Expert: Ivan Goldberg, M.D. - 2/13/2006

Question
Dr. Goldberg,

Is there a way that I can locate a Psychiatrist/Psychopharmacologist with experience treating mixed mania bipolar in my area? And also are there doctors that will consider reducing their initial fees since I will be paying out of pocket and first time fees are almost $200.

Is it true that Lamotrigine is only available as a generic at doses up to 25mg and above that dose is only available as a brand name Lamictal. If so, why is this the case?

Does Venlafaxine increase serotonin in general or only at specific serotonin receptors like 5HT2A?

Why is it that 5-htp that increases serotonin can be associated with sedation and sleepiness, but SSRI's that increase serotonin are not?

Thank You

Answer
Is there a way that I can locate a Psychiatrist/Psychopharmacologist with experience treating mixed mania bipolar in my area?

See:
http://www.psycom.net/depression.central.psychiatrists.html

And also are there doctors that will consider reducing their initial fees since I will be paying out of pocket and first time fees are almost $200.

I doubt it. Forst time fees can be up to $800.

Is it true that Lamotrigine is only available as a generic at doses up to 25mg and above that dose is only available as a brand name Lamictal. If so, why is this the case?

All Lamictal is brand . . . there are no generics.

Does Venlafaxine increase serotonin in general or only at specific serotonin receptors like 5HT2A?

Increases it in genral.

Why is it that 5-htp that increases serotonin can be associated with sedation and sleepiness, but SSRI's that increase serotonin are not?

Every SSRI, including the most stimulating ones, put some people to sleep.

Best regards . . .

Ivan
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