Expert: Ivan Goldberg, M.D. - 11/30/2006

Question
hello,
in march 2006, i had a psychotic episode, i had to be restrained by police. thought my husband was trying to kill me etc. after being admitted, the drs came to the conclussion that i was suffering from severe post partum depression. they put me on an antipsychotic and anti deppresant.
when i came home i started having severe panic attacks. my dr took me off the anti psychotic. they put me on kalonopin and lamictal, they thought i might be bi polar. I was still depressed and my heart would race and beat so hard in my chest.
anyway the new dr i started seeing was absolutely sure i was bi-polar. Ive been seeing him for about 3 months once a week. he has me on500 depekote with my synthroid in morn night is 1 200 equetro, 1 centrum vitamin, 2 500 depekotes then bedtime 400 seroquel and 1200 lithium and 300 equetro
Ive noticed since he started the lithium im needing to take more seroquel to feel normal. why is this? I actually feel worse, why? Do you think i need to take all these meds for manic bipolar and is this the normal course? But really i feel that lithium is making me feel worse, help!!!  

Answer
Hi, Tamara,

It is common for people with bipolar disorder, especially people who have had a psychotic episode to require a "cocktail" of medications. The combination of lithium, divalproate (Depakote) and carbamazepine (Equetro), especially when mixed with Seroquel often does a good job of controlling bipolar symptoms.

There are also possible interactions that can make you uncomfortable, such as the thyroid depressing effects of bith lithium and Equetro. Also to be kept in mind is the need for blood tests to check lithium and Depakote blood levels and the possible negative effects of Equetro on the blood.

If you have major doubts about your treatment, you may want to get a second opinion from an expert. A list of experts can be found at:
http://www.psycom.net/depression.central.psychiatrists.html

Best regards . . .

Ivan
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