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Suggest Treatment For Depression Whensuffering From Bipolar Disorder

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Posted on Sat, 26 Apr 2014
Question: I am bipolar and am currently taking lamictal, seroquel, abilify and am still stuck in a depression. How can i reason with my psychiatrist to put me on wellbutrin?
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Answered by Dr. Jonas Sundarakumar (1 hour later)
Brief Answer: Current combination of medication needs review... Detailed Answer: Hello and welcome to Healthcare Magic. Thanks for your query. On going through the medication that you are currently taking, I can see that you are on a mood stabilizer (Lamictal) and two different antipsychotics (Seroquel and Abilify). You have mentioned that you have 'bipolar disorder', but I find it a bit unusual that you are on two different antipsychotics, in addition to the mood-stabilizer. Now, anti-psychotics are usually used in the treatment of bipolar disorder when the person has psychotic symptoms or during the initial phase of a manic episode-in order to bring down the symptoms quickly (as mood-stabilizers can take a few weeks to bring on their full effect). So, I think the first step would be to clarify your diagnosis with your psychiatrist and find out why you are on two different anti-psychotics, in addition to the mood stabilizer. Regarding your question on starting an anti-depressant like Wellbutrin, psychiatrists are usually very cautious about this since there is a risk of the anti-depressant inducing a "switch" to a manic episode. However, if the depressive episode is severe and persistent, and not getting controlled by the mood stabilizer, then, an anti-depressant can be started while continuing the mood stabilizer. So, in conclusion, I would suggest that you first discuss and clarify about your diagnosis and the necessity for the current combination of 3 medication. Secondly, if your depressive symptoms have been going on for some time despite being on an adequate dose of a mood stabilizer, then you can discuss about the possibility of starting an anti-depressant medication, in addition to your mood stabilizer. Wish you all the best. Regards, Dr. Jonas Sundarakumar Consultant Psychiatrist
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Above answer was peer-reviewed by : Dr. Prasad
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Dr. Jonas Sundarakumar

Psychiatrist

Practicing since :2003

Answered : 2190 Questions

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Suggest Treatment For Depression Whensuffering From Bipolar Disorder

Brief Answer: Current combination of medication needs review... Detailed Answer: Hello and welcome to Healthcare Magic. Thanks for your query. On going through the medication that you are currently taking, I can see that you are on a mood stabilizer (Lamictal) and two different antipsychotics (Seroquel and Abilify). You have mentioned that you have 'bipolar disorder', but I find it a bit unusual that you are on two different antipsychotics, in addition to the mood-stabilizer. Now, anti-psychotics are usually used in the treatment of bipolar disorder when the person has psychotic symptoms or during the initial phase of a manic episode-in order to bring down the symptoms quickly (as mood-stabilizers can take a few weeks to bring on their full effect). So, I think the first step would be to clarify your diagnosis with your psychiatrist and find out why you are on two different anti-psychotics, in addition to the mood stabilizer. Regarding your question on starting an anti-depressant like Wellbutrin, psychiatrists are usually very cautious about this since there is a risk of the anti-depressant inducing a "switch" to a manic episode. However, if the depressive episode is severe and persistent, and not getting controlled by the mood stabilizer, then, an anti-depressant can be started while continuing the mood stabilizer. So, in conclusion, I would suggest that you first discuss and clarify about your diagnosis and the necessity for the current combination of 3 medication. Secondly, if your depressive symptoms have been going on for some time despite being on an adequate dose of a mood stabilizer, then you can discuss about the possibility of starting an anti-depressant medication, in addition to your mood stabilizer. Wish you all the best. Regards, Dr. Jonas Sundarakumar Consultant Psychiatrist