John had a psychiatrist appointment on Monday morning. He goes about once every three months, and I pretty much always go with him.
We like his psychiatrist, Dr. Wilson, a lot. The first psychiatrist John saw after coming out of the hospital misdiagnosed him, immediately started taking him off Risperdal (substituting Pristiq), and pretty much ignored me when I tried to tell her that John was psychotic again.
After John’s second hospitalization, Dr. Wilson met with the two of us for an hour, listened to me when I told him about John’s symptoms (because he was delusional, John didn’t perceive a lot of manic behavior as symptomatic), and diagnosed John with bipolar disorder. Over time, he tapered John off the Risperdal, relying solely on the mood stabilizer Depakote. When John continued to experience residual depression months after his psychotic break, Dr. Wilson gradually switched him from Depakote onto Lamictal, which has been working great for about 15 months now. No depression. No trouble concentrating. No manic swings.
On Monday, Dr. Wilson confirmed that John’s been very stable. He cautioned us, though, that sometimes when people are stable on the meds, they begin to question whether they really need them. He explained that due to the severely disruptive nature of any mood episodes (John was on disability for 3 months, and he was lucky that he didn’t lose his job), he doesn’t recommend playing with a medication that’s working unless a patient has been stable for ten years.
John didn’t have a problem with this recommendation. With the Lamictal, he doesn’t experience any side effects, so taking a pill every night is no big deal. Now, if he were still on the Risperdal, which left him lethargic and messed with his ability to focus and do complex math (he’s an engineer), I think it would be a different story. Fortunately for John, Risperdal isn’t part of the equation right now.
Read the rest of this entry »