Thanks for using DoctorSpring.com for posting your query.
I have gone through your question in detail and I can understand what you are going through.
YOu brother has a bipolar mood disorder and the Depakine he is on is a very good mood stabilizer. Mood stabilizers are the first line options in the treatment of bipolar mood disorder. Here are certain suggestions:
1) Get the Serum Valproate levels done. This will give us an ideal about the blood levels of Depakine. If they are less than 50 then the dosage wil have to be increased to three/four tablets per day.
2) Adding another mood stabilizer along with the existing Depakine. Eg. Lithium, Oxcarbazepine, Carbamazepine, quetiapine etc.
3) If there are such frequent switches the Rameron may be stopped as the use of antidepressant for bipolar depression is still controversial as it may make the illness more resistant and may start the rapid cycling. Mood stabilizers or a combination of mood stabilizers or if at all antidepressant is required, Bupropion is a a good option.
4) You may add cognitive behavioural therapy a specialized form of counseling with the help of a psychotherapist.
You may discuss these options with your psychiatrist.
Dr. Srikanth Reddy MD
Patient replied :
Thank you so much Doctor for your comprehensive answer. It is the first time I hear about combinations of stabilizers. Thank you.
We did have an analysis of Valporic acid last month and it was 79.5 µg/ml
Is Bupoprion a stabilizer ?
Can it be given with Depakine ?
Without antidepressant ?
Bupropion is not a mood stabilizer.
It is an antidepressant but safest to be used in bipolar mood disorder.
First line treatment is a mood stabilizer and depakine is one such. Bupropion is just an addition.