Expert: Ivan Goldberg, M.D. - 4/3/2009

Question
My son aged 21 years has been diagnosed with Bipolar Disorder. He has been prescribed with Depakote 100 mg per day. He has been taking this medicine for the last 8 months. But we dont find any noticeable improvement. So much so that he has left his studies in Engineering.

In between he was prescribed Oliza 10 mg and Meloset 3mg. But after taking these medicines he has stopped taking these two after finding some adverse effects. So now he is only on Depakote 100 mg. His sleep cycle is totally disturbed.

He and all the family in distress. Any advice? Any alternate line of treatment?  

Answer
Hi . . .

People with bipolar disorder are usually best treated with mood stabilizers. Lithium, Depakote, Lamictal, Tegretol and Trileptal are examples of mood stabilizers. When Depakote is used as a mood stabilizer, it is usually prescribed in doses of around 2,000 mg a day. The correct dose is determined by blood tests that are done 12-hours after the last dose.

Oliza is an antipsychotic medication and while it is sometimes prescribed briefly for people with bipolar disorder, it has too many side effects to be used as a long-term treatment. Meloset is a sleep-inducing medication.

I find it hard to believe that any well trained psychiatrist would prescribe 100 mg a day of Depakote for someone with bipolar disorder. I think your son needs top see a psychiatrist who understands the needs of someone with bipolar disorder.

Best regards . . .

Ivan
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