Mental Health

Have Mental Health Questions? Ask a Psychiatrist Online

Ask an Expert,
Get an Answer ASAP!

Mental Health
This answer was rated:

I am treatment resistant....have gad, bipolar,depression,57

yrs old not too functional.....i...
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
Show More
Show Less
Ask Your Own Mental Health Question
Answered in 2 hours by:
5/11/2013
Dr. Kaushik
Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 4,690
Experience: MD Psychiatry
Verified

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
Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 4,690
Experience: MD Psychiatry
Verified
Dr. Kaushik and 87 other Mental Health Specialists are ready to help you
Ask your own question now
Customer reply replied 4 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..

Ask Your Own Mental Health Question
Ask Dr. Kaushik Your Own Question
Dr. Kaushik
Dr. Kaushik
Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 4,690
4,690 Satisfied Customers
Experience: MD Psychiatry

Dr. Kaushik is online now

A new question is answered every 9 seconds

How JustAnswer works:

  • Ask an ExpertExperts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional AnswerVia email, text message, or notification as you wait on our site. Ask follow up questions if you need to.
  • 100% Satisfaction GuaranteeRate the answer you receive.

JustAnswer in the News:

Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.

What Customers are Saying:

I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much

Corrie MollPretoria, South Africa

I thank-you so much! It really helped to have this information and confirmation. We will watch her carefully and get her in for the examination and US right away if things do not improve. God bless you as well!

ClaudiaAlbuquerque, NM

Outstanding response time less than 6 minutes. Answered the question professionally and with a great deal of compassion.

KevinBeaverton, OR

Suggested diagnosis was what I hoped and will take this info to my doctor's appointment next week.
I feel better already! Thank you.

ElanorTracy, CA

Thank you to the Physician who answered my question today. The answer was far more informative than what I got from the Physicians I saw in person for my problem.

JulieLockesburg, AR

You have been more help than you know. I seriously don't know what my sisters situation would be today if you had not gone above and beyond just answering my questions.

John and StefanieTucson, AZ

I have been dealing with an extremely serious health crisis for over three years, and one your physicians asked me more questions, gave me more answers and encouragement than a dozen different doctors who have been treating me!!

Janet VPhoenix, AZ

< Previous | Next >

Meet the Experts:

Dr. Keane

Dr. Keane

Therapist

1,379 satisfied customers

Clinical Psychology PhD, Licensed Professional Counselor with experience in marriage/family, teens and child psychology.

TherapistMarryAnn

TherapistMarryAnn

Therapist

3,984 satisfied customers

Over 20 years experience specializing in anxiety, depression, drug and alcohol, and relationship issues.

Dr. Olsen

Dr. Olsen

Psychologist

2,336 satisfied customers

PsyD Psychologist

Norman M.

Norman M.

Principal psychotherapist in private practice. Newspaper contributor, over 2000 satisfied clients on JA

2,246 satisfied customers

ADHP(NC), DEHP(NC), ECP, UKCP Registered.

Dr. Michael

Dr. Michael

Psychologist

2,177 satisfied customers

Licensed Ph.D. Clinical Health Psychology with 30 years of experience in private practive and as a clinical psychology university professor.

Steven Olsen

Steven Olsen

Therapist

1,728 satisfied customers

More than twenty years of expertise in counseling, psychological diagnosis and education

Anna

Anna

Mental Health Professional

1,656 satisfied customers

Licensed Clinical Social Worker with 29 years in addictions and mental health.

< Previous | Next >

Related Mental Health Questions
I have generalized anxiety disorder with panic attacks that
I have generalized anxiety disorder with panic attacks that I treat and keep managed with BCT, exercise, eating a well balanced diet, and breathing exercises. For the most part this works well. This p… read more
TherapistMarryAnn
TherapistMarryAnn
Therapist
Master's Degree
3,984 satisfied customers
I suffer from social anxiety, insomnia, panic attacks, and
Hi, My name is***** suffer from social anxiety, insomnia, panic attacks, and ocd. I had a doctor for a while, when i had health insurance. I lost my insurance, and she changed practices and can't see … read more
JohnMichaels,MS,LPC
JohnMichaels,MS,LPC
Counselor
Master\u0027s Degree
167 satisfied customers
I have generalized anxiety disorder with panic attacks at
I have generalized anxiety disorder with panic attacks at times. For the most part I have improved a great deal through BCT and other lifestyle changes. I had it terrible after I quit smoking for abou… read more
Linda D.
Linda D.
Master\u0027s Degree
721 satisfied customers
I have a history of health anxiety and panic. I went to hear
Hi. I have a history of health anxiety and panic. I went to hear a band Saturday and smoked about 5 cigarettes. I never smoke! I am very health conscious with diet, running, etc. I did smoke a few in … read more
TherapistMarryAnn
TherapistMarryAnn
Therapist
Master's Degree
3,984 satisfied customers
I have been having severe panic attacks. I am currently
I have been having severe panic attacks. I am currently waiting to hear back from PA schools and I haven't slept in 5 days. what do i do. … read more
LeahMSWuofm
LeahMSWuofm
Clinical Social Worker
Master\u0027s Degree
719 satisfied customers
I have anxiety disorder and panic attacks. Lately when I get
I have anxiety disorder and panic attacks. Lately when I get worked up or irritated if I yell or feel anger I almost instantly get a dizzy feeling like I will faint or something. One of my biggest sym… read more
TherapistMarryAnn
TherapistMarryAnn
Therapist
Master's Degree
3,984 satisfied customers
Ever since my mom died I have extreme anxiety. Sleep. Good
Ever since my mom died I have extreme anxiety JA: How long have you been dealing with this? Is there anything in particular that seems to make the symptoms better or worse? Customer: Sleep JA: Anythin… read more
JohnMichaels,MS,LPC
JohnMichaels,MS,LPC
Counselor
Master\u0027s Degree
167 satisfied customers
Was on Zoloft 200 mg for GAD and 1mg of Atavan to aid sleep.
Was on Zoloft 200 mg for GAD and 1mg of Atavan to aid sleep. Over the last few months I've steadily gained weight and I fully tapered off the medicine about 3/4 weeks ago. DUring my time on the medici… read more
Dr. Kaushik
Dr. Kaushik
Psychiatrist
4,690 satisfied customers
OKMH925100 Is it possible to treat panic disorder/anxiety
OKMH925100 Hi! Is it possible to treat panic disorder/anxiety disorder without medication?? I'm in my mid-thirties and just started having panic attacks after a very stressful past 4 years (I thought … read more
LeahMSWuofm
LeahMSWuofm
Clinical Social Worker
Master\u0027s Degree
719 satisfied customers
I have a question regarding anti-anxiety and sleeping
I have a question regarding anti-anxiety and sleeping tablets. Can you help me with this? … read more
Linda D.
Linda D.
Master\u0027s Degree
721 satisfied customers
I suffer from anxiety and panic. I went to a wedding on
I suffer from anxiety and panic. I went to a wedding on Friday night and had approx 3-4 glasses of white wine. I woke up on Saturday in the throws of a horrendous panic attack. I had the attacks under… read more
LeahMSWuofm
LeahMSWuofm
Clinical Social Worker
Master\u0027s Degree
719 satisfied customers
I suffer from anxiety and panic. I went to a wedding on
I suffer from anxiety and panic. I went to a wedding on Friday night and had approx 3-4 glasses of white wine. I woke up on Saturday in the throws of a horrendous panic attack. I had the attacks under… read more
LeahMSWuofm
LeahMSWuofm
Clinical Social Worker
Master\u0027s Degree
719 satisfied customers
I have unbearable anxiety, Too much sleep makes it worse.
Too much sleep makes it worse. Xanax has qorked in past … read more
LeahMSWuofm
LeahMSWuofm
Clinical Social Worker
Master\u0027s Degree
719 satisfied customers
Broke my wrist on 4/23 and stared having panic/anxiety
Broke my wrist on 4/23 and stared having panic/anxiety attacks. Cast removed but still getting attacks everyday. Dr prescribe hydroxyl inexpensive and busprine which made me worse. I've gone cold turk… read more
LeahMSWuofm
LeahMSWuofm
Clinical Social Worker
Master\u0027s Degree
719 satisfied customers
I have panic/anxiety disorder. After many years on Xanax Xr
I have panic/anxiety disorder. After many years on Xanax Xr (1 mg. twice daily) my new psychiatrist convinced me to taper completely off the xanax xr, using klonopin 3 times daily (.5 .5. 1mg) while t… read more
Dr. Kaushik
Dr. Kaushik
Psychiatrist
4,690 satisfied customers
Klonopin at nite to sleep and zanax by day for anxiety,
klonopin at nite to sleep and zanax by day for anxiety … read more
Vakul Aren
Vakul Aren
Consultant Physician
Post graduation (Liverpool, U.K.)
3,907 satisfied customers
Anxiety and panic attacks sometimes, if i,am dealing with a
if i,am dealing with a lot of stress or i,am about to have a medical procedure soon i get very nervous. … read more
TherapistMarryAnn
TherapistMarryAnn
Therapist
Master's Degree
3,984 satisfied customers
I'm having severe trouble with anxiety and sleep and panic
I'm having severe trouble with anxiety and sleep and panic attacks I've been going through a lot I cannot seem to get a doctor to understand how important it is for me to calm down so that I could sta… read more
llw26
llw26
Private Practice
Doctoral Degree
11 satisfied customers
Disclaimer: Information in questions, answers, and other posts on this site ("Posts") comes from individual users, not JustAnswer; JustAnswer is not responsible for Posts. Posts are for general information, are not intended to substitute for informed professional advice (medical, legal, veterinary, financial, etc.), or to establish a professional-client relationship. The site and services are provided "as is" with no warranty or representations by JustAnswer regarding the qualifications of Experts. To see what credentials have been verified by a third-party service, please click on the "Verified" symbol in some Experts' profiles. JustAnswer is not intended or designed for EMERGENCY questions which should be directed immediately by telephone or in-person to qualified professionals.

Disclaimer: Information in questions, answers, and other posts on this site ("Posts") comes from individual users, not JustAnswer; JustAnswer is not responsible for Posts. Posts are for general information, are not intended to substitute for informed professional advice (medical, legal, veterinary, financial, etc.), or to establish a professional-client relationship. The site and services are provided "as is" with no warranty or representations by JustAnswer regarding the qualifications of Experts. To see what credentials have been verified by a third-party service, please click on the "Verified" symbol in some Experts' profiles. JustAnswer is not intended or designed for EMERGENCY questions which should be directed immediately by telephone or in-person to qualified professionals.

Show MoreShow Less

Ask Your Question

x