Q. I have been diagnosed many things in my life, from bipolar disorder to schizophrenic to schizoaffective. The latter is the currently used label. I take 600 mgs. of Meclobimide and 800mgs of sulpiride. I find valium helps my social phobia most, but the doctors are reluctant to prescribe it so I rarely get to use this as a help. In fact it helps me to face groups of people more than the sulpiride. My doctor says I will have to be on this combo for life. But these are very dangerous drugs, and I wish you would comment on

1) what makes them use the s-a term rather than bipolar II, which seems more correct to me, and

2) the use of very potent medications long-term leading to cancer and sudden death and heart attack.

3) And info about the efficacy of Meclobimide?

 

  A. 1. Diagnostic criteria are set up for all psychiatric illness. There is, however, some ambiguity and overlap between diagnoses. I do not know what your symptoms are, so it would be impossible for me to even have a reasonable opinion as to why they have labeled you schizoaffective. I would definitely ask your doctor why this diagnosis. I am sure he or she will be glad to review it with you.

2. I would hope the odds of sudden death, cancer, etc., are relatively low versus the risk you face from your illness. Talk to your physician about your concerns. They are not all that high from either of the medications you are using.

3. Meclobimide is a reversible monoamine oxidase inhibitor, and should be a good choice for bipolar disorder II, depression, or social phobia.