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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Is It Safe To Use Topamax And Celexa For Bipolar Disorder Type2?

Hi I m been Dx Bipolar type 2 for about 8 years now I m been taking Topamax 200 mg Celexa 40 mg qd Effexor XR 300 mg qd and atarax 20 mg tid I just moved from CA to TN and I have been having a lot of manic episodes lately I last saw my psychriatrist a few days before I left CA that was In January I haven t been able to get medical in TN yet but can Use CA medical at the ER I was also seeing a therapist too Do my meds need adjusting the one person who s been there by my side is at wits end and my family turned their back on me Please I m desperate Help!
Thu, 27 Aug 2015
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Psychiatrist,  's  Response
Hello thanks for asking from HCM for your health related queries

I can understand your concern. You have bipolar disorder type 2 (BPAD-2) and were taking Topiramate, Celexa (Escitalopram) and Effexor (Venlafaxine). Topiramate is a mood stabiliser drug and helps to control the mood swings and helps in manic episodes. Celexa is a SSRI drug and Effexor is SNRI drug. Both are antidepressants and higher doses of these antidepressants can cause manic switch in an individual suffering from Bipolar disorders. So most of psychiatrists avoid using SSRIs or SNRIs in patients of bipolar disorders.

In my opinion as you are suffering from Bipolar disorder there is need to change the medicines. Effexor and Celexa should be tapered gradually as you are having a lot of manic episodes. Some other strong mood stabiliser should be added to the prescription. Medicines like Sodium Valproate can help to control the manic episodes. Low dose antipsychotics can also help. So please consult a good psychiatrist near by and ask for re-evaluation.

Thanks, Hope this helps you. Take care

Dr. Seikhoo Bishnoi,
Psychiatrist
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Is It Safe To Use Topamax And Celexa For Bipolar Disorder Type2?

Hello thanks for asking from HCM for your health related queries I can understand your concern. You have bipolar disorder type 2 (BPAD-2) and were taking Topiramate, Celexa (Escitalopram) and Effexor (Venlafaxine). Topiramate is a mood stabiliser drug and helps to control the mood swings and helps in manic episodes. Celexa is a SSRI drug and Effexor is SNRI drug. Both are antidepressants and higher doses of these antidepressants can cause manic switch in an individual suffering from Bipolar disorders. So most of psychiatrists avoid using SSRIs or SNRIs in patients of bipolar disorders. In my opinion as you are suffering from Bipolar disorder there is need to change the medicines. Effexor and Celexa should be tapered gradually as you are having a lot of manic episodes. Some other strong mood stabiliser should be added to the prescription. Medicines like Sodium Valproate can help to control the manic episodes. Low dose antipsychotics can also help. So please consult a good psychiatrist near by and ask for re-evaluation. Thanks, Hope this helps you. Take care Dr. Seikhoo Bishnoi, Psychiatrist