bipolar mania, or what?

Question

My wife is bi-polar. Here are ALL her meds. She is on 600 mg lithium 2x daily, luvox 200mg at night, klonopin 1 mg at night, depakote 500 mg 2x daily for myoclonus(has CP), and efffexor xr 150 mg in morning. Her current problems are she is up all night unitl 4-5 am and then sleeps all morning and part of afternoon. She eats once a day..usually cereal. Drinks up to 18 juices a day. Says she loves me and wantsme, but has lesbian cybersex at night even after we have sex, and a lesbian lover beyond that. She has psychotic detachements of staring, mumbling and talking to her dead mother that lasts for 10 -20 minutes. After which she has no memory of it. She has had her labs and her lithium is 0.7 and depakote is also at ok levels. Dr says her meds are working, and I say they are not because of her symptoms. The dr says that my wife is doing this on purpose. I think the dr is all wrong and she needs something. We live in Hawaii and there are not any dr taking new patiants.

Answer 1

It sounds like she is in the throes of a manic episode. Hypersexuality, insomnia, psychosis, and poor judgement (her "diet") are all present. Her doctor is a fool; the woman needs hospitalization!
It is possible to change doctors upon hospital admission if her psychiatrist does not have privileges at the particular hospital she's admitted to. Take her to the emergency room, if you can.
In the mean time, it may help to take antidepressants in the AM. Try more Klonopin at night. Encourage her to develop a consistent bedtime and medication regimen. I take my antidepressants and mood stabilizer at breakfast, and the antipsychotics at night. I usually have no problems sleeping, but if I do, I take 2mg Klonopin.

Answer 2

I'm surprised she's not bouncing off the walls!!!! no wonder she can't sleep!!! You really need to have her see another Dr. It sounds like she is being over medicated. and the combination of them together is causing severe side effects from them. The medications she is on can cause the symptoms that she is having. All the meds she is taking have insomnia as a common side affect. and dry mouth. I doubt very much she is doing it on purpose. Take her to the hospital if you can't see a Dr. she needs to be re evaluated and possibly admitted to the hospital until they can stabilize her. The MEDS aren't working.

Answer 3

It sounds like part of her problem is that she is still having seizures. When was the last time they did an EEG? Maybe the Depakote isn't working anymore. Seizure meds often become ineffective overtime. If the Dr. isn't listening to you its time to get a new one. How can he think he knows your wife better than you?

Answer 4

Bipolar disorders are characterized by mania and depression, which usually alternate. Exact cause is unknown, but heredity, changes in the level of brain neurotransmitters, and psychosocial factors may be involved. Diagnosis is based on history. Treatment consists of drugs, sometimes with psychotherapy.
Lithium is used to treat and prevent episodes of mania (frenzied, abnormally excited mood) in people with bipolar disorder (manic depressive disorder; a disease that causes episodes of depression, episodes of mania, and other abnormal moods). Lithium is in a class of medications called antimanic agents. It works by decreasing abnormal activity in the brain.
Clonazepam (klonopin) is used to control seizures. It is also used to relieve anxiety.
Valproic acid is used alone or with other medications to treat certain types of seizures. Valproic acid is also used to treat mania (episodes of frenzied, abnormally excited mood) in people with bipolar disorder (manic-depressive disorder; a disease that causes episodes of depression, episodes of mania, and other abnormal moods). It is also used to prevent migraine headaches, but not to relieve headaches that have already begun. Valproic acid is in a class of medications called anticonvulsants. It works by increasing the amount of a certain natural substance in the brain.
Venlafaxine is used to treat depression. Venlafaxine extended-release (long-acting) capsules are also used to treat generalized anxiety disorder (excessive worrying that is difficult to control), social anxiety disorder (extreme fear of interacting with others or performing in front of others that interferes with normal life), and panic disorder (sudden, unexpected attacks of extreme fear and worry about these attacks). Venlafaxine is in a class of medications called selective serotonin and norepinephrine reuptake inhibitors (SNRIs). It works by increasing the amounts of serotonin and norepinephrine, natural substances in the brain that help maintain mental balance.
Please see the web pages for more details on Bipolar disorder, Lithium, Clonazepam (generic name) Klonopin (brand name) Valproic acid (generic name) Depakote (brand name) and Venlafaxine (generic name) Effexor (brand name)