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Hello, I am a male that has been diagnosed with bipolar disorder due to my strong family history (7 direct relatives are affected maternally--a grandparent and all of his children, including my mother). I have had problems with anger management and outbursts, hypomania, impulsivity, substance abuse, depression, and intense obsessive-compulsive tendencies. My manic/depressive mood swings have ranged from months to within the same day, depending on stress levels, since I can remember (but most significantly, the end of high school). Lamictal has proved ineffective at a high dose. I was recently prescribed instant release Adderall (10 mg) to treat my comorbid ADHD. After trialing it for a month or so, I had a massive panic attack which I believe resulted from an interaction with methylene blue which I co-administered. After that panic attack, I developed a bodily obsession (breathing focus) for some time, and roughly 6 months later, it seems that my obsessive-compulsive tendencies are through the roof (severe guilt, doubt, and intrusive thoughts, mostly relationship-related). I have been diagnosed with bipolar disorder and ADHD, but is it possible that I may also (or ONLY) have OCD, considering that it has the most severe symptoms? Would there be any medication(s) that might particularly benefit me and address most of the problems which I am experiencing? I have been told that I may have Asperger's syndrome as well, given my toe-walking and speech impediments social and behavioral disturbances when younger, if that helps.
are you there/
Hello, yes I am here
So you want to ask specifically for a medicine that can be useful in most of your diagnosis?
Yes, any pharmaceutical, nootropic or homeopathic treatment that could possibly help me would be appreciated
see, considering your multiple diagnosis, in my view, a combination of a mood stabilizer along with an SSRI antidepressant can be very helpful in your case.
A combination of mood stabilizer like Sodium Valproate + SSRI antidepressant like Fluoxetine or Sertraline can control most of your symptoms.
Sodium valproate is the first line medicine for treating Bipolar disorder
while SSRI antidepressant can control OCD, anxiety symptoms, panic attacks.
mood stabilizer will prevent any manic or hypomanic switch over
what do you think about this combination?
anger management and outbursts, hypomania, impulsivity, substance abuse, depression, and intense obsessive-compulsive tendencies.
this combination can be useful for all the disorders you have mentioned above.
I think this sounds very good, although I sometimes worry about SSRI effects in the long-term. May alternatives such as Wellbutrin or Anafrinil be as effective?
Wellbutrin is not very useful for controlling anxiety or OCD, although it can be useful for ADHD symptoms.
once you are stabilized on the combination of mood stabilizer + SSRI antidepressant, your doctor can consider the option of adding wellbutrin also.
SSRI antidepressant are the most widely used antidepressants worldwide and have comparatively lesser side effects when compared to older antidepressant like Anafranil
SSRI can be safely taken for long term
Okay, thank you very much for your input and advice
you are most welcome,
thanks for coming to JA
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