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Suggest Treatment For Apathetic Behavior And Irritability
Question: Hi again Dr. XXXXXXX
I wanted to ask you about the same case. My fiancé is feeling very apathetic still. She feels as if she's empty from emotions. She does still tell me that she loves me but other than that she feels she does not care much about anything. She is also very irritable about the small things and everything gets on her nerves. She tried an anti-psychotic medication but she says it just makes her stop thinking about stuff. It does not help with the irritability or not caring about anyone/anything in your life. She also has the tendency to drink now way more than before.
My question is whether the medications that she is taking will help her towards the goal of feeling more stable and normal?
I wanted to ask you about the same case. My fiancé is feeling very apathetic still. She feels as if she's empty from emotions. She does still tell me that she loves me but other than that she feels she does not care much about anything. She is also very irritable about the small things and everything gets on her nerves. She tried an anti-psychotic medication but she says it just makes her stop thinking about stuff. It does not help with the irritability or not caring about anyone/anything in your life. She also has the tendency to drink now way more than before.
My question is whether the medications that she is taking will help her towards the goal of feeling more stable and normal?
Brief Answer:
Discuss the option of Latuda
Detailed Answer:
Hello,
Thanks for reverting back to me.
I am sorry to know that medication did not help her in irritability and she developed some unpleasant effects such as lack of affection.
First of regarding your question I understand that initially person experiences that medicine is blocking her thoughts but over the time it helps in stabilising the mood and random thoughts. If you go for timeline most patients start responding by end of one week and continue to improve over next 6-8 weeks. I mean to say that Olanzapine have enough potential to make her stable.
Now regarding tolerability issues and presence of irritability it is recommended to discuss the option of latuda with her psychiatrist. I feel that her episode meets the criteria of mixed features and looted can have a better effect to control her irritability and lack of emotions. I must clarify that there are other options and your psychiatrist may not agree with me (he knows better than me about the patient) but bringing the latuda under discussion is suggested.
I hope this helps you.
Do not hesitate to discuss anything relevant to her well being.
Thanks again.
Discuss the option of Latuda
Detailed Answer:
Hello,
Thanks for reverting back to me.
I am sorry to know that medication did not help her in irritability and she developed some unpleasant effects such as lack of affection.
First of regarding your question I understand that initially person experiences that medicine is blocking her thoughts but over the time it helps in stabilising the mood and random thoughts. If you go for timeline most patients start responding by end of one week and continue to improve over next 6-8 weeks. I mean to say that Olanzapine have enough potential to make her stable.
Now regarding tolerability issues and presence of irritability it is recommended to discuss the option of latuda with her psychiatrist. I feel that her episode meets the criteria of mixed features and looted can have a better effect to control her irritability and lack of emotions. I must clarify that there are other options and your psychiatrist may not agree with me (he knows better than me about the patient) but bringing the latuda under discussion is suggested.
I hope this helps you.
Do not hesitate to discuss anything relevant to her well being.
Thanks again.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for your response. The thing is we broke up and it's been hard for me to just convince her to talk to her psychiatrist. It will be even harder to interfere and go to her meeting with her psychiatrist. She hid the fact that she didn't start taking her anti-psychotic until a week after it was prescribed. She knew she was going to gain weight and she did gain some on the first 4 days that's why I can not see any hope she would stay on it. She told me that she'd rather be depressed/mind filled with random thoughts than to be overweight even though I was trying to convince her that mental health is everything and weight can be lost later.
Do you think having a mood stabilizer along with an anti-depressant will do her any good? I am extremely worried if she goes into a manic state from adding the depressant.
I can not see her taking my word for the medication you suggested (Latuda). I am not being able to convince her to drink less which she knows it's bad for her. I will try to bring it up though maybe if I could talk to her psychiatrist in the future.
Do you think having a mood stabilizer along with an anti-depressant will do her any good? I am extremely worried if she goes into a manic state from adding the depressant.
I can not see her taking my word for the medication you suggested (Latuda). I am not being able to convince her to drink less which she knows it's bad for her. I will try to bring it up though maybe if I could talk to her psychiatrist in the future.
Brief Answer:
Antidepressant can be added with mood stabiliser
Detailed Answer:
Hello,
Thanks for reverting back to me.
The choice of medication in her case is balancing act and we need to keep many things for consideration such as risk of switching, risk of ongoing episode, risk of weight gain and many others.
Although considering her profile I completely agree that a mood stabiliser should be given and antidepressant can be added for a duration till she start feeling better. Once it is done the antidepressant can be stopped/reduced to decrease the risk of full blown mania.
Regarding your question there are no clear guidelines but in principal I start with low dose antidepressant along with mood stabiliser and stop the antidepressant well before it becomes a risk factor/precipitating factor for manic episode. Till date I rarely observed manic episode from such prescription provided patient was under proper supervision.
latuda was recommend because it has effecacy in bipolar depression as well ads XXXXXXX and have very low propensity of causing weight gain.
I hope this clarifies.
Thanks again.
Antidepressant can be added with mood stabiliser
Detailed Answer:
Hello,
Thanks for reverting back to me.
The choice of medication in her case is balancing act and we need to keep many things for consideration such as risk of switching, risk of ongoing episode, risk of weight gain and many others.
Although considering her profile I completely agree that a mood stabiliser should be given and antidepressant can be added for a duration till she start feeling better. Once it is done the antidepressant can be stopped/reduced to decrease the risk of full blown mania.
Regarding your question there are no clear guidelines but in principal I start with low dose antidepressant along with mood stabiliser and stop the antidepressant well before it becomes a risk factor/precipitating factor for manic episode. Till date I rarely observed manic episode from such prescription provided patient was under proper supervision.
latuda was recommend because it has effecacy in bipolar depression as well ads XXXXXXX and have very low propensity of causing weight gain.
I hope this clarifies.
Thanks again.
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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