Taking Quitipin, Licab XL for bipolar disorder. Can taking both tablet is advisable?

Question

Hello doctor,

My grandmother aged 80 years has had depression for the past 25 years, and she has been taking Lithium tablets since then. However, recently as advised by a psychiatrist, she started taking Qutipin 100 mg and stopped Licab XL. Now she is taking Licab XL along with Qutipin 100 mg, as she was exhibiting nonsensical talk and behavior. But now with Licab XL and Qutipin, she is exhibiting violent behavior like shouting at people for no reason and nonsensical talk. I need suggestions if taking both Qutipin and Licab XL is advised.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and understand your concerns. There is no harm in taking both Lithium (Licab XL) and Quetiapine (Quitipin), as they are commonly used treatments for bipolar depression and can be used at the same time. In fact, I have at least 15 to 20 patients with the same combination and do not find any difficulty in the form of increased aggression. I also like to inform you that your grandmother suffers from some other disorder, rather than pure depression as the current treatment is rarely used in pure cases of depression. It is possible that she suffers from bipolar disorder. Regarding further management, I do not think I am in a position to advise you on the next course of action. It will be appropriate to see her doctor again. In case you need a second opinion you may approach me. I will be glad to assist you.

Thank you.

Answer 2

Hi,

Welcome back to icliniq.com.

There have been various research studies, which indicate the relationship between weather and bipolar disorder. Most of the studies concluded that bipolar depression gets aggravated in winter while bipolar mania gets aggravated in summer. The worsening of symptoms from the last few weeks may be because of summer and it can not be denied. This seasonal variation in the severity of illness is contributed by melanin, which gets released excessively in winter and the level falls beyond a limit in summer, causing imbalance and symptoms in a vulnerable patient. Regarding admission to the hospital, I like to make it clear if there is any risk to her life, other's life, the home atmosphere, or poor quality of life for family members due to her aggression, then admission can be considered. If there is a danger to self and others, she definitely needs to be admitted. I hope this answers you further.

Thank you.