I am diagnosed with bipolar with psychotic symptoms .i had depression first ,with psychosis. I was on valproate at first now I am on lithosun and zipsydon from last three years I have no mania or hypomania nor depression but I had very little psychosis .my question is that do ever can we stop all medicine of bipolar and if stop does it comes back again.
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Bipolar disorder typically has relapsing remmiting course and there is a risk of fresh episode of all medications are stopped abruptly. However, if in past you had multiple episodes of depression / mania / hypomania then, better to continue on maintenance dose of lithium for a min period of 5 years during which if you are totally symptom free, based on treating psychiatrist's discretion. Eventually medications can be stopped gradually. However, previous literature suggests that there is high risk of relapse once lithium is discontinued. So, my personal opinion is to continue on lithium for minimum of another 2-3 years so that overall remission period is 5 years (if you had multiple previous episodes) and taper off other meds gradually. But, these measures to be taken strictly under guidence of your treating psychiatrist and personally you should not alter any dose of meds before consultation. Â
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If you are maintaining well, discuss with your treating psychiatrist about titrating the dose dow. Epsodes can occur at any time. The mood stabiliser and antipsychotic help in postponing the same, reduce the severity if it occurs and hasten recovery. Good luck. Â
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There is possibility that your medicines can be stopped but you have more than 2 episodes of depression and mania & you are almost stable in less number of medications. So I would recommend you to trust your treating clinician and follow him/her for guidance. If he/she thinks you need to continue medications than please continue them.Â
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Maintainance treatment should continue, however decision to gradual discontinuation depends on number of episode, severity of episode, duration of symptom free period.Â
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Dear Lybrate user, bipolar disorder is an episodic illness with interepisodic period of less/ no symptoms, when patients can lead near normal life. One may taper doses and stop medications only if episodes are infrequent, less than 3 in lifetime and interepisodic normalsy has achieved for more than 1 year. But maintainance dose of mood stabilizers would help to prevent further episodes and also can reduce severity of further episodes. In your case, it is better to continue maintainance dose till you are completely asymptomatic for at least 2 years and then you can think of tapering down the dose, strictly with the advice of treating psychiatrist. Â
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Hi lybrate-user, if you r stable for more than 1-2 yrs, you could consider reducing and stopping, however if you had relapse and more then two episodes then you may need to continue medications for at least 5 yrs. It is important to have review regularly with your doctor and discuss prior coming off meds as doctor may need to review regularly while you r off meds. Â
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This is a troublesome question to a lot of people on medication. Bipolar 1 what you have now is a long-term recovery program. You should not rely on medication alone and must therefore combine it with some therapy too. This is the best approach. Comply with all the medical prescriptions, and work in tandem with a counselor for a long time and learn coping skills and techniques to handle the daily challenges you will face. There are certain adaptations that will suit you during the elation phase (even if you don't have those symptoms) and there are certain behaviors that are required during the depressed phases. In the meantime, you can do certain things that will give you benefits anyway. Emotional therapy will alleviate a lot of the problems faced in this condition because it is a mood disorder. You need to particularly look at your levels of anger both for its reasonableness and to express it in an appropriate manner. I suspect that much of this anger may have origins in early childhood that you may never be aware of it now. Talk to your parents and explore that angle. This information will help the counselor too. Also, you will need to check whether there is any genetic factor involved. You must exercise regularly, eat healthily and sleep normally too. If your motivation and cooperation are good much can be achieved. You must have a time-structured schedule filled with interesting and reasonable activities and it must be monitored for compliance and delivery. The reason I say this is that many times you will be inclined to have grandiose notions and confidently believe that you can do without the medication. This will set you back many months in the treatment and delay and sabotage the recovery: forewarned you are forearmed. If this combination of medication with therapy is maintained for at least three years without any episodes or breakdowns, it is possible to taper the medication in consonance with the doctor. Â
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