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Q: Son's Ativan "desire"
Hi Dr. Phelps,
My 20 y/o BP son is having terrible anxiety mostly in the evenings.. He is
on Depokote ER 500 am and 500 pm and 10 Zyprexa pm. Please help! I am
worried that he will get addicted to Ativan. He is asking for it everynight.
He is phobic about blood draws which makes it impossible to know what his
Depokote Levels are. The Doctor won't add Lithium because the doc cannot
monitor it. What anxiety medicine to you give (if any) to your patients?
Have you seen BP patients get addicted to Ativan? Any suggestions? Thanks,
Jayne
Dear Ms B' --
Sometimes (most of the time, in my opinion) in this context, the Ativan
"desire" serves as a marker for the continued presence of a
"manic" component, i.e. a high energy component. If
there's no antidepressant around, the only medication approach is to try to
get more mood stabilizer on board. Your son probably has gained a lot
of weight, with the Depakote and Zyprexa, so it would be scary, I'm
guessing, to add more of one or the other. That means looking at the
rest of the mood
stabilizer list (4th item on first list; opens as Word document); see
also, as you may already have done, the list of alternative mood stabilizers
as described on my site under "treatment details". Lithium
is a candidate, though also can cause weight gain. As I know you have
pursued, time for some input from someone who's comfortable managing complex
bipolar disorder -- e.g. who can tell your current doc' how to do the
lithium, or some alternative.
Dr. Phelps
Published July, 2001
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