Suggest Treatment For Nervousness With Bipolar Disorder

Posted on Sat, 9 Aug 2014

Question: I went to see a doctor 2 years ago he told me I have bilpolar disorder he gave me sulpiride and it has been working fine but recently I have to up my intake from 25, 50 and now to 75 mg, I have random violent thinking, nerviosness with a tick on my nose, some times I have a really upset response to somewhat small thinks, I don't really know if I am bipolar or squizofrenic, can you change my drug for another, I hope you can recommend one being sell over the counter also please give several options because I am living in mexico and don't know wich one I can get here, thanks

please send answer to YYYY@YYYY

Answered by Dr. Abhishek Kapoor (10 hours later)

Brief Answer:
Answer these questions

Detailed Answer:
Hi
Thanks for using healthcare magic. I, Dr Abhishek Kapoor, would help you in this query.

Treatment in your case depends upon diagnosis. If you have bipolar disorder, then you need mood stabilizer and antipsychotic. In schizophrenia, you need antipsychotic only. Please answer few queries, so i could help you:

1. Any past history of depression for more than two weeks?
2. Any past history of mania?
3. Any past history of hallucination or suspiciousness?
4. Are you able to maintain your daily activity?

Regards
Dr. Abhishek Kapoor
Psychiatrist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Abhishek Kapoor (7 hours later)

yes I have a very hard depression attack just before going to see the doctor he gave me sertraline

I use to be very active (cleaning the house) for a week and then just doing the minimum to go by daily for another 2 weeks

no mania

no hallucinations, just very vivid imagination, when I go to sleep I image cutting limbs of noisy neighbors, sometimes when I wake up my first thinking is "I want to kill somebody", I am not violent physically but when explode I am very abusive verbally

I have a somewhat normal life, I do very little exercise, work with computer all day, but if I don't have my sulpiride, I explode with very little, I do video editing and photo editing
the depression attack was about 2 weeks in duration
Tank you

Answered by Dr. Abhishek Kapoor (21 minutes later)

Brief Answer:
You need mood stabilier

Detailed Answer:
HI

You are not a case of schizophrenia. I think, you have bipolar disorder. With history of depression and antidepressant included hypomanic, diagnosis in your case would be bipolar disorder or recurrent depressive disorder. In that case, you need a mood stabilizer, that would help to control the mood swings. I would suggest you to take lithium or valproate or carmazepine as mood stabilizer. It would help to overcome from depressive symptoms. Rest you can discuss with your psychiatrist.

If you need further help, you can ask.

Regards
Dr. Abhishek Kapoor
Psychiatrist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Abhishek Kapoor (1 hour later)

is carmazepine = carbamazepine?

Do I need to discontinue any sulpiride or sertraline if I use carbamazepine?

how many mg do you recommend for each one?

thanks

Answered by Dr. Abhishek Kapoor (56 minutes later)

Brief Answer:
You can start with 200 mg of carbamazepine

Detailed Answer:
HI

Sorry for wrong spelling. This is carbamazepine. You can start with 200 mg per day and gradually increase the dose. after psychiatrist consultation In case, you do not get any improvement in depressive symptoms with carbamazepine only, then you can take sertraline with carbamazepine. It would help to avoid antidepressant induced hypomania. When your doctor starts carbamazepine, you can gradually discontinue sulpiride.

If you have more query, you can ask.

Regards
Dr. Abhishek Kapoor
Psychiatrist

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar