I have a question for psychiatrists only please.?

Question:

My best friend in the whole world has suffered with bi-polar for the past 5 yrs. In the beginning she was put on Depakote and then weaned from that and was placed on Lithium. Over the last two years she has had manic outbursts and had to be hospitalized at least 2 times. The first hospitalization a psychiatrist took her off one of her daily doses of Lithium (she had been on 4 a day for years). The second hospitalization she was put on Ambilify along with the Lithium. Approximately 3 months ago she switched psychiatrists and the new one is giving her Welbrutrin XR along with the Lithium and Abilify and she just saw her doctor yesterday and he wants to wean her off of Lithium to go back to Depakote and Tegretol (she took Tegretol yrs. ago and made her sleep all the time). She is super depressed now and has no desire to do anything but eat and sit around. Are there any other newer medicines that could possibly help her out than the ones already on the market?

Answers:
Geez.remind me not to go to that nurse. I understand that you are a concerned friend and it sounds like your friend has been on every mood stabilizer imaginable. Some doctors are prescribing aytpical antipsychotics, like Zyprexa http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203492.html and Risperdal. http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a694015.html Some psychiatrists will even prescribe small doses of Clozaril http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202157.html in extreme cases.
A medication I have seen used more is Lamictal http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202786.html and Topamax. http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203085.html Unfortunately, most of these medications have side effects like sedation and weight gain. Since there are so many medications and people respond to medication differently, patients often have to change meds over and over again to find the right mix.
The problem with multiple hospitalizations and skipping from one doctor the next is that your friend does not have one treatment provider who knows her history, knows what works, and knows what doesn't work. That's probably why she's been on and off Depakote and Lithium so many times. Yes, there are records, but psychiatrists will often try medications again if there is any indication that it worked, even a little bit.
That, and, in my experience, some psychiatrists are quite arrogant and get into prescribing pissing matches, each one assuming they know more than the next. So, some psychiatrists will keep patients on the same meds, and others will assume they know better and change them. She needs to find one doc and stick to him.

Is your friend in any kind of treatment or just receiving meds? One of the common misconceptions is that psychotropic medications will cure all symptoms of a mental illness. The meds address only half the problem. If your friend is not in therapy, she should look into it, especially if she is depressed.

Other Answers:
ALWAYS THINK OUTSIDE THE BOX TO GET THE RIGHT ANSWER. HAVEN'T YOU BEGUN TO QUESTION THE KIND OF CARE (OR LACK OF CARE) THIS HUMAN BEING IS RECEIVING? IT IS NORMAL FOR A PATIENT TO HAVE AN EVALUATION OF HIS CARE AFTER AN INTERVAL OF TIME TO DETERMINE WHETHER OR NOT THE APPROPRIATE TREATMENT IS BEING PROVIDED FOR EVENTUAL WELLNESS. WHAT SEEMS TO BE MISSING HERE IS A CORRECT DIAGNOSIS. LET'S TRY THIS. LET'S TRY THAT. THEY SAY "CHANCE FAVORS THE PREPARED MIND" SO LET'S HOPE SOMEONE WHO LOVES THIS INDIVIDUAL WILL SOMEHOW ADVOCATE LONG ENOUGH AND FIRMLY ENOUGH ON HIS/HER BEHALF TO CREATE A HEALING ENVIRONMENT BY WHICH YOUR FRIEND CAN REGAIN A LASTING WELLNESS. I AM NOT A PSYCHIATRIST. I AM A THINKER. IT SEEMS TO ME YOU MAY, AT SOME POINT, BE ABLE TO EITHER ADVOCATE FOR, OR HELP, YOUR FRIEND TO GET WELL AGAIN. IF YOU CAN'T TAKE THIS ON PERSONALLY, YOU MAY BE ABLE TO WORK BEHIND THE SCENES GENTLY UNTIL YOU CAN SEE YOUR FRIEND IS ON THE RIGHT PATH. MY POINT IN ALL OF THIS IS TO TELL YOU I THINK WE CAN BOTH AGREE THE COURSE YOUR FRIEND IS, AND HAS BEEN ON, IS NOT THE RIGHT ONE. I WISH YOU EVERY SUCCESS WITH THIS OUTCOME. YOU OBVIOUSLY CARE ABOUT YOUR FRIEND. THANK GOD YOU DO. JUST THE FACT YOU DO CARE IS HELPING HER FIND HER WAY TO THE RIGHT OUTCOME. SENT TO YOU WITH LOVE AND SUPPORT FROM SOUTH PORTLAND, MAINE.

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I have a question for psychiatrists only please.?

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