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A 38-year-old female asked:

Bipolar 2 disorder. extreme anxiety bad sleep cycles. on wellbutrin, topamax, abilify, (aripiprazole) clozazepam , temazepam , zopliclone ? what now?

3 doctor answers10 doctors weighed in
Dr. Pamela Pappas
Psychiatry 43 years experience
Options: There are other options for your bipolar 2 condition. Wellbutrin won't help anxiety, and may stimulate it in some. Topomax is not a particularly robust mood stabilizer, but does work for some (apparently not you?). Seroquel may help this, anxiety, and your sleep issues. Latuda (lurasidone) is another option. Hoping you're working with a psychiatrist as you try these various medications -- psychotherapy too!
Dr. Donald Jacobson
A Verified Doctor commented
A US doctor answered Learn more
Seroquel is the only medication approved as mono therapy in bipolar 2 disorder so far.
Feb 4, 2014
Dr. Pamela Pappas
Psychiatry 43 years experience
Provided original answer
True, Dr. Jacobson.
Feb 4, 2014
Dr. Donald Jacobson
A Verified Doctoranswered
41 years experience
Complex situation: I have many patients with this very problem. I would generally stop the zopiclone first and then the temazepam and gradually lower the clonazepam. How? By adding in escalating doses of trazodone while gradually cutting back on the others. Sometimes i will add in a sedating anxiolytic antihistamine like hydroxyzine. Sometimes switch to more sedating neuroleptic like seroquel or saphris (asenapine). Good luck!
Dr. Andrew Berry
Clinical Psychology 15 years experience
Eval: Get a full psychiatric evaluation to determine what bothers you, and consider medication to take the edge off them symptoms. Next, get a referral to a reputable psychotherapist to discuss what your current emotional state and life experiences mean to YOU including being bipolar. Meds and therapy together are the most optimal approach, for the most part.

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Last updated May 7, 2016

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