QUESTION:

Dear Dr. Heller,

My husband was diagnosed three times this year by three separate psychiatrists.  First as Post Traumatic Stress Disorder, then ADD & Depression, and finally as Bipolar II & (tested with mild) ADD.  He went for help with depression, anxiety and drug addiction.  Now he is being prescribed Zyprexa as a mood stabilizer, Paxil for depression and Adderall for ADD.

The problem is that my husband has more problems with addictive behaviors now than six months ago.  He has become increasingly disinterested about work, our relationship, family, life in general, and completely lustful when it comes to eating, drinking and smoking pot (Zyprexa?).  He takes his Zyprexa after work and checks out. I am unsure about his diagnosis and treatment.  He and the doctors believe medication is working for him.  The doctor told me that diagnosis are never simple and clear cut, that PTSD was a catch-all and my husband was not in anyway Borderline.  But this treatment has changed our life together, entirely for the worst.  It would not matter as much to me if it were just he and I, but we have five children, and I need a husband, friend and partner in this.

Please help me.

ANSWER:

I would be highly suspicious of the generalized anxiety disorder.  This genetic “disorder” has an elevated 5HT1 receptor – which gets stimulated by Paxil and Adderall, increasing his anxiety.  I often have success with this population by adding BuSpar and then Remeron for a while. It’s important to know all the diagnoses, and I urge you to look at the screening test I use for my patients.

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