[lemur]

Hi there, my father is bipolar and is taking Olanzepine 20mg and Depakote (unsure of that dose) and has been doing so for around 2 years now. He sleeps 18 hours a day (I'm not exaggerating) and he says he is depressed, despondent and shows little interest in anything. We had a meeting with the doctor to talk about his medication in the hope of changing it but she didn't seem to want to change it at all, after a lot of pleading and talking she agreed to add in a low dose of an antidepressant. Now, the thing is, I am aware that antidepressants are bad news for bipolar patients and she even said that he will need to be monitored closely on this in case his mood becomes too high and he starts going manic. I brought in some suggestions for alternatives for the Olanzepine, one of which was Lamictal, which is an alternate mood stabiliser that specifically is known for helping with the depression. She didn't seem interested in prescribing this medication, should I talk to gp? What to do?

Has anyone here taken Olanzepine and Depakote? What were your side effects?

Has anyone taken Lamictal? What were you side effects?

Should he be taking TWO mood stabilisers like this?

What are you opinions on adding in another medication, i.e the antidepressant, rather than switching one of the mood stabilisers?

Thank you!

[bizi]

just my opinion, I amnot a doctor.
He is sleeping way to much find out what his doses are.
and repost them.he may be taking too much of either one. is he bipolar 1 or 2. Has he ever been psychotic before. delusional, paranoid, racing thoughts or speech. this could be signs of mania or a true manic episode. This what we worry about for someone put on an anti depressant. But he should be slowly titrated up and not start out on a a full dose and when does she want to see him again?
bizi It is good that he has you to be an advocate for him. Has he had a regular check up with his family gp, there may be something else going on.
bizi

[Mari]

Hi,

I am not a doc and I do not even have any experience with those two meds, but he probably does not need that much Olanzapine. What a mess!

If the psychiatrist will not lower the doses of those two, then go to a his general practitioner or make an appointment with another psychiatrist even if you have to get in the car and drive to the next big city.

That psychiatrist is a horrible. (I have lots of bad words for her right now but spewing them out here probably will not help you.)
Work it out so that another doctor takes care of him if at all possible. He does need to see his family doctor for a regular assessment and to check for diabetes. Also, the family doctor can help you find another psychiatrist or advocate for your father if he has to go back to her. My hope for your father is that you do whatever you can to get him to a new psychiatrist.

My guess is that two years ago, he was manic and violent and she drugged him to stop what was happening. She was supposed to lower his meds after he calmed down.

Lamitcal is not likely the right drug. He probably does not need an anti-depressant. He needs less Olanzepine. (Adding an anti-depressant might help him but the major problem right now -- based on what you have posted-- is likely too much Olanzepine.)

depressed, despondent and shows little interest in anything

I am sorry that he is dealing with that right now.
Get a hold of the book Bipolar Disorder For Dummies.
Also check to see if you have an active local hapter of NAMI (National Alliance on Mental Illness). They work with families of bipolar people.

Crazymeds is a good site. Here is the olanzapine page: http://www.crazymeds.us/pmwiki/pmwiki.php/Meds/Zyprexa

Mari

[mymorgy]

he desperately needs a new psychiatrist. no way should he sleep 18 hours and still be depressed. i am glad he has you as an advocate.
bobby

[Dmom3005]

First I want to welcome you to our room.
Next I wanted to say you are being a great advocate for your father.

And now I agree with the rest of the room. Please get to the gp, and
have him/her help with this. Also have a full physical about other
issues. Just to make sure.

Also to find a new Psychiatrist.

Please let us know how he is doing.
We care.

Donna

[waves]

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.

-------------

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

[anneo59]

Hey hope situ w your dad and pdoc improves or he changes doc and meds. I did not do well on those meds except for lamictal. Was also more alert and less depressed on this as well. The best to you!

Originally Posted by lemur

Hi there, my father is bipolar and is taking Olanzepine 20mg and Depakote (unsure of that dose) and has been doing so for around 2 years now. He sleeps 18 hours a day (I'm not exaggerating) and he says he is depressed, despondent and shows little interest in anything. We had a meeting with the doctor to talk about his medication in the hope of changing it but she didn't seem to want to change it at all, after a lot of pleading and talking she agreed to add in a low dose of an antidepressant. Now, the thing is, I am aware that antidepressants are bad news for bipolar patients and she even said that he will need to be monitored closely on this in case his mood becomes too high and he starts going manic. I brought in some suggestions for alternatives for the Olanzepine, one of which was Lamictal, which is an alternate mood stabiliser that specifically is known for helping with the depression. She didn't seem interested in prescribing this medication, should I talk to gp? What to do?

Has anyone here taken Olanzepine and Depakote? What were your side effects?

Has anyone taken Lamictal? What were you side effects?

Should he be taking TWO mood stabilisers like this?

What are you opinions on adding in another medication, i.e the antidepressant, rather than switching one of the mood stabilisers?

Thank you!

[anneo59]

that is the truth! Interesting to read about other folks' experiences. Sometimes it takes a while to find something that works, as many of us know!!!!!

Originally Posted by waves

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.

-------------

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

[anneo59]

you can find a workable situ for your dad! You all are blessed to have one another!!!

Originally Posted by Dmom3005

First I want to welcome you to our room.
Next I wanted to say you are being a great advocate for your father.

And now I agree with the rest of the room. Please get to the gp, and
have him/her help with this. Also have a full physical about other
issues. Just to make sure.

Also to find a new Psychiatrist.

Please let us know how he is doing.
We care.

Donna

[anneo59]

been there and done that and changed docs, cuz that doc thought all that sleeping was "normal"!!!!!! Outrageous!

Originally Posted by mymorgy

he desperately needs a new psychiatrist. no way should he sleep 18 hours and still be depressed. i am glad he has you as an advocate.
bobby