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Dr. Kaushik
Dr. Kaushik, Doctor
Category: Health
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Experience:  Family Physician
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My finance is in PT school now. He has OKMH1010100

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My finance is in PT school now. He has been recently been diagnosis with bipolar at the age of 28. In his second year of school he began to feel as if he was "suppressing" certain memories. His stories became more extreme as if he our apartment has been wired and so on. He came home one day and pretty much snapped. The next day I took him to a therapist and put him on Seroquel 75 mg, clonidine 0.1 mg 1-2 tabs and vit d 1000mg (d/t low vit D level 13 was his lab result). He is also on Adderall 30 mg bid (he was placed on this medication since 2009) when he was undergraduate school. He goes through his moments of ups and downs because he messes with his dosage because sometimes he will be up late studying and feels as if the meds make him to drowsy for his exams the next day. So this week he has had numerous exams and seems as if he has only taken his meds maybe twice this week, but he says he has been taking them. He has become delusional and has began to think the school is after him and won't let it go. If he has missed a few doses can this trigger his old thinking pattern? Also he has never had been like this, can thinking like this all of a sudden trigger at the age of 28? Since he has been diagnosis with this he has been a tad paranoid, but as long as he takes his meds he can function and not pay too much attention to his thoughts unless he has an exam, which stress can trigger increased paranoia. It's so odd to me because we have been together for 9 years and lived together for 4 years and this behavior literally came out of know where.

Greetings !

Welcome to the site.

I am Dr. Kaushik and i am a psychiatrist and i believe i can help you with your problem.

First of all i am sorry to learn about your fiance's condition and i empathize with both of you.

Well you see since you mention that your fiance has been taking adderall since 2009 and now recently has been diagnosed with bipolar disorder with paranoid behavior ( house being wired , etc ) then there is a huge possibility that his condition could have been precipitated by long term use of adderall since this drug has been known to cause mania, paranoia, psychosis in some of it's users. Also you mention that he has been irregularly taking the adderall which again calls for more concern since this must be interfering with steady state levels of this drug even worsening his condition further.

So it is not the missing of the dose that has been resulting this kind of odd bizarre paranoid behaviour but it looks like this is a side effect of long term use of adderall , in other words the trigger of his condition at his age of 28 years is quite possibly the drug adderall itself which is a psychostimulant and quite known to cause such side effects.

Kindly see the link below to see for yourself about this side effect of adderall.

http://www.rxlist.com/adderall-drug/side-effects-interactions.htm

So i suggest that you consult with his doctor and bring him off adderall and observe him closely for 1-2 months while being off adderall as this much time will be required for adderall to leave his system completely. Meanwhile seroquel shall be continued , the dose of which can be titrated up to as much as 150 - 200 mg / day by making increments of 25 mg every 1 week.

Clonidine's use in his condition is redundant and you may talk about it with his doctor and it shall be brought off too.

Instead of clonidine it will be better if a mood stabilizing drug such as depakene or depakote can be added to stabilize his fluctuating mood.

So to summarize.

-- Addreall could be the triggering agent for his condition and therefore it needs to be brought off. In fact adderall is not to be used in a person with diagnosis of bipolar disorder since it can raise the risk for development of manic episode.

-- Seroquel's dose can be raised to 150 -200 mg / day to optimize it's action by making increments of 25 mg every 1 week.

-- Clonidine's use is redundant and it shall be stopped.

-- Adiition of depakene or depakote at dose of 500 mg in two divided doses can be made to add more efficacy to his current drug regime.

-- Vitamin D shall be continued as it is.

Kindly discuss these finer points with his doctor who i suppose will be able to appreciate the drug regime better.

Wish your fiance all the best and speedy recovery.

I hope this helps.

Please kindly leave a Positive rating if you are satisfied with the answer.

Regards.
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