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Dr. Vikas
Dr. Vikas, Psychiatrist
Category: Mental Health
Satisfied Customers: 2219
Experience:  MBBS ; M.D Psychiatry, MS. Health Informatics
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I have a friend in an emotional and psycological marriage.

Customer Question

I have a friend in an emotional and psycological marriage. He keeps telling her he will change, but he never does. He has a way of convicing her to always go back. He is nice when he know he is losing her. He went to the doctor and got put on Wellbutrin will this change his abuse cycle. He had a panic attact the first day he took and I am told he is feeling and anxious, parinoid. Will he get worse like violent?
Submitted: 5 years ago.
Category: Mental Health
Expert:  Dr. Vikas replied 5 years ago.

Hello,

Could you please tell,

What was the diagnosis in his case?

Any history of previous psychiatric or medical disorder?

Any history of psychiatric illness in his family, specially of mood disorder?

Is he under treatment of any psychiatrist?

Any other medicines he is or was currently taking?

Any history of drugs or alcohol abuse?

Thanks
Customer: replied 5 years ago.
He was dignosied wil depression and he is on wellbutrin. No acohol or drugs that I know of. I just don't know why my friend puts up with when he is nice he is really nice.
Expert:  Dr. Vikas replied 5 years ago.

Thanks for the information. I guess, you are not much aware of his previous history!

Well in that case what I can say is that his behavior could be a manifestation of his illness that is depression. You have mentioned that on the very first day of taking Wellbutrin he his experiencing Panic attack, paranoia, being anxious this should be conveyed to his treating doctor.It is possible that he is not tolerating Wellbutrin in the current dose and there may be a need of dose readjustment. Also sometimes antidepressants may activate the latent / underlying Bipolar disorder and cause activation and agitation in patients which requires the addition of mood stabilizers or an atypical antipsychotic and / or discontinuation of buproprion.

If you have any other query, please feel free to ask.

Regards
Customer: replied 5 years ago.
Didn't get the answer I was looking for I want to know if I have to worry about him getting violent.
Expert:  Dr. Vikas replied 5 years ago.
Hi,

As I mentioned earlier, in his case activation of latent or underlying Bipolar disorder needs to be ruled out. In Bipolar disorder during manic phase patient may become violent depending on the severity of illness.

Please see the link below to know about the symptoms of mania

Warning Signs of Mania

If you have any related query, please feel free to ask.

Regards
Customer: replied 5 years ago.
His abuse cycle was about every 7 days could that change, and will he still cycle?
Expert:  Dr. Vikas replied 5 years ago.
Please tell me exactly since when he was on this drug, in what doses and now how he is feeling?

What about his behavior now, it is changed?

Is he still feeling anxious , paranoid , agitated?

Do you want to know about mania depression cycle ?

What do you mean by abuse cycle?
Customer: replied 5 years ago.

What about his behavior now, it is changed? He is being really nice now.

Is he still feeling anxious , paranoid , agitated? Panic Attacks still and anxious
from what I was told tonight he is having panic attacks a few times a day.


Do you want to know about mania depression cycle ? I know they would fight approx. every 7 days or so.

What do you mean by abuse cycle? he would be nice and say sorry and keep telling her he would change and then a 5-7 days he would blow up again.

Expert:  Dr. Vikas replied 5 years ago.
Thanks.


If there is no abrupt change in his behavior and he is not feeling paranoid, anxious, it is a good sign.

If he is still experiencing panic attacks the dose of Wellbutrin still needs to be adjusted and may be a Benzodiazepine class drug such as Ativan / Klonopin needs to be added to Wellbutrin to stop his panic attacks.

If his symptoms (Being unpredictable, become abusive) are because of depression very soon the change in his behavior would be noticed by your friend once his symptoms are totally under control.

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Dr. Vikas
Dr. Vikas
Mental Health Professional
2219 Satisfied Customers
MBBS ; M.D Psychiatry, MS. Health Informatics