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Do you think that of all the DSM 4 diagnoises


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Do you think that of all the DSM 4 diagnoises, that bipolar disorder requires the most medications? People often take mood stablizers, antidepressents, anti pyscotics, sleeping pills, benzodiazines and I am sure that I am forgetting other things.

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I think it depends on the patient.

There are some bipolar patients who require no medication at all (though clearly this is incredibly rare) and some people with other disorders who are on 5+ medication cocktails to control their condition. There are different levels of severity for every diagnosis.

It also depends on how many conditions the person has - some people have multiple psych conditions, and that tends to require more meds.

To some extent, it can also depend on the preference of the patient and the psychiatrist.

It's incredibly difficult to make such a broad generalization, and to some extent, it isn't really even all that productive. Why do you ask?

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I'm sure there are a lot of people out there that do fine on monotherapy but we don't see them too often on a site like this. My pdoc said it's pretty common for BP II's to do fine on Lamictal by itself.

Yeah, this site is never really a fair sample - every time I start a new med, I have to tell myself that to get past all the horror stories we hear. People whose MI is relatively "easily" managed are unlikely to seek out this community at the same rate as those of us who are kicking around the med-go=round all the time

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i think that it's an unnecessary and improper generalization. many bipolars do fine on lithium alone. many schizophrenics require three or four medications to manage their illness. many DSM diagnoses, such as personality disorders or eating disorders generally do not require medication to treat them so that question is not even applicable to them.

sometimes people forget how huge the DSM is.

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I think it depends on the patient.

There are some bipolar patients who require no medication at all (though clearly this is incredibly rare) and some people with other disorders who are on 5+ medication cocktails to control their condition. There are different levels of severity for every diagnosis.

It also depends on how many conditions the person has - some people have multiple psych conditions, and that tends to require more meds.

To some extent, it can also depend on the preference of the patient and the psychiatrist.

It's incredibly difficult to make such a broad generalization, and to some extent, it isn't really even all that productive. Why do you ask?

I was just thinking about what condition generally reqire the most medications. I am one of those with a complicated combination of diagnosises.

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I'm sure there are a lot of people out there that do fine on monotherapy but we don't see them too often on a site like this. My pdoc said it's pretty common for BP II's to do fine on Lamictal by itself.

Yeah, this site is never really a fair sample - every time I start a new med, I have to tell myself that to get past all the horror stories we hear. People whose MI is relatively "easily" managed are unlikely to seek out this community at the same rate as those of us who are kicking around the med-go=round all the time

I often try to ignore what the side effects are for the first month. I usally look back and they have all passed. My pyschtriest always tells me before prescibing but I do not obsess about it.

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Guest Vapourware

You basically can't make any generalisations about how many medications a person would need based on their diagnosis. It varies from person to person. Some people may be fine on monotherapy, others may need multiple medication. Also, the number of medication required may vary even within a diagnosis.

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yes, I think most of us here would agree that this is simply an impossible generalization to make. Most commonly, I'd say the treatment resistant folks require the most meds, or combinations, and that can happen with any dx.

Anna

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I don't think it's possible to come to any sensible conclusions or suppositions with regard to which condition requires the highest level of medication. I'm BP1 with psychotic features, and am currently taking 4 separate meds. At times in the not too distant past I was taking 7 or 8 different meds everyday. I'm hoping that it won't happen, but there'll more than likely come a time when I need to be on an extended med regimen once again.

At the end of the day, there are so many factors at play here, such as whether the pdoc has particular prefences in the treatment s/he prescribes - eg does s/he have a "go to" med, or use lithium as a baseline drug, or believe in only introducing it to the med combo later on down the road. You may find pdocs who just throw more and more meds at patients, so that it gets to the stage where treatment is primarily about medicating side effects. Or a patient might be seeing a GP who may not have a sufficient grip on the nuances of treating psych patients, and so prescribes potentially inappropriate meds. You may see unusual combinations of meds in cases where patients are treatment resistant.... this can go on and on.

Of course, the pot of gold at the end of the rainbow is really finding a pdoc who medicates symptoms and doesn't get caught up on or let his/her patient get hung up on labels. In my own case I haven't quite found this pot of gold, and I do get hung up on labels, but I do at least have a pdoc who's prepared to, for example, prescribe an extremely high dose of seroquel, because that's just what works for me. The next member here might be able to get by on a lower dose of seroquel, but with higher doses of other meds that I can't tolerate. The actual quantities of meds shouldn't really mean anything. It should be about what the most appropriate meds are for any one person at any one time, and you can't make a value judgement on that.

[edit: what I'm really trying to say here is that you can't just look at the number of meds any of us here is taking and decide that BP is "the one" for most highly medicated, because we are each being treated by different medical professionals in different contexts.]

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I think BP does require the most in theory. If you look just at pharma med sites... Sz only needs one AP. MDD only one. OCD one. But bipolar med approvals are always like, " drug a is approved to treat manic episodes when combined with lith or valproate" etc. Or lamictal, "approved to lengthen time between episodes but not to treat episodes". It seems more complex, fundamentally. Even if things work ideally, we need a bunch to bring us down in a mania, which we ditch some of when we are depressed. It's a delicate balance it seems.

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I think BP does require the most in theory. If you look just at pharma med sites... Sz only needs one AP. MDD only one. OCD one. But bipolar med approvals are always like, " drug a is approved to treat manic episodes when combined with lith or valproate" etc. Or lamictal, "approved to lengthen time between episodes but not to treat episodes". It seems more complex, fundamentally. Even if things work ideally, we need a bunch to bring us down in a mania, which we ditch some of when we are depressed. It's a delicate balance it seems.

A lot of people do just fine on Lithium alone, or Depakote alone, or Lamictal alone, or an AP alone, etc. They are doing so fine that they don't seek out sites like this one, a place where those struggling with meds and illness come to hang out.

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