Expert: Ivan Goldberg, M.D. - 4/7/2009

Question
QUESTION: MY DAUGHTER IS 31 YEARS OLD, SHE WAS JUST DX. WITH BI POLAR
THEY GAVE HER MOBAN 20 MG AND 25 MG. BENADRYL AND SEROQUEL 50 MG PRN ALL MEDS ARE GIVEN AT HS. IT SCARES ME WITH ALL THE MEDICATION...SHE SEEMS TO ONLY SLEEP 4 TO 5 HOURS A NIGHT IF SHE DOES NOT TAKE THE SEROQUEL. WHAT DO YOU KNOW ABOUT THE SUCCESS AND EFFECTIVENESS OF THESE DRUGS? I GUESS THEY GAVE THE MOBAN DUE TO DIABETES IN THE FAMILY AND NO WT. GAIN.

ANSWER: Hi, Elaine . . .

The most important treatment for people with bipolar disorder is to have their mood fluctuations reduced through the use of a "mood stabilizer." The best mod stabilizer is lithium and when it does not work well when taken alone, it often has to be augmented by the addition of Depakote, Tegretol, Trileptal, or Lamictal. I prescribe the combination of lithium and Lamictal most often.

Itry hard to avoid thee use of antipsychotic  medications such as Moban and Seroquel unless the individual I am treating has psychotic symptoms. This is be because of the possible severe side-effects of antipsychotic medications. See:

http://en.wikipedia.org/wiki/Tardive_dyskinesia

AND

http://en.wikipedia.org/wiki/Neuroleptic_malignant_syndrome

Best regards . . .

Ivan
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---------- FOLLOW-UP ----------

QUESTION: DR.
She was very manic and even psychoic, she had to be hositalized for one week, can she be taken off the antipsychotic medication,once she stabalizes?

Answer
Elaine . . .

It is my practice to take people who have psychotic manic episodes off of antipsychotic medication as soon as possible. This ranges form a few weeks to a few months after the psychosis is controlled and they are stable on lithium or a similar medication.

Best regards . . .

Ivan
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