Q. Any advice on going off low dosage bipolar medications?

Answered by Dr. Ashok Kumar Choudhary and medically reviewed by iCliniq medical review team.

 

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Hello doctor,

I am a 56 year old male. I was diagnosed bi-polar, as part of an attempt to save a failing marriage and took a low dose of Carbamazepine (200 mg) and Lamotrigine (100 mg) for about six years and during that time felt fine. During another relationship that I should have ended much sooner, the dosage was increased. I followed up with counseling, which was very helpful and lowered the dosage down to what my psychiatrist said was not really clinically high enough to do any good (100 mg and 25 mg), but he felt I should have something in my system in case I needed it and could build up to a higher dose quicker. I continued at this low dosage for several years and recently sought a second opinion and another psychiatrist said I should try going off the medication since the dosage was so low and my lab results showed very low levels of the Carbamazepine. I am willing to give it a try, what do you think? I workout often, have a stable job, a stable relationship, family in the area, etc.


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Dr. Ashok Kumar Choudhary
M.B.B.S., M.D. PSYCHIATRY
Andrology, Geriatrics, Psychiatry, Psychologist/ Counsellor, Psychotherapy, Sexology

Hello,

Welcome to icliniq.com.

I read your query and understand your concerns. As you can see both of your psychiatrists agree that the dose is too low to have any efficacy and I agree with same as 100 mg of Carbamazepine and 25 mg of Lamotrigine have no value in the treatment of bipolar disorder.

However, I feel prevention is better than cure and I will prefer to take on one medication at a time and that too slowly. I mean four weeks for a single medication and eight weeks total to stop both the medications.

To conclude I like to state that I will prefer to support the opinion of the second psychiatrist for the following reasons.

  1. The dose is too low to be considered efficient.
  2. I do not think situational disturbance can be diagnosed as bipolar disorder. I may be wrong on this point as I have limited information.
  3. All the life parameters are in stable mode and withdrawing medication can be attempted.

I hope this helps you.

For more information consult a psychiatrist online --> https://www.icliniq.com/ask-a-doctor-online/psychiatrist

 
 
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