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Dr. Kaushik
Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 4532
Experience:  MD Psychiatry
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i am treatment resistant....have gad, bipolar,depression,57

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i am treatment resistant....have gad, bipolar,depression,57 yrs old not too functional.....i take 300mg lithium,2mg of klonopin9dr says its too much?>gabapentin 300mg and some sleeping pill. is there any new adjunct drugs out that work with lithium

Hi there,

 

Welcome to Just answer !

 

I am sorry to learn about your condition and I empathize with you.

 

Well yes you can use Lamictal ( lamotrigine ) , which is also a mood stabilizer as an augmenting agent for Lithium. The effective dose for lamictal as an augmenting agent in a bipolar disorder is 100-400 mg / day .

 

Another alternative that can be used instead is another mood stabilizer Topamax ( Topiramate) at dose of 75-150 mg / day .

 

So you shall discuss both these drug options with your prescribing doctor for using one of them as an augmenting agent for lithium so as to potentate it's efficacy against your symptoms of bipolar disorder.

 

I hope this helps.

 

Wish you all the best.

 

Please kindly leave a Positive rating if you are satisfied with the answer as only then will I be credited for my service.

 

If there is any further assistance needed please feel free to ask using the reply button.

 

Regards..

 

Dr. Kaushik and other Mental Health Specialists are ready to help you
Customer: replied 3 years ago.

DR...do you think 2 mg of klonepin is good for gad, panic attacks.....the DR is trying to get me off a benzodiazipine, however isnt the big picture, and my ability to be somewhat functional being comprized. what is a good and effective substitute

Klonopin is an effective drug to manage GAD and panic attacks but the dose is variable from person to person plus klonopin cannot be kept for long term treatment because of it's tendency to make the consumer dependent on it.

 

So one important reason why your doctor seems to be adamant in continuing on this drug is because of the addiction / dependency risk that this drug carries , so I can acknowledge his intentions to put you on an effective but not addictive drug.

 

A good effective and safe alternative for klonopin to manage GAD, panic attacks would be Abilify ( aripiprazole ) at a modest dose of 10-15 mg/ day to be taken at night only.This is an anti psychotic drug but at this dose it is known to produce good anti anxiety effects too thereby making it effective in your case. In addition to this abilify being an anti psychotic will prevent manic episodes from developing.

 

So abilify seems to be a well rounded drug for managing your conditions of anxiety and panic attacks plus bipolar.

 

So to summarize -

 

Lamictal or Topamax ( preferably lamictal) as an augmenting agent for bipolar disorder and klonopin being replaced by abilify for controlling your anxiety , panic attacks and also contributing towards your bipolar disorder.

 

I hope this helps.

 

Wish you all the best.

Please kindly leave a Positive rating if you are satisfied with the answer as only then will I be credited for my service.

 

Regards..