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Dr. Kaushik
Dr. Kaushik, Psychiatrist
Category: Mental Health
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Experience:  MD Psychiatry
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PDOC in Hospital Emergency room advised me to stop taking AntiD

Resolved Question:

PDOC in Hospital Emergency room advised me to stop taking AntiD meds cold turkey (Paroxetine)which had been taking for 18months previous on Jan 29th as believed causing Hypomania(1st occurence)and Hypokalemia with which I presented.Said re evaluation of major Depression diagnosis(since 18yrs old) necessary by Consultant because of possible switch to BP 2,yet this follow up appointment is not until April 24th with no check up, meds, support or advice in the interval period- it public health care,waiting lists etc..?Im 21,scared and sick but cannot afford private care on my own.Dont know if will make it to that appointment,each day is so tough.Should I go back to Hospital and ask a 2nd opinion or what would b your advice?Thanks
Submitted: 7 years ago.
Category: Mental Health
Expert:  Dr. Kaushik replied 7 years ago.

Hi there,


Welcome to Just Answer !


Well, it must be frustrating for you to suffer all this while and also wait for the revaluation, and i am really surprised to know that while consulting you to stop the drug paroxetine, the PDOC , did not provide you with any consultation on which drug to be sustained on , till your next appointment takes place , on 24 april , which is like almost 2 months away from now. This i say because, even if you are now Bipolar 2 , then once you stop paroxetine , you will be become susceptible to Depression ,and already as i presume you have not been placed on any mood stabilizer or anti psychotics , so are equally susceptible to a hypomanic episode as well. This means that after stopping paroxetine , you may have 1 more problem to deal with ( depression) , in addition to the hypomania , although i fully agree with the advice on re - evaluation of your condition , as it is quite possible you may be having Bipolar 2 disorder , but having said that i am disappointed with the lack of insight of the PDOC , in providing you with an alternative to stopping of paroxetine.


However, you shall not worry , as i have a suggestion , which will keep you off from from depression as well a hypomanic episode till your next evaluation . So, i suggest you either visit the PDOC gain or ask your GP, and ask either of them to start you on A MOOD STABILIZER such as Lithium or valproate or carbamazrpine or oxcarbazepine , as such a mood stabilizer will be able to prevent depression as well as hypomania , even after you stop paroxetine . In addition ,ask them to also give you an alternative anti depressant , just in case you starting suffering from depression and it overwhelmes you , the good alternatives will be Milnacipran and venlafaxine , both of these belong to SNRI group of anti depressants , whch is different from paroxetine , which belongs to SSRI anti depressants , so you will not have to worry about its side effects.


Well, it is important for you to get placed on a mood stabilizer after stoping paroxetine , for reasons stated above and also to have alternative anti depresants ,as well, simply because 2 months is a fairly long period ,and we donot want to take chances , and make your life miserable , so i suggest you go the hospital again and discuss what i have mentioed here .


I wish you best of health.


I hope my answer serves your query according to your satisfaction.




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