Q. I'M THE HUSBAND OF A SUFFERING WIFE WHO HAS HAD 9 EPISODES OF MANIC AND DEPRESSION IN THE LAST 11 YEARS. SHE START WITH A PSYCHOSIS 15 DAYS AFTER BEING OUR 1 KID MUM, WHERE SHE GOT REALLY BAD SEEING UNEXISTING THINGS ALSO. SHE WAS HOSPITALISED AND CAME OUT THE CLINIC WITH HIPOMANIA DURING 45 DAYS AFTER THE 15 SHE WAS AT THE CLINIC. THAN SHE SWITCH TO A MAJORS DEPRESSION FOR AL LEAST 60 MORE DAYS. SHE DID THE SAME ONE AND TWO YEARS AFTER. THE THIRD ONE THE EPISODE WAS A SOFT ONE. THE 4 YEAR WE BRING A NEW BABY AND 30 DAYS AFTER SHE SWITCH TO A MAJOR DEPRESSION . THE Dr. GAVE HER A TRICYCLIC ANTIDEPRESSANT WHICH TURN HER OUT TO A MANIC EPISODE AND NEED TO BE HOSPITALISED AGAIN. AFTER SHE WENT OUT THE HOSPITAL SWITCH TO A DEPRESSION AGAIN. THEN SHE HAD ONE AND A HALF YEAR OF NORMAL MOOD AND THEN SHE QUIT LITHIUM AND GOT A NEW MANIC- DEPRESSION EPISODE AND HAD TO GO TO CLINIC. SHE CAME OUT HAVING LITHIUM AN OXCARBACEPINE . THEN SHE WENT 2 MONTHS AFTER ONTO A DEEP DEPRESSION AND THE NEW Dr. CHANGE LITHIUM BY VALPROATE AN SHE DID ALMOST WELL. AS SHE FELT SLEEPY THE Dr. QUIT OXCARBACEPINE AN THEN VALPROATE AND STAR TO GIVE HER OLANZAPINE AS A MOOD STABILISER AND SAID THAT SHE HAD TO TAKE IT FOR 5 YEARS AT LEAST (BIG MISTAKE I GUESS) BUT Dr. NOT ONLY QUIT VALPROATE, START TO GIVE PAROXETINE AN SHE HAD A NEW MANIC-DEPRESSIVE CRISIS. ONE YEAR LATER AN OTHER Dr. GAVE HER PAROXETINE AND OXCARBACEPINE AND SHE HAD A NEW SWITCH. NOW A NEW Dr. IS DOUBTING THAT MY WIFE HAS A BIPOLAR DISORDER AND SHE'S TRYING TO SEE IF SHE HAS PERSONALITY DISORDER.
MY QUESTIONS ARE:
1) IS THERE ANY DOUBT ABOUT MY WIFE IS A BIPOLAR PERSON
2) IS THERE ANY ANTIDEPRESSANT WHICH WE COULD USE AND BE SAFER THAN PAROXETINE THAT SHOWS TURNS MY WIFE FAST TO A HYPOMANIC MOOD.
A. It is probable that your wife has bipolar disorder. Clearly she has a mood disorder with highs and lows, so the real question is how to best treat it. People with highs need to stay on medications. Lithium is still the gold standard for bipolar depression, and it sounds as if it worked for her. Tricyclic antidepressants are a poor choice in depressed bipolars (bipolar = manic depressive) unless there is absolutely no other choice. Paxil (paroxetine) is not so bad, but it did not work for her. I tend to favor nefazodone (Serzone) in bipolars since there is a lower chance of it causing mania.