Hello doctor, I am a 34 year old male weighing 81 kg. I had my first manic episode 16 years back, for which I was put under psychiatric care for two months. Then again after a couple of years, I had some depressive symptoms for which I was prescribed Escitalopram 20 mg once daily and some ayurvedic herbs for two years. After that again six years ago, I had a second manic episode for which I was hospitalized for two months and diagnosed with a schizophrenic disorder, and was given Lithium carbonate 500 mg twice daily and Amisulpride 50 mg before bedtime. Due to some thyroid elevation problem, Magnesium valproate 200 mg twice daily was prescribed instead of Lithium carbonate. But from the past three months, I am experiencing loss of appetite, lethargy, weight loss, abdominal cramp, and acidity. My psychiatrist put me on Bupropion 150 mg once daily, which caused tremors and sweating. So he changed it into Clonazepam, which is causing acute indigestion. Please suggest some medicines as am losing a lot of weight and feeling lethargic.
Hi. It seems that you have bipolar affective disorder and currently in the depression phase. According to me, your thyroid disturbances should have been treated while taking Lithium, rather than discontinuing it, as Lithium is the best medicine for your condition. Loss of appetite is due to Magnesium valproate tablets as it causes liver dysfunction. I suggest you get a liver function test done. I would advise you try increasing Magnesium valproate to minimum 500 mg, twice daily and also increase Amisulpride in low dose. Consult your specialist doctor, discuss with him or her and increase the dosage with their consent. Before starting Bupropion, you should have tried minimum effective doses of current medication. I would like to see your recent thyroid profile for better understanding. Revert with more information to a psychiatrist online -->