I agree with the observation that your father was probably medicated for mania at one point and the meds were not adjusted down to maintenance dosages as they should have been.

With all the meds he is on, the symptoms you describe do not surprise me the slightest bit. He sounds flattened by over-medication, more than truly depressed.

Bearing in mind that I'm not a doctor either:

I think it's pathetic to add an antidepressant without first trying a reduction in the battery of knock-out meds he is on.

New psychiatrist definitely in order.

I see no indication for Lamictal for now. Your father's potential need for any sort of antidepressant treatment can be evaluated once he is allowed to be more ... "awake"?

He might very well be fine with a slow reduction of one or both of the olanzapine and the Depakote. Which is lowered first will depend on his overall health status and bipolar episode history, but I'd expect olanzapine would be the first to go, since it is the stronger of the two and poses greater health risks. Also, 20mg is the max dosage. He might have needed that much for acute symptoms, especially if he is a smoker (smoking increases olanzapine clearance), but it seems excessive for maintenance purposes.

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My experience with these meds: I've taken 10-15 olanzapine for acute episodes (I'm a non-smoker of normal weight). I take Depakote as my regular maintenance drug. My Depakote dosage is usually raised first to treat acute symptoms; in case of specific symptoms or if the Depakote fails, I've had olanzapine added onto it, but only on a temporary basis. The olanzapine was used for the shortest period possible, and the Depakote was always tapered back to my maintenance dosage after I was well for a while. My maintenance dose of Depakote is about half as much as what I've taken for acute episodes.

waves