Posted by 10derheart on February 8, 2012, at 17:54:39
I have a close family member who has just been rx'd Saphris as his first tx for bipolar I. I am wondering what you all think of this. I am a bit surprised they would begin with an AAP.
He is a 30-year-old man who has been depressed with symptoms of apathy, lethargy, anhedonia, weight gain, excessive sleeping and eating, hopelessness, etc. for about one year. Before that he was acutely manic for weeks at a time, followed by brief (2-3 weeks tops) of depression and/or "normal" mood. In his manias he experienced much grandiose thinking, paranoia, irritability, overspending, some delusions and more things I've probably forgotten. The thing is, I thought maybe Saphris would be more for something acute, used first anyway. He has been formally diagnosed with bipolar by four providers: two MA social workers who are psychotherapists, one psychologist and the psychiatric nurse practitioner who is now prescribing.
Okay, so actually she rx'd Lamictal several weeks ago which he did not fill because he is 100% broke and the pharmacy needed $45.00. He knows I would have paid for at least the first month, but he did not/would not ask. So when time rolled around for the next appt., he emerges with this Saphris rx, supposedly because she needs to "stabilize his mood before prescribing anything for bipolar," and because it's "cheaper than the lamotrigine you can't afford." Yeah....huh?
I have to explain this perosn does not pay attention and his memory is also poor ever since this depression set in, so he is a bad reporter of anything that goes on in appointments. Not really his fault as I think the cognition stuff in part of the disease. So maybe it's not quite what she said. I get not giving one of the ADs alone, but I don't get that Saphris makes more sense than Lamictal. He has has zero manic symptoms since December 2010.
What does anyone think? What other info could I give here? We have prayed and waited for him to take a med - any med - because all his life he's been anti-med and refused and his manic episodes have caused great pain and turmoil in the family. But this drug seems so odd. She wants him on 5 mg 2x a day, but he is so severely exhausted and a little nauseated he is only taking 5mg once a day now. He says he can't stand these SEs for more than 2-3 more days.
I also worry as he has not seen a regular MD for over 10 years. He is about 30 pounds overweight and has never had his BP or BS tested, or anything else for that matter. I've been urging him to see a doc and have his testosterone checked for months and months now (he has almost zero interest in sex). Does anyone think think it's a little reckless to rx powerful meds without doing any baseline medical tests on a person? I do.
I know this is disjointed. I am in a hurry and anxious about a test I have to take today, so sorry for my less than flowing writing.
Thanks anyone....-- 10der
MDD (presently in complete remission); ADD-Inattentive type; mild anxiety (not fomally dx'd)
Meds: Strattera 80 mg q day
poster:10derheart
thread:1009736
URL: http://www.dr-bob.org/babble/20120202/msgs/1009736.html