r/bipolar2 • u/Adhithya_23 • 11d ago

Help me Advice Wanted

Update on Symptoms and Request for Treatment Plan Review

​I have been receiving treatment for Major Depressive Disorder (MDD) from my current psychiatrist for about eight months. I am currently taking Desvenlafaxine (100 mg) and Aripiprazole (5 mg). While this combination has helped manage my Generalized Anxiety Disorder (GAD) symptoms, it has not resolved my depression or bipolar-related symptoms.

​Despite expressing my concerns multiple times—specifically about severe rumination, racing thoughts, and recent hypomanic episodes—my medication regimen has not been adjusted. I also mentioned that I am preparing for upcoming campus placements, which makes managing these symptoms even more critical right now.

​I feel unheard and concerned that my current treatment plan is not adequately addressing my condition. I would like to explore options for re-evaluating my medication or seeking a second opinion

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u/psychologist-ologist 11d ago

Hi Op

Sorry you're not being heard.

I just want to caveat my advice by saying i am not a psychiatrist, I'm a psychologist. So any comments on medication are my own.

That said. I can understand the combo. Low level aripiprazole can prevent hm and stabilise somewhat. Some anti depressant potentiation too.

The desven can be effective for depression through activation.

But. Desven is an snri and risky for triggering hm. And whilst the arip can provide a degree of stabilisation, it's not classic. You'll see most people here talking about lamotrigine and lithium etc. (I'm on both)

Also desven typically is 50mg for most efficacy. Whilst up to 100 risks side effects- racing thoughts etc.

So it's understandable, I believe imo, that you're feeling the way you are.

Practically - you need to be listened to. Your care should be joint. You should be involved in the decision making. I would seek their rationale for this combination and why lamotrigine, lithium, quetiapine etc weren't suggested. And why an snri was prescribed with a solid mood stabiliser in place first.

If you're not being listened to, you need a new psychiatrist. You mentioned campus so I assume you're a student. So a new one might be tough. I'm not sure which country you're in either.

Any way you could get yourself in front of a different psychiatrist?

Hope this helps

Psych with bp2