bipolar disorder, Dr. Paul Markovitz  Q. I was diagnosed as Bipolar 9-10 years ago, Borderline was added to the mix about 4 years ago. I have been none resistant to the medications from the get go. You name it I've been on it. Currently I am in a "mixed state", have been for approximately 4-5 months. It's unbearable. I am becoming unhinged. I am currently taking 200 mg Effexor in am, 75 mg mg Topamax in am, 200 mg Neurontin an, 100 mg Effexor in afternoon along with 75 mg, Seroquel and 200 mg Neurontin and 100 mg Topamax at night with 200 mg Seroquel and 200 Neurontin at night with Klonopin for the anxiety which has turned into sheer terror. I'm terrified of everything. Showers sleep, awake, outside.

  A. I do not know what to tell you. I do not know anywhere near enough about you to offer an opinion about your case specifically.

You are, however, on an awful lot of medications that do the same thing, and many of the dosages seem low. Effexor usually takes 200 mg twice daily to work. Neurontin is not very effective under 2400 mg daily. Topamax is thought to work best at 200 mg twice daily. Ask you doctor about dosages.