiapine [200] once a day gradually increase upto 400-700 mg/day as per drug response
2. combination of fluoxetine and olanzapine [fostera 5 and 10] once a day at night, can be increased to twice a day
3. lithium 450 mg sr preparation twice daily, there are some precaution while tking lithium u can read it from net,,it is very lengthy so i can nor explain here
4. lamotrigine start with 12.5 mg twice daily and keep in mind about any skin reaction after taking it, if skin reaction occurs then stop the drug immediately and consult your psychiatrist..

i hope these will help u in managing your son
best luck
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Psychiatrist Dr. Jonas Sundarakumar's  Response
Hello and thanks for writing in.

I understand that you are deeply concerned about your son's diagnosis. Now, Bipolar disorder is a treatable problem, but regular and long term treatment is essential. Treatment is with mood stabilizer medication which will prevent the episodes of depression or mania.

One of the challenges, carers face is to get the patient to take medication regularly. So, as parents it would be good if you take up the responsibility of giving him medication everyday and regularly. He will also need periodic follow up with his psychiatrist and also periodic blood tests to check whether the blood levels of the mood stabilizer are adequate.

Regards,
Dr. Jonas Sundarakumar MBBS., DPM., MRCPsych.(U.K.)
Consultant Psychiatrist
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Suggest treatments for Bipolar disorder

In my opinion if your son is getting repeated episodes of ups and down then he need long term treatment. You need to persuade him to take treatment. As parents, you need to encourage him to have regular sleep wake cycle, have some kind of relaxation exercises or yoga, helping him deal with stressful situation and teaching him better coping skills and avoiding any kind of substance use if he takes any.