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What Causes Persistent Depression While Treating Bipolar Disorder?

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Posted on Fri, 11 Nov 2016
Question: My sister is 23 and she is bipolar and depressed. She's on 80 mg of Prozac, 3 mg of clonazempan and 20 mg of Zyprexa. She's still severely depressed and I would like some suggestions or possibilities regarding different medicines for depression
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Answered by Dr. Alexander H. Sheppe (44 minutes later)
Brief Answer:
Consultation

Detailed Answer:
Hello, and thanks for your question.

Treatment of bipolar depression can be difficult, but consists of triple therapy: an antidepressant (done), an antipsychotic (done), and a mood stabilizer such as lithium, Depakote, or Lamictal. She needs one of these added. Lithium is the gold standard and would be my choice for her.

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Above answer was peer-reviewed by : Dr. Raju A.T
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Follow up: Dr. Alexander H. Sheppe (46 hours later)
Ok, thank you so much for your help. For right now, the doctor is planning to put her welbutrin instead of a mood stabilizer. The Zyprexa is the only medicine that she has been on since she went through the psychosis. Suicidal thoughts have been a major issue since, so Ive been wondering if the Zyprexa could be causing this issue.
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Answered by Dr. Alexander H. Sheppe (2 hours later)
Brief Answer:
Followup

Detailed Answer:
Welcome back,

Wellbutrin might help with depression, but the doctor needs to be careful, because sometimes this medication could cause a manic episode. It is safe and effective if done carefully.

I do not believe Zyprexa is causing suicidal thoughts -- Zyprexa is actually approved to treat bipolar depression and to treat suicidal thoughts, so it is actually probably helping this rather than hurting it.

Please remember to rate and close this answer thread when you are finished and satisfied.

In the future, for continuity of care, I encourage you to contact me directly at my private web address below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private web address: tinyurl.com/DrSheppeAnswers
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Above answer was peer-reviewed by : Dr. Arnab Banerjee
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Answered by
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Dr. Alexander H. Sheppe

Psychiatrist

Practicing since :2014

Answered : 2236 Questions

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What Causes Persistent Depression While Treating Bipolar Disorder?

Brief Answer: Consultation Detailed Answer: Hello, and thanks for your question. Treatment of bipolar depression can be difficult, but consists of triple therapy: an antidepressant (done), an antipsychotic (done), and a mood stabilizer such as lithium, Depakote, or Lamictal. She needs one of these added. Lithium is the gold standard and would be my choice for her. tinyurl.com/DrSheppeAnswers