
Can Leximal Be Added To Medications For Depression When Suffering From Bipolar Disoreder?

My son has Bipolar 1 and after a 6 month mania he is now in the deepest depression His Psychiatrist prescribes Epitec 25mg twice a day,eppilum 500mg and Risperdal 2mg at night Yet Dr the severe depression is not lifting Can he take Leximal with the above meds? How long till this darness starts lifting?
Regards
XXXX(Mom)
Leximal should be avoided in bipolar disorder patients.
Detailed Answer:
Hello thanks for asking from HCM for your health related queries
I can understand your problem. Your son 0f 25 years age has been diagnosed with Bipolar affective disorder and had one episode of Mania but currently he is in worse depressive phase. He is on Lamotrigine 25 mg, Sodium Valproate 500 mg and Risperidone 2 mg per day. His depressive symptoms are still persisting.
If we consider his drug therapy as per my opinion he is on right drugs for Bipolar disorder with depression. Risperidone and Sodium Valproate will help in stabilising his mood and Lamotrigine (epitec) will help in improving his depressive symptoms of bipolar disorder. But with these medicines his symptoms are not remitting.
As per my opinion the doses of drugs should be increased. Lamotrigine in 25 mg dose is a low dose of drug and it should be increased to 50-100 mg per day to see its effects. I usually prescribed the drug in range of 50-200 mg per day to my patients. Dose of sodium valproate is also less, it should be increased to 750-1000 mg per day. A lot of mood stabilisers have therapeutic window phenomenon, that is if we use insufficient doses they don't result in full effect. So as per my opinion you should consult his psychiatrist again and discuss about dose adjustments of drugs.
Adding Leximal or Escitalopram would not result in benefit instead it may result in manic switch which may prove harmful. The drug is not usually used in bipolar patients so as per my opinion it should not be given to him.
Most of individuals start showing improvement of symptoms of depression in about 4-8 weeks with proper doses of drugs.
Thanks, hope this helps you. Please ask again for more doubts.

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