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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

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What Is The Treatment For Bi Polar Disorder?

my father is having a problem of bi polar disorder as explained by doctor,now taking medicines
riprex er 250 (0- 0 -1)
lamitor dt 50 mg(1-0-1)
panzed (1-0-0)
melact tab(0-1-0)
now he is facing with the problems ,, not a sound sleep in the night,, high tension and fear, avoid to go in public ,, please advice
Fri, 21 Mar 2014
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Psychiatrist 's  Response
Welcome to hcm!

I think that the prescription needs some revision and then it will automatically take care of his sleep and other problem issues.

According to me , his sodium valproate should be increased to 750-1500 mg, all preffrably at night ( uptill 1 gm ) and rest in morning after breakfast.
You can stop lamitor all together - as the effect of valproate at adequate dosage will take care of bipolar fluctuations.

melact has only methyl cobalamin , if there is no deficiency of Vit b 12 in your father, we can opt for better combination of multivitamin, like neurogardin or chorus etc, which will help his health.

If at all there is some sleeping issues, one can add zolpidem at night , in a dose of 6.25 to 12.5 mg. This is non addictive molecule and safe.

It is difficult to understand if his fear is due to anxiety or suspiciousness, as details in question are not enough. so, at present I cannot tell what will be suitable to add for this part.

However, you may discuss the above advice points with his treating team and get them working.
It will be worthwhile to get his routine blood test, including platelets, liver and kidney test.

Hope the reply helps you
please feel free to ask more questions for any clarification

Dr. Manisha Gopal
MD psychiatry
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What Is The Treatment For Bi Polar Disorder?

Welcome to hcm! I think that the prescription needs some revision and then it will automatically take care of his sleep and other problem issues. According to me , his sodium valproate should be increased to 750-1500 mg, all preffrably at night ( uptill 1 gm ) and rest in morning after breakfast. You can stop lamitor all together - as the effect of valproate at adequate dosage will take care of bipolar fluctuations. melact has only methyl cobalamin , if there is no deficiency of Vit b 12 in your father, we can opt for better combination of multivitamin, like neurogardin or chorus etc, which will help his health. If at all there is some sleeping issues, one can add zolpidem at night , in a dose of 6.25 to 12.5 mg. This is non addictive molecule and safe. It is difficult to understand if his fear is due to anxiety or suspiciousness, as details in question are not enough. so, at present I cannot tell what will be suitable to add for this part. However, you may discuss the above advice points with his treating team and get them working. It will be worthwhile to get his routine blood test, including platelets, liver and kidney test. Hope the reply helps you please feel free to ask more questions for any clarification Dr. Manisha Gopal MD psychiatry