Psychosis and Antipsychotics

Thank you for answering my question about psychosis just now.

My diagnosis right now is bipolar.  My diagnois before was major depression with psychotic features.  I have had several psychiatrists and they all leave me on an antipsychotic.  Also, I am taking Effexor XR, 300 mg and Risperdal 2 mg.  My doctor has not prescribed a mood stabilizer.

I have asked my doctor if I will always need an antipsychotic.  His response is he would be afraid for me to try.

Does this sound right to you?  No mood stabilizer although I was manic for about six to eight months?  Do most doctors prescribe mood stabilizers for their bipolar patients?  One last question, please, can psychosis become really bad during a manic phase?

Thank you.

[HFHS MD - RG]

The standard of care in treating bipolar disorders is adding mood stabilizers either lithium or depakote. Some psychiatrists have also started using either neurontin, lamictal, or topamax as alternatives.

You may want to discuss with your psychiatrist regarding your diagnosis and treatment. Being on antipsychotic does not prevent manic episodes and does not treat the mood swings (manic and depressive episodes) evident in bipolar disorders.

The severity of a manic episode can be duly influenced by the presence of psychosis as well as the severity of depressive episode can be influenced by the presence of psychosis.

Your concern for the use of anitpsychotic is very evident. Have you been experiencing some side effects that you ought to tell your doctor about?

[Doggies4]

I have been on an antipsychotic for fifteen years.