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Suggest Treatment For Anxiety And Depression In A Bipolar Patient While On Ziprasidone Hcl, Lithium Carbonate And Methylphenidate
Question: Our son has three prescriptions for bipolor, depression. We're concerned that the blood is not being monitored regularly and he is having serious, serious depression and anxiety from family issues, doesn't want to be alone, cries often, can't sleep (for two weeks). The drugs are ziprasodone hcl, 20 mg, methylpagnidate 20 mg, lithium carbonate er 450 mg. His dr wants him to double up the ziprosodone to help him sleep. We need your advice
Brief Answer:
The levels of Lithium carbonate should be monitored.
Detailed Answer:
Hello,
He is suffering from Bipolar Depression and is on Ziprasidone 20, Lithium Carbonate 450 and Methylphenidate 20 mg per day.
Ziprasidone is a second generation antipsychotic drug and is one of the commonly used anti-psychotic drugs for bipolar depression. The drug is safe to use and starting dose is about 40 mg per day. Even if they have advised to double the doses, there is no need to worry. The dose will be safe.
Baseline blood investigations like complete blood count, liver function tests and renal function tests should be done prior to starting the drug and also periodically while on this drug. Over all, the drug is safe to use.
Methylphenidate is an amphetamine drug and is also safe to use. The drug has high abuse potential so should be given under regular supervision of a psychiatrist only.
Lithium Carbonate is a mood stabilizer drug and has good efficacy. The drug follows therapeutic window phenomenon and its levels should be measured periodically in patients taking it. The drug is safe and effective in levels of 0.6-1.2 m.mol/ltr. Its levels should be in blood workup.
There is no harm in doubling the dose of Ziprasidone. He is on the right medicines but the levels of Lithium should be monitored and his baseline blood investigations should be done.
Hope I have answered your query. Let me know if I can assist you further.
Thanks and take care.
Regards,
Dr. Seikhoo Bishnoi
Psychiatrist
The levels of Lithium carbonate should be monitored.
Detailed Answer:
Hello,
He is suffering from Bipolar Depression and is on Ziprasidone 20, Lithium Carbonate 450 and Methylphenidate 20 mg per day.
Ziprasidone is a second generation antipsychotic drug and is one of the commonly used anti-psychotic drugs for bipolar depression. The drug is safe to use and starting dose is about 40 mg per day. Even if they have advised to double the doses, there is no need to worry. The dose will be safe.
Baseline blood investigations like complete blood count, liver function tests and renal function tests should be done prior to starting the drug and also periodically while on this drug. Over all, the drug is safe to use.
Methylphenidate is an amphetamine drug and is also safe to use. The drug has high abuse potential so should be given under regular supervision of a psychiatrist only.
Lithium Carbonate is a mood stabilizer drug and has good efficacy. The drug follows therapeutic window phenomenon and its levels should be measured periodically in patients taking it. The drug is safe and effective in levels of 0.6-1.2 m.mol/ltr. Its levels should be in blood workup.
There is no harm in doubling the dose of Ziprasidone. He is on the right medicines but the levels of Lithium should be monitored and his baseline blood investigations should be done.
Hope I have answered your query. Let me know if I can assist you further.
Thanks and take care.
Regards,
Dr. Seikhoo Bishnoi
Psychiatrist
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
How often should blood tests be done for all of these drugs?
Brief Answer:
The investigations should be done in 3 months
Detailed Answer:
Hello,
If baseline investigations were normal then these should be repeated every 3 months.
Lithium levels should be checked too in 3 months.
Hope I have answered your query.
Thanks and take care.
Regards,
Dr. Seikhoo Bishnoi
Psychiatrist
The investigations should be done in 3 months
Detailed Answer:
Hello,
If baseline investigations were normal then these should be repeated every 3 months.
Lithium levels should be checked too in 3 months.
Hope I have answered your query.
Thanks and take care.
Regards,
Dr. Seikhoo Bishnoi
Psychiatrist
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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