Helped Over 500,000 patients with 98%+ satisfaction.

Connect & Get Personalized 1-to-1 Answers from Expert Doctors

DoctorSpring > Question Home

Deep depression after normal mood with MANIAC DEPRESSION. Treatment?

Resolved Question:

This is an inquiry about my brother around 58.
He ad been diagnosed with manic depression since he was very young.
The problem is that doctors can not manage to stabilize him.
He becomes well and after a couple of months or less he drops into a very deep depression. He looses weight, he is isolated in his room, he does not call or talk and he feels scared. Last time he stayed in this phase for two months !!
Now he is ok but we know he will drop to depression. He worries too.
He takes 1 Remeron 30 mg per day and
2 Depakine 500 mg per day
Plus some blood pressure pills.

Category: Psychiatrist

Ask Your Own Question

 22 Doctors Online

Thanks for using 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.

Kind regards
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.


Dr. Srikanth Reddy
Category: Sexologist
Doctor of Medicine (MD), Psychiatry Residency Program,2001 – 2012
M.B.B.S,Mahatma Gandhi Institute Of Medical Sciences, Sevagram

Certificate Course in sex Therapy and Counselling, Sexology and Counselling, A
Sexology,Medikon Sexual Sciences, Mumbai

Training in Advanced Neurology at a leading corporate hospital (CARE hospital) in Hyderabad

Child Psychiatry Training in National Institute of Mental Health and Neuro-Sciences, Bangalore

Sex Therapy and Counsellingat MEDIKON Sexual Sciences, Mumbai.
Dr. Srikanth Reddy and 4 other Medical Specialists are ready to help you

Users who read this, also read:

Make informed and better medical decisions.

Join the 500,000 people who found a smarter, quicker way to get Answers, Recommendations & Expert Opinions.

Expert Doctors at fingertips

Recommendation on next step. Second-opinion.Multi-specialty.

Save Time

Average time for answers: 6 hours.

Save Money

$35 for typical specialist consult vs. $120 for a local appointment.

Free Follow-ups

Clarify, ask further questions for free in private conversation.

100% Satisfaction

Money back guarantee for the 1st reply. MEDNET Quality Board.

Start My Consultation



Doctor Spring is a novel online Doctor consultation platform where you can get your medical questions answered by leading Doctors. Just Submit your question and rest assured that you will consult a Doctor easily. Once you submit the question, the Doctor from the concerned specialty will reply within hours. You can always ask more questions or add details with follow-up question options and make it an online doctor chat. You may use this service to consult a specialty or for getting medical second opinion. All paid services come with a MEDNET quality assurance and 100% money back guarantee.

DoctorSpring in news