Hello
Welcome to Health Care Magic

You are a 39 years old otherwise health female. You are a known case of Bipolar Disorder for last 20 years. You are on lithium carbonate, aripiprazole, venlefexine, dexaamphetamine and thyroid medications. You have been recently diagnosed with hypothyroidism. Since last 6 months lethargy, irritation, tiredness, restlessness etc have increased. Recently you have been diagnosed with sleep apnea.

Now first of all after reading your history I would like to tell you that you that more or less you are taking right drugs. But Lithium is known to cause hypothyroidism as side effect in about 20-30% individuals. So shifting to some other mood stabilizer like Valporate can be think of.

You have developed symptoms of depression only. This occurred most probably due to cyclical nature of Bipolar disorder. Pristique is a good drug to control depressive symptoms but probably it is not working properly. Other medicines like combination of Fluoxetine and Olanzapine can be think as other treatment option. This combination has been approved for use in depression and bipolar disorder. Other drug like Lamotrigene is also a good option which can correct depression in Bipolar illness.

Aripiprazole is an atypical antipsychotic and is a good drug for bipolar disorder. I am not able to ascertain why you are taking vynase. It is a stimulant drug and it is known to cause excitement as side effect. It may even worsen the symptoms of Bipolar Disorder.

So first of all please visit your Psychiatrist again and discuss about new symptoms that have been recently developed.

For sleep apnea, wait for symptoms of depression to improve. Improvement in symptoms only will correct mild sleep apneas. Try to reduce your weight. If apnea doesn't improve with antidepressants visit your doctor.

There is no need to get frustrated, you will improve with just mild changes in medicines.

Hope I cleared your doubt, if you have more questions you can ask again.
Thanks
Dr. Seikhoo Bishnoi, MD

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