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Dr. Phil, MD
Dr. Phil, MD, Board Certified Physician
Category: Medical
Satisfied Customers: 58344
Experience:  GP in the United States
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My husband had an accute episode of manic depression over 24

Customer Question

My husband had an accute episode of manic depression over 24 years ago and it took almost 9 months for him to recover from it. Initially he was on very high doses of medication which had very severe side effects and rendered him unable to function. After some months I was recommended to take him to a private psychiatrist who was fabulous and he made a very quick recovery under his care and 2 separate sessions of ECT treatment first time 6 doses and second time 3 doses. 9 in all.
He was completely normal with the help of Lithium for almost 24 years but unfortunately last year he messed up with the lithium and had a relapse. Unfortunately that doctor is no longer with us as he passed away some years ago.
Since the relapse he has been hospitalized twice, first time for 4 weeks and secondly for 5 weeks. He was last discharged from the hospital in Jan of this year and has been on a cocktail of medication since.
The medication he is on is as follows
Lithium 1200mg nightly (same dosages for some years now)
Prozac 20mg and Olanzapine 15mg daily.
He is having very bad side effects from this and so far the doctors have only reduced the Olanzapine from 20mg to 15mg and are refusing to reduce further.
I am extremely frustrated with this situation as I can see that until they start reducing the medication we will never know how he is actually doing and during this time he is experiencing a lot of the awful side affects that are to be expected with this medication. I really need a second opinion.
Submitted: 1 year ago.
Category: Medical
Expert:  DrRussMD replied 1 year ago.
HelloFirst: you need to take him in person to another psychiatrist.We do not replace a hands on opinion here.Second: I would present this to his doctors, as you have, but also from this standpoint.What is their responsibility as to the side effects?Prozac and lithium together can cause serotonin syndrome, which can be life threatening.Are they content with this.If he responded well to lithium, and if he is not depressed, there is no need for prozac, and that can be the first drug tapered.Please click a positive. OK, so you might have more questions or want to give me more information: Please use reply to expert if you have further questions. When you are ready, please click a positive rating [hopefully excellent—that’s how we are paid, per rating]. If you forgot something, come back. I am here daily.
Expert:  Dr. Phil, MD replied 1 year ago.
I would like to provide another opinionYou didn't specify what he was hospitalized for so we don't know what meds to adjustAlso, was his lithium level checked?if so,what was it?was he hospitalized for mania?