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Dr-A-Greene, Psychologist
Category: Mental Health
Satisfied Customers: 309
Experience:  Clinical and Forensic Psychologist
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My son is 31 years old. Went to see the Pshiciatrist today

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My son is 31 years old. Went to see the Pshiciatrist today because he suffers from severe anxiety and depression. This was not the first time he visited a pshiciatrist. Various meds were prescribed over the years however the treatment is short lived because he stops taking the meds because of ?side effects after a week or even a few days.
Today he was prescribed Aropax SR the lower dose and Rivotril .5mg one a day.
I have been suffering from anxiety from the age of about 28 and has been on Aropax (now Paxal) since then. I certainly find that it benefits me and I am in a very stressful job and copes very well. Do you think Aropax is the answer for him? He was diagnosed with ? BP grade 2.
was he diagnosed with depression and anxiety or Bipolar II? There is a difference in treatment regimens and I would need to know that first...
Customer: replied 5 years ago.

Approx 12 years ago with TLE. Scans normal after 3rd repeat. Then diagnosed about 8 years ago with BP 2.

If he truly has anxiety/depression, Paxil (aropax) and klonopin (rivotril), as needed, is very effective. Paxil is an antidepressant that also works on anxiety and klonopin is a benzodiazapine that works to quell major anxiety, as needed. Be careful with the klonopin (rivotril) though - it's habit forming.

That said, if you son has Bipolar Disorder, the treatment of choice usually is NOT an SSRI because the potential to kick someone into a full fledged manic episode is there. Bipolar is usually treated with mood stabilizers such as Lithium. These drugs have a higher incidence of side effects, but are much more effective for Bipolar Disorder.

Another common issue with patients with Bipolar is that they often discontinue meds because they don't like the way the medications make them feel. Just FYI. Please let me know if you have any more questions.



Got it - well, the mood stabilizers work well with Temporal Lobe Epilepsy and Bipolar alike (e.g. Trileptl). I guess my query would be, was the psychiatrist aware of his history of Bipolar?

Customer: replied 5 years ago.

Thank you for the information. Charles had a 2 courses of about 4 sessions each ECT.

(against my believe).

What will you suggest. To treat the anxiety and depression as planned then reasses the BP? He is not a typical BP. He has highs and lows however i dont believe more than the average person. Normally the mood swings will be justified by "something" that happened prior to it.

At the time of diagnosing TLE..the dr did not suggest BP or even mentioned it

Okay - well, Bipolar II is a hard diagnosis to make and would likely take more than one appointment to notice it. And, as you suggested, it may not be Bipolar II at all - just normal mood swings. I don't think it would hurt anything to treat the anxiety and depression as planned. I would just keep an eye out for more extreme symptoms. If he has any completely sleepless nights, fast/disjointed speech, or other manic symptoms, you might want to rethink it. Otherwise, your plan sounds good to me! Thanks and the best of luck to you and your son!
Customer: replied 5 years ago.

Hello Dr Greene

Im Charles , I have sleepless nights most nights, i wake up several times per night with fear and sometimes severe panic attacks with excess sweating and heavy breathing

My heart beats really fast while sleeping from constant anxiety which even gets my stomach working several times at night.

I really hope Aropax (Paxil) will help me with this disorder.

Hi Charles -

It's nice to meet you. Thank you for describing a bit of your symptoms to me. Yes, what you're describing sounds like an anxiety disorder. Paxil is a good drug for panic and anxiety, but please be aware that it takes a while to work and get into your system. Also, the klonopin (rivotril) can be very helpful if used as needed for panic. In the future, you may want to inquire about a medication specifically for sleep as well.

Other natural things that may help: melatonin (for sleep) and a magnesium supplement (anti-anxiety).

Finally, remember to lower your intake of caffeine and other natural stimulants. I wish you luck with this regimen - it sounds like a good one to me.

Customer: replied 5 years ago.

Dr Greene

I have one more question which doesnt relate to medication but to the psyche of a realationship. I met a woman whom after one date told me she was married (44) but had extramarital affair with a work colleage older than her for approx 6 years under her husbands nose. She even had him visiting her home with her husband there and she acted like he was just a friend visiting which her husband believed was a friend.

Is she the type of person that will keep doing this as im very afraid she will do the same to me.

Well, they always say that "the best indicator of future behavior is past behavior." I think you are right to be concerned. While it's possible that she is attempting to change her ways and is coming clean with you right away, the risk is certainly there. If you decide to engage is a relationship with her you two are already starting out at a disadvantage because of the potential trust issues. You would have to be very transparent with her that this is a concern of yours and she would have to be equally transparent with you.

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