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Dr. Kaushik
Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 4662
Experience:  MD Psychiatry
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I am suffering from anxiety and depression although i feel

Resolved Question:

I am suffering from anxiety and depression although i feel there may be more to it that that. I am on valium and recently ended up in A&E after drinking ot top of it and suffered a manic episode. i was saent home without help or advice. I feel awful and don't know what to do now. I have seen my GP and have a referal for psychiatrist but not for another 7 weeks.
Submitted: 8 years ago.
Category: Mental Health
Expert:  Dr. Kaushik replied 8 years ago.

Hi there,

Welcome to Just Answer !

It seems like you had to put up with a lot of struggle and agony in the recent past. I would like to offer my help in the capacity of a psychiatrist , and hope it does help you to get the right treatment , because first of all we need to have a probable diagnosis for your condition and secondly i am not convinced with the treatment you have been placed on. Valium ( valproate ) is a mood stabilizer and is used in bipolar disorder and major depression, but it needs to be added to an anti depressant in case you have depression as your diagnosis , but i believe your doctor did not do that , and that is why you have not been reccuperating well .

NOW , that you had experienced a manic episode , so, your diagnosis now is no longer unipolar depression, but your diagnosis now is Bipolar Disorder, as in bipolar disorder atleast 1 episode of mania should have occurred , in otherwise depressive state and so this diagnosis fits your condition.

So , i propose that since you have few weeks , before you meet your psychiatrist, i am mentioning below a treatment regime for your probable diagnosis of Bipolar disorder , which would also take care of your anxiety.

1) 1 Anti depressant should be started , to treat your depression, a good anti depressant would be Venlafaxine (effexor XR) or Paroxetine (paxil) or fluoxetine(prozac) or escitalopram (lexapro). Your GP should choose any one of the mentioned anti depressant and he/ she should decide on the right dosage and time of intake.

2) 1 Anti psychotic drug needs to be added to your regime , in order to prevent any further episode of mania , as what happpens is that since you are a bipolar, and are already succeptible to manic episode , and to add to this, anti depressants may unmask the mania, thereby by use of anti psychotics we attain a right balance and prevent mania from occurring. Examples of good anti psychotics are --- olanzapine or risperidone ( risperdal) or quetiapine ( seroquel). You may use any one of these and discuss with your GP the right dose and time of intake.

3) 1 Anti anxiety drug such as clonazepam (klonopin) or buspirone(buspar) or alprazolam( xanax) shall be added , for your anxiety and also to assist you to sleep if you have insomnia .

4) Continue the use of Valium ,as a mood stabilizer, as it is required to prevent mood swings , which occur in bipolar disorder , it also helps in keeping one calm .

So, i suggest you discuss the above mentioned treatment regime with your GP , let him decide on the drug dosages and the time of intake , and start this treatment right away, and i believe this treatment will take care of your symptoms and by the time you meet up with your psychiatrist , you will be much better and he/she can also review the treatment and offer his advise .

I wish you all the best .

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


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