Quote:
Originally Posted by gwenlian
My husband and friend are worried that I'm over medicated but I'm not sure. I really like my psychiatrist, she listens to me and talks to me about the meds. My dx's are Bipolar I and Generalized Anxiety Disorder. Here are the meds I'm taking:
Geodon, 80mg in am, 160mg in pm
Welbutrin 450mg
Effexor 450mg
Klonopin 1mg every 4 hours
Lamictal 300mg
The Effexor just got increased on Thursday and Friday I was my usual anxious depressed self, Saturday I had a manic episode that turned into a mixed episode and then finished with some hypomania. This morning I woke up feeling pretty good but as the day progressed so did my depression and anxiety.
I've only had one true manic episode/mixed episodes 4 years ago that lasted for a little over a week. I've been dealing with depression and anxiety mostly. I was still having a high level of depression so six months ago she first raised my Geodon to 320mg total and that didn't work so she put it back down to 240mg. Then she started me on 150mg of Effexor and it was starting to work but I didn't know if I could deal with the sexual side effects so we switched that out to 50mg of Zoloft which was a disaster. After the Zoloft she put me back on the 150mg of Effexor then a month later raised it to 300mg. I was inpatient two weeks ago and the only thing they did was cut my Welbutrin down to 150mg which caused me to be more depressed. She raised the Welbutrin back up to 450mg and started me on the 450mg of Effexor.
I really like her and finding a new good psych is so hard that I'm reluctant to get a second opinion. Do you think a second opinion is a good idea or are my meds albeit high still in the realm of normal?
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Hey sorry to hear, I'm no pdoc but from my experience being on such high doses of Welbutrin and Effexor if you're bipolar, you're just going to be in a distressing dysphoric manic state most of the time. A couple of suggestions: switch from Geodon to Latuda asap...Latuda is incredible for bipolar depression for me I needed 120mg. But it's remarkable and is weight neutral. Then have your pdoc or another consider bumping up the Lamictal...I take 600mg because at that dose it works more of an anti-depressant. Now, it is was me, I get of Welbutrin since it makes me irritable and tapper of Effexor and switch to Fetzima...about 80mg is typically effective for depression. Then, I'd consider adding Lithium starting at 300mg ER bid, then taking a blood level and go from there. Obviously, you'll have to find a doc that will consider that but so 4 things here: Latuda, Lamictal at 600mg, Fetzima, and Lithium all help bipolar depression, mixed episodes and mania! Best of luck!!!!