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    Bipolar and anxiety
    Anon_81448 posted:
    I have bipolar 1 mixed. I am on a host of meds including lithium 1500mg,
    lamictal 300mg, Zoloft 200mg, zyprexa 20mg and was just taken off klonopin and put on Xanax 4 mg daily. Yet I still have some anxiety and ppanic attacks. I'm not sure what's going on especially being on this much

    Maybe Dr. Goldberg can lend his thoughts.
    Joseph F Goldberg, MD responded:
    Dear Anon,

    Generally speaking, antidepressants like Zoloft are considered unwise to take during a mixed episode since, when mania symptoms co-occur with a depression, antidepressants can worsen the mania symptoms without relieving the depression symptoms. It is possible that the continued use of an antidepressant in a mixed state could be driving agitation or anxiety, or rendering the other medicines less effective.

    Dr. G.
    jselleck replied to Joseph F Goldberg, MD's response:
    Anon, anti depressants could be causing your mixed states to begin with. I was diagnoised BP II 8 years ago and for the first three years did pretty good. Then my doc put me on a new anti depressant (the one Lilly makes that now they're cross prescribing for pain, can't think of the name.) and it actually made my mania symptoms worse. I haven't take an anti depressant for two years and I'm doing better than I have been in the 8 years since I was diagnoised. You might want to have your doc consider that it the Zoloft that's making your symptoms so bad. Best of luck.


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