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What are the treatment option for bipolar disorder?

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Patient's Query

Hello doctor,

I have bipolar disorder, panic attacks, social and generalized anxiety disorder. I have one to three panic attacks per day, constant anxiety, and fear of leaving the house. No motivation to work, no energy, apathetic, without mood. Right now I am in a depressive episode.

I previously tried Valproic acid, Lithium, Carbamazepine, Xanax, Lorazepam, Clonazepam, Rudotel, Lexotanil, Fluoxetine, Sertraline, and Escitalopram. SSRI does not have an effect on me.

Right now, I take Lamictal 50 mg daily and Tranxene 5x5 mg daily. Tranxene loses its anxiolytic effects and my anxiety becomes more severe. I am planning to titrate Lamictal 100 mg. However, it should not help with anxiety.

What are my treatment options? Benzodiazepines are not an option because I am getting used to them. Two days later I have a consultation with my psychiatrist, but I want to hear possible treatment for my conditions from another option.

I have done thyroid, heart function, men hormones, prolactin, kidney and liver function tests. All are normal.
Answered by Dr. Parth Nagda

Education:

MBBS

Professional Bio:

Dr. Parth N. Nagda is a psychiatrist with valuable clinical experience in diagnosing and managing a wide spectrum of mental health conditions. He provides compassionate care to patients dealing with challenges in general psychiatry as well as sexual medicine. His areas of expertise include mood and anxiety disorders, relationship and sexual health concerns, and personalized therapy for overall mental well-being.

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Hello,

Welcome to icliniq.com.

If your anxiety is not responsive to SSRI's (selective serotonin reuptake inhibitors), then you should consider trying TCA (tricyclic antidepressants) class of antidepressants. They will help with your anxiety and panic attacks.

Apart from Tranxene and Benzodiazepines, there are few other options for anxiolysis. If you are specifically looking for something to be added to the TCA such as Propranolol, Buspirone, Tofisopam, Clobazam, Hydroxyzine, and Pregabalin.

Also, you can consider Mirtazapine, which will act as an antidepressant and also for anxiolysis. It is a NaSSA (Noradrenergic and specific serotonergic) class of antidepressants.

Medically reviewed by Dr. Vinodhini J.
Published At March 19, 2020
Reviewed At May 6, 2024

Education:

MBBS

Professional Bio:

Dr. Parth N. Nagda is a psychiatrist with valuable clinical experience in diagnosing and managing a wide spectrum of mental health conditions. He provides compassionate care to patients dealing with challenges in general psychiatry as well as sexual medicine. His areas of expertise include mood and anxiety disorders, relationship and sexual health concerns, and personalized therapy for overall mental well-being.

This doctor is not available for online consultations on the platform anymore.

Consult other doctors in the same speciality

Education:

BDS

Professional Bio:

Dr. Vinodhini J. is a Dental Surgeon with extensive years of clinical experience. She specializes in the diagnosis, prevention, and treatment of dental and oral health issues, including restorative, surgical, and cosmetic procedures. With a patient-centered approach, she focuses on maintaining oral health, alleviating discomfort, and enhancing smiles. Her expertise ensures comprehensive care tailored to each patient’s dental needs and overall wellbeing.

This doctor is not available for online consultations on the platform anymore.

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Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Parth Nagda
Dr. Parth Nagda

Psychiatry

Consult this doctor

Education:

MBBS

Professional Bio:

Dr. Parth N. Nagda is a psychiatrist with valuable clinical experience in diagnosing and managing a wide spectrum of mental health conditions. He provides compassionate care to patients dealing with challenges in general psychiatry as well as sexual medicine. His areas of expertise include mood and anxiety disorders, relationship and sexual health concerns, and personalized therapy for overall mental well-being.

This doctor is not available for online consultations on the platform anymore.

Consult other doctors in the same speciality
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