probably i am BP1, still i can't tell because depression is still a big issue but under an antidepressant i switch easily. my drugs are:
seroquel 50mg (AP)
risperidone 1mg (AP)
stelazine 1mg (typical AP)
stablon (AD) smaller dose
since my 1st mania 4 years ago and things are getting worse but more or less i function - of course badly - but life is going on. Until 3 months ago when after a swine flu i became unstable and oscillating more frequently. my family started to believe that things went out of control and that the above meds need to be changed and that i should be put on a proper MS. i have thought of 3 possiblities to discuss with my pdoc today:
1. to take seroquel only as a monotherapy and raise the dose to 100-150 hoping to lift depression and act as a mood
stabilizer while cutting off all the other AP's. Adding or not an AD depends on the seroquel helping or not.
2. to stop all the AP's except a minor dose of seroquel 25-50mg say + lithium + and AD if lithium proves no good for
depression
3. to take another MS like valproate or gabapentin (the last is weak)
i really am running out of ideas and i don't think the pdoc can propose other choices - perhaps he can-. of course there remains another AC like lamictal or tegretol or trileptal Of course each of the above choices has its shortcomings, for instance in 1 i can keep increasing my seroquel with no use also risk of TD and bad withdrawal later
yesterday i had severe suicidal thoughts and hearing voices ordering me to cut my throat off (i reduced my AD so probably i am depressed), my parents got alarmed and informed the pdoc that my BP is to be taken seriously this time because not that things don't improve but in fact deteriorate so we need a strong intervention instead of the trivial sedatives i'm taking, i.e. i need an MS like all other human beings
can you think of the above choices and propose one or suggest others. of course it depends on the pt, but i mean which sounds a more logical approach
thanks a lot
ezz