Hi, just looking for some info/advice.

My best friend has recently been diagnosed bipolar 1. I actually know heaps about bipolar as I have a long distance close friend with bipolar 2. Therefore I could recognise a lot of the symptoms and I knew exactly what he had before it was diagnosed.

I am a little concerned as my best friend's gp is going to manage the condition himself, rather than refer him to a psych like my other friend was. My best friend's symptoms are obviously quite severe being bp 1, and he rapid cycles and often experiences mixed states. And the mania is so high and comes on so quickly.

He was initially prescribed 100mg of seroquel (regular not XR) and 50mg of Pristiq. He took this for two weeks, and obviously it's done little so far.

He has just gone through a horrendous break up with his cheating boyfriend and it's obviously affected him quite badly. Went in for a med adjustment today, and I'm rather concerned at what the gp has told him to do.

He's increased the Pristiq to 100mg... and told him he can take the seroquel as he pleases, anywhere between 50-200mg a day 'depending how he feels'. And to come back in 6 weeks!!!!!! He is about to go through one of the toughest times of his life as he also has a 5 week nursing prac to get through as he is nearly finished his course.

I'm slightly alarmed as my other friend needed at least 400mg of Seroquel XR (not regular) to stabilize her... and when they tried her on 100mg of Pristiq instead of 50, her hypomania went through the roof and she spent over 16k on stuff she didn't need.

I know bp 1 and 2 are probably different in a lot of ways but his mania has always been way more severe than her highs so it really worries me. If he only takes 50mg of seroquel and 100mg of Pristiq surely he will be manic constantly??

Can anyone advise on whether this is the correct kind of meds for bp1? I asked him what the doctor said regarding increasing it further and the doctor told him 100mg was the 'normal' bp dose. It was my understanding that dose was only used for sleep?? And shouldn't he really be on XR to keep the mania at bay during the day?!

Any advice or experiences would be so helpful and appreciated, thank you !!!