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The question was submitted 06/29/2008

Subject: Bipolar Relapse

Hi

I was doing well as my bipolar illness was kept under control for 6 years until 2007 when I moved into my own house which is lonely and I had financial responsibilities too. I got hospitalised 7 times in a year then with one hypomaniac episode and the rest are on the downside.

My question is that I have taken lithium for 6 years of 800 to 1200 mg. Will the lithium be effective or tolerated if I kept on taking lithium of 1200 mg for so long? No wonder I got admitted time and again with the faverin 50 mg that didn't help.

Now my psychiatrist has prescribed me 100 mg of quetiapine and my life depends on its efficacy with 20 mg of prozac. It is not that I didn't help myself. I tried to do brisk walking at East Coast beach, giving tuition part time, attending prayer groups and eat properly. But the downside comes like a thief. Thank God I didn't attempt suicide but the suffering is unbearable. Please help and advise.

Answer from DepNet

It does sound like you are doing alot to try to help yourself. at the same time, it also sounds like the environmental stress that you have been oing through has taken its toll on you.

Lithium does not have problems with tolerance i.e being less effective with time, the dose may however need to be adjusted during different phases of the illnesses.

I think it is important to work closely with your psychiatrist to titrate and adjust the medication to get the best efficacy fpr you. Psychotherapy may also be useful for the depressive phase of the illness. You may also want to consider a second opinion if the symptoms are persistent.

Take good care.

The answer was published on DepNet 07/01/2008