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Dr. Vikas
Dr. Vikas, Psychiatrist
Category: Mental Health
Satisfied Customers: 2253
Experience:  MBBS ; M.D Psychiatry, MS. Health Informatics
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Oxybutynin Chloride 5 mg 1 tablet twice daily switched from

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Oxybutynin Chloride 5 mg 1 tablet twice daily switched from vesicare due to cost.Lamotrigine 150 mg 1 in morning and one 1 at night 300 mg total and then lorazepam .5mg one at night plus two to three times daily as needed for anixety. I feel more awake at night and more manic. Example I could cash advance up to 2,500 dollars on my discover card. I dislike enuresis and bipolar it's like upward roller coaster is there a fix that can be helpful in this regard?
Submitted: 6 years ago.
Category: Mental Health
Expert:  Dr. Olsen replied 6 years ago.
Hi there,
Thank you for waiting.
This question may be answered by a psychiatrist (M.D.).
Please wait for another expert.
Customer: replied 6 years ago.


Expert:  Dr. Vikas replied 6 years ago.

You are currently taking Lamotrigine for Bipolar disorder but this medicine is more effective in treating depressive episode that manic symptoms in bipolar patients.

For effective control of your manic symptoms you may discuss with your doctor about adding a mood stabilizer such as Sodium Valproate or Quetiapine. Both of these medicines are very sedating in nature and will also control difficulty in sleeping.

Since, Lorazepam should not be taken for long duration because of its addiction potential, once you sleep symptoms improve with above mentioned medicines, your doctor may slowly taper down Lorazepam.

I hope this helps.

Best wishes,


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Dr. Vikas, Psychiatrist
Category: Mental Health
Satisfied Customers: 2253
Experience: MBBS ; M.D Psychiatry, MS. Health Informatics
Dr. Vikas and other Mental Health Specialists are ready to help you
Customer: replied 6 years ago.
Hi I work at Mickey D's and do a lot with taking orders and collecting money. Switching around medications will that cause me problems with taking cash and throw off my drawer as a side effect of the medication? I had that problem once before with a medication and was taken off register for a month. I just don't want to lose my job that carries health insurance. Any thoughts? How high of a dose do you think would be needed and would blood work be required? Just curious and I do agreee Ativan can be addtive.
Expert:  Dr. Vikas replied 6 years ago.
Well, you need not to worry about that. Since both of the medicines I have mentioned are very sedative, your doctor will advice you to take them only when you sleep.

The strength of dose will depend upon the clinical symptoms. Sodium Valproate may increase the body level of Lamotrigine so your doctor may reduce the dose of Lamotrigine further.

Quetiapine is usually started at a dose of 25 mg per day and the usual dose range is from 400 -800 mg per day depending on the clinical symptoms.

Your doctor will order serum lipid profile, Liver function test, Kidney function test and Blood sugar most likely.