Brief Answer:
Stop Sizopin. Take this arrangement (regimen) instead. You will feel fresh.

Detailed Answer:
Hi!

1. You mention that your main problem is that you do not feel fresh and feel sleepy throughout the day.

2. This is a side effect caused by the medication called as Sizopin, of which you are taking 50 mg

3. Sizopin, also called as Clozapine is given for people who have Bipolar disorder, but only for a
short while. This is a very hazardous drug that has to be given under careful weekly meetings and face to face conversations with your psychiatrist.

4. When a person is given Sizopin,
1. This drug affects something called as your PY450 cytochromes all throughout your body.
2. This causes issues with other medications.
3. Sizopin causes your WBC Blood count to drop - decreasing your immunity.

5. Sizopin is not addictive. I kindly request you to stop this medication.

6. Pacitane is a drug that is given to counter the problems and side effects of antipsychotic
drugs like Serenace or Risperidone. These problems include restlessness of legs (akathisia)
and trembling of hands (EPS) which you are familiar with, probably, from past prescriptions
as you have mentioned in the medication history.

7. Sulpitac 200 mg, or Sizopin 50 mg do NOT cause any issues that require Pacitane 2 mg.

8. Kindly stop Pacitane - You will experience these benefits - mental clarity, no feelings of
strangeness (derealization and depersonalization). No dryness of mouth or constipation.

9. I strongly suggest that you take a low dose of either Quetiapine, at 50 mg instead of
Sizopin 50 mg. Quetiapine is quite good for bipolar issues. Probably superior to Clozapine
given your personal issues.

So, you must modify your drug regimen to be,

Lithium twice a day.
Sulpitac once, and
Quetiapine (Sizoquit) once,
Ativan once, at night.

I am convinced this will solve your problem, with which you have presented.

However,

According to my experience, this is the best, most side effect free drug schedule for your kind self.

Macorate 600 mg Twice instead of Lithium. (Benefits: No hand temor, Head nods. )
Topiramate 100 mg once. (Weight control.)
Sulpitac 200 mg once, and
Ridazin 10 mg at night. (This is to prevent dependence on Ativan - Ridazin gives you sleep without any feeling of heaviness)

I will advise you to try this medicine, called as Arkamin which is cheaply available in every
pharmacy, without prescription from a doctor. This is available in 100 mcg strength only.
Take one tablet in the morning and one at night. This will definitely stop your physical desire
to smoke. However, you need to want to stop smoking, at the level of your mind, to succeed
with Arkamin.

One nice medication is available for your smoking in tandem with Bipolar issues called as
Champix. This is rather expensive, It is also available without prescription at any pharmacy.

A third medicine is available called as "Smoquit". I would not recommend Smoquit for you
because you have a bipolar problem and you might, rarely develop excitation as a result of
taking smoquit. So, remember this.

You might also like to try chewing nutmeg (alternative medicine - AYUSH) which contains
myristica fragrans, which is a natural antidote to tobacco.

I am interested in helping you out through the ups and downs.

Please feel free to ask any of your doubts, or problems.

I am at your service.

Wishing you all the best.
Dr. Neel Kudchadkar

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Brief Answer:
You know that your mood is swinging when you become irritated.

Detailed Answer:
Hi!

A person who has bipolar disorder suffers from sensitivity to cigarettes, tobacco and coffee. If you smoke, you will keep experiencing these mood swings. The best way is to substitute something for the action of smoking that can give you the same satisfaction. I would like to point out that the major problem is that sufficient medicines are not reaching your brain. This is because nicotine in cigarettes destroys the medications in your liver.

So, stop smoking and avoid stimulants like soft drinks and tea and coffee in excess since they contain caffeine and this makes your mood even worse.

Once these actions are taken, you will find a very vast improvement in your life.

Believe me. It works.

Thanks,
Dr. Neel Kudchadkar

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