bipolar disorder, Dr. Paul Markovitz  Q. I'm tired, I've seen doctors, psychiatric assistants, but never a real psychiatrist. They've always been too busy when I've been recommended. Anyway a long story short, my medical doctor and many counselors have diagnosed me with chronic depression, but when I take my medication (Wellbutrin 100mg and Zoloft 200mg) a day I find I get what is described as Manic. My heart starts racing, I can't stop moving, I can't carry on a simple conversation with people because my concentration level is so low. I feel like I have to be on the go at all times and I am very moody. I could be laughing one minute the so angry the next for no apparent reason. When I don't take the medication I have no energy, and really my concentration is never good, I don't want to talk to people or see people I just want to hide in my basement and hope the world disappears. My question is what do I do, who do I talk to, what medication should I be on? The way it is now is medicated or not I'm still not normal.

  A. Well, if you have any anxiety symptoms, Wellbutrin is a really bad medication for you to be on. It does not treat anxiety, and can make existent symptoms of anxiety worse. Zoloft causes anxiety is about 12% of the folks who use it, but these symptoms usually go away (not always) in a couple weeks.

Other options include Serzone as 500 mg at bedtime (get to this dosage over time) if you are not obsessive. Effexor XR is also an option at enough medication dosage to rid yourself of carbohydrate craving (if you have it). This is usually around 450 mg of Effexor XR per day. Celexa also is a decent choice since it is less stimulating than Zoloft, but as effective. You are likely looking at a dosage of 80 mg/day to resolve your illness.