Expert: Ivan Goldberg, M.D. - 6/21/2005

Question
Hi, i have a question about whether i have an anxiety problem that can/should be helped with medication.

I am bipolar. and the past year, i was very anxious (i got better a month ago). i was really compulsive - for a while, i only ate mcdonalds and oreos.  i didn't want to go out, and when i did i got stressed and had out of body experiences. or i would feel really detatched and have trouble staying with myself and concentrating on the situation.  i constantly felt like i couldn't catch my breath. i would have 10-15 seconds of panic randomly throughout the day.  and at times, i had panic attacks or i felt like i was on the verge of throwing up for hours.  i think it really constricted my life, cause i didn't want to do anything out of my routine.  and it was hard to interact with people, watch movies, or do anything stimulating.

Can I be bipolar and have an anxiety problem too? and can this problem be treated with medication? i have a history of substance abuse with benzos. and i'm already taking lots of medicine:

400 mg lamictal
40 mg celexa
450 wellbutrin XL
1 mg risperdal

If this happens again, do you think it can be medicated? or am i already taking so many meds that its not good to take more?  i am moving in two months and am worried it will bring back my anxiety.  I was hoping to develop a plan of axtion so i know what my options are if i get anxious again.  any advice would be great. thanks!

Answer
People with bipolar disorder who also have an anxiety problem often do better when gabapentin (Neurontin) is added to their meds.  A full work-up to accurately diagnose the anxiety is imperative, and cognitive-behavior  therapy is often useful.

Best regards . . .

Ivan
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