Expert: Ivan Goldberg, M.D. - 3/7/2009

Question
Dear Doctor.
I have been suffering from depression and bipolar manic  disorders since 4 years I am 27 years old male.
now my psychiatrist considered that I have racing black thoughts that preoccupates my mind he gave me the following treatment to follow :
Escitalprom 1 pill every morning
Olanzapin (Zyprexa)1 pill every night
My question is as follows:
1-is Zyprexa Olanzapin good to control the black thoughts symptom that I am suffering from?
2-knowing that I've started taking it since three days and the treatment runs for the 6 coming months.When am I supposed to feel better with this drug is it after one month or two months?
3-what are its major side effects if any?
Thanks in advance""

Answer
Hi!

While I cannot comment on your personal medical care I can talk about the treatment of bipolar depression in general.

People with bipolar depression often have racing thoughts the content of which is related to hopelessness, death, and suicide.

When I treat anyone with bipolar disorder I think they should be taking a major mood stabilizer. The drugs I prescribe most often as mood stabilizers are lithium, carbamazepine and oxcarbazepine.

The antidepressant I use most often to treat people with bipolar depression is lamotrigine.

I do not like to prescribe olanzapine because of the possibility of it causing tardive dyskinesia (TD). For more information on TD please see:
http://www.ninds.nih.gov/disorders/tardive/tardive.htm

Best regards . . .

Ivan
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