Lance Steinberg

Currently, manic depression is treated both by the actual type of manic depression bipolar one, bipolar two, etc. as well as the current phase a person may be in. The phase can be one of depression, one of mania, or a combination called mixed, as well as if there are symptoms of not being in touch with reality psychosis. Also, the physician must take into account if the symptoms are acute, or chronic. To make things even more complicated, there are certain medication‘s that are FDA approved for certain age groups. And, if there are medical issues, certain medicines can be very problematic.
Your question is very very important. As you can see, there’s no one easy absolute answer that is appropriate for everybody.
I would suggest talking to your psychiatrist about your specific symptoms in addition to making sure all the medical issues you may have are known to the psychiatrist, and then get the psychiatrist to categorize the type of bipolar disorder you have, the phase you are in, and explain all of the options that may be helpful. I would schedule an extra long session so that the psychiatrist can explain in detail the safety and efficacy of all the various medication‘s that may be beneficial. Lots and lots of hope!
Lance Steinberg MD, Inc.
Assistant Clinical Professor
UCLA (Geffen) NPI
1(818)224-3540

Both are very good medicines. The first thing I always do is make sure there is no medical condition that might be causing anxiety or depression or the lump in your throat. Once an internist or neurologist has examined you and cleared you have another medical condition, and if it is medically safe to be on Zoloft., Many people would consider doing two things: one would be cognitive behavioral therapy that would include stress reduction techniques, and then slowly increase the Zoloft to potentially 175 mg for several weeks, and potentially 200 mg after that. Should be cognitive behavioral therapy and higher dose of Zoloft not be effective, I would likely switch to another medication category with a different mechanism of action. This might include Cymbalta, Effexor, Pristiq, Trintellix, And so forth. Frequently anxiety and depression coexist in certain people. It’s better to mostly focus on your symptoms that are bothersome to you then trying to nail down a label. Hope this is helpful. All the best!

Lance Steinberg MD, Inc.
Assistant Clinical Professor
UCLA (Geffen) NPI
1(818)224-3540

Your medicine contains the chemical olanzapine. And common side effects include both insomnia and constipation. If the medication is doing an excellent job for you, would discuss with your physician various approaches to minimize insomnia and constipation. Best wishes!

Lance Steinberg MD, Inc.
Assistant Clinical Professor
UCLA (Geffen) NPI
1(818)224-3540

The most important thing is to be supportive. Be there to hold your sibling and listen to the emotional pain and difficulties. Love unconditionally. At the same time, direct your sibling to get professional help. Would strongly encourage directing your sibling to a psychiatrist. Even offer to take your sibling to meet with a psychiatrist. The expert and enabled you to be maxim Lee supportive in a very positive way while guiding your sibling to effective interventions that will be based upon the acuity and intensity of the depression and help your sibling be safe and recover maximally.

Lance Steinberg MD, Inc.
Assistant Clinical Professor
UCLA (Geffen) NPI
1(818)224-3540

This is an extraordinarily common issue. It is usually neurologically based, frequently genetic, but some people may have had an infection at one time that triggered obsessive compulsive disorder. The best way to help somebody with this difficulty would be to find out whether they would want some specific help. Would strongly encourage your friend to seek professional advice and treatment. Your friend could then run by the professional what type of help would be most advantageous from a friend. Generally, one should avoid enabling certain inappropriate behaviors, and merely being supportive of one’s friend seeking help and guidance from an expert.

Lance Steinberg MD, Inc.
Assistant Clinical Professor
UCLA (Geffen) NPI
1(818)224-3540

The manufacturer of sertraline does state that dizziness is a common side effect; however, many people have different terminology for dizziness compared to vertigo. Two really differentiate the two would be done best buy a neurologist. So, if you get dizzy from this medicine, you definitely are not alone. Some of the common side effects go away with time and some depend upon the amount of medication one takes. If the medicine has been especially helpful for you, then it certainly would be worth talking about this with a neurologist. There are many many medication‘s that are good for dizziness and vertigo if that is an option that you choose to take. It is always wise to make sure there is nothing else medically going on that might cause the symptoms. To be prudent, would consult with a neurologist. Wishing you only the best, Lance

Lance Steinberg MD, Inc.
Assistant Clinical Professor
UCLA (Geffen) NPI
1(818)224-3540

Atenolol is a theory complex molecule. The best approach would seem to be an extraordinarily through analysis by an outstanding university affiliated academic Dermatologist. This would really help understanding the skin and all of its layers and particularly point to interventions.

Lance Steinberg MD, Inc.
Assistant Clinical Professor
UCLA (Geffen) NPI
1(818)224-3540

Wow! Or should I say bow wow! Lol! Truthfully, I don’t have the answer. I do know that many medications can have anti-histamine effects, including some serotonin medicines. However, I must plead ignorance. I am not specifically familiar with SSRIs in regard to dog allergies per se. I frequently combine certain antihistamines with SSRIs to potentially augment sedation, and appetite and even use them to decrease serotonin syndrome. You actually ask a very very brilliant question. The ultimate expert would likely be your personal allergy immunology physician that is helping you with dog allergies. I hope this helps you.

Sounds very very scary! I would strongly encourage you to list all of the details of your experience during these episodes including all of your thoughts, emotions, and physical feelings. But also try to understand if there are any particular triggers and anything that might help you feel better. If you talk directly with a psychiatrist about your personal experiences especially with a detailed sequence of events, the psychiatrist can help your understanding about what may be at the root of the issue, how to medically evaluate it, and ultimately come up with some very effective and efficient approaches to making things much much better! They getting a consultation with a psychiatrist, you are truly investing in your quality of life and definitely improving your future! Lots and lots and lots of hope! Get a consultation today so you can immediately get relief and have an even greater opportunity to enjoy your future sym symptom-free!

Lance Steinberg MD, Inc.
Assistant Clinical Professor
UCLA (Geffen) NPI
1(818)224-3540

This is an excellent question. In general, if you ever want to take over the counter medication‘s, it’s always an excellent idea to talk with your pharmacist. Your pharmacist generally has access to a a very sophisticated computer program that will tell you if there are any serious drug interactions. Make sure you give the pharmacist all the medications,supplements and vitamins that you are taking I use a computer app called epocrates. It’s excellent, but not always as thorough as The pharmacist sophisticated computer program. According to my app, epocrates , Benadryl seems to be OK with Seroquel and valproic acid. There are actually others as well. Generally, Benadryl is also tolerated quite well. So, before actually purchasing some Benadryl, this is pure Benadryl without any other components, consult with your pharmacist. Have your pharmacist run Benadryl with the Seroquel and valproic acid to make sure it goes well. Every once in a while some new findings come to the awareness of pharmacists and physicians so I always advise asking the pharmacist that very day you’re about to purchase the medication in case any new data has arisen. Hope this is helpful, and may you never ever get another cold !

Lance Steinberg MD, Inc.
Assistant Clinical Professor
UCLA (Geffen) NPI
1(818)224-3540

I would actually go by the clinical judgment of your psychiatrist, or a neurologist. There are so many different approaches to aggression. Would certainly see if any of your diagnoses that you mentioned they specifically be contributing to the aggressive episodes. This would be very very helpful in getting the most appropriate and prudent medication. It also would help to fill up a Hierarchy of potential medication interventions. An EEG would be most appropriate if you are strongly considering a seizure disorder or abnormal wave forms. I would strongly encourage you to talk with your psychiatrist about your specific issues so that the multitude of medications that could benefit you could be looked at, in addition to anti-epilepsy medication‘s.

Lance Steinberg MD, Inc.
Assistant Clinical Professor
UCLA (Geffen) NPI
1(818)224-3540

I’m so very sorry to hear this happened. The first thing most physicians consider our medical causes that need to be ruled out. That would include a sudden increase in thyroid hormone, a sudden increase in certain chemicals that act like adrenaline, and so forth. So having a very very thorough medical exam including blood and EKG as well as thorough examination of your nervous system on a basic physical examination.
From a medication perspective, sometimes serotonin medicines actually do “poop out“. So sometimes an increase is necessary. Sometimes it may have been a poorly manufactured generic. Sometimes the body really needs a new and structurally different medication. While all these medical issues are being evaluated, would definitely strongly consider cognitive behavioral therapy with exposure response prevention. Really really really helps!

Lance Steinberg MD, Inc.
Assistant Clinical Professor
UCLA (Geffen) NPI
1(818)224-3540

I am so sorry to hear you’re having akathisia. It can truly be so very very bothersome. Let me preface the following ideas by stating that the medicine Soltus is not used in the United States for various reasons. However, akathisia issues are worldwide. The first thing many of us do is try beta blockers like propranolol. Depending on your cardiac status, and physiology, and sensitivity to this medication. The several sources that I have consulted use from 30 mg to 80 mg per day, and one source was 60 mg to 120 mg per day. Obviously consult with your physician. The use of a benzodiazepine is very common. It’s one of the first augmentation strategies given in conjunction with a beta blocker. One of the more common benzodiazepines used here in the United States is diazepam. Various doses have been used. Once one goes beyond beta blockers with benzodiazepine augmentation, the scientific evidence for alternative interventions is not as solid. Some of the medication‘s that are used include the medicine clonidine instead of a beta blocker. Other alternatives include Cyproheptadine,mianserin, Mirtazapine, and medicines in the class of anti-muscarinic‘s like benztropine. Always follow your doctor‘s advice. Wishing you only the best.

Lance Steinberg MD, Inc.
Assistant Clinical Professor
UCLA (Geffen) NPI
1(818)224-3540

The best way to support bipolar children is to be both empathic and understanding while also giving them confidence and strength to understand their mood issues, and how to navigate and modulate their mood, and potentially regulate their mood. Do this in conjunction with a primary therapist and psychopharmacologist. It’s very important to understand that every human being has mood issues, and part of our growth as people include how to be aware of our moods, track them, and learn how to deal with them in a positive and constructive manner. I’m a big believer in using a mood calendar as a tracking device. The national Institute of mental health at one time had a mood chart that would help an individual be aware of their moods, and notice mood trends. This would be beneficial for all of us. There are certain trends that may indicate a need for increased talk therapy and possibly change in medication. It’s important to be concrete about the parameters. Would actually discuss with the primary therapist and psychopharmacologist as to when it is important to contact them, and never to hesitate to ask for help and direction. Medication is often a component in helping people with mood issues, as is stress reduction techniques.

Lance Steinberg MD, Inc.
Assistant Clinical Professor
UCLA (Geffen) NPI
1(818)224-3540

Please understand that Risperdal has its own set of side effects. So Alexa is an excellent medication and the important issue is that it has worked in a specific way, apparently very beneficially, and that might steer Wein into going back to it. Importantly, Celexa does have some cardiac issues. Prozac may cause weight loss. Zoloft because we can. All of these an anti-depressant medication‘s, the serotonin reuptake inhibitors, when added to Respert all, can increase the likelihood of serotonin syndrome. Very important to discuss all of this with your Health care provider.

Lance Steinberg MD, Inc.
Assistant Clinical Professor
UCLA (Geffen) NPI
1(818)224-3540

This is a very astute question. It sounds like she has symptoms that include possible hallucinations and paranoia. These things can be for many many reasons. Your best off telling your mom to talk to a doctor that is either a neurologist or a psychiatrist. Would not jump to conclusions on her diagnosis, although schizophrenia is possible. Sometimes stress, medication, forms of depression and anxiety, can cause symptoms like these. Would suggest seeing if your mom is comfortable talking with you about what the doctor said, or allowing you to talk directly to the doctor. Your question is brilliant. Your mother is lucky to have you . Ultimately, she should be carefully evaluated by a neurologist or psychiatrist. It’s OK to not have all the answers to her questions or worries. It’s OK to respond with you need to talk to a specialist. And, it’s OK for you to just be supportive and caring . Try to get an opportunity to talk with the doctor that she saw for further guidance in case of difficulties arising and for you to get some personal help with a psychiatrist or mental health professional. This could also be an opportunity for you to talk with your own regular doctor for help in guidance. Best wishes!

Lance Steinberg MD, Inc.
Assistant Clinical Professor
UCLA (Geffen) NPI
1(818)224-3540

Depakote is a medicine used for many things, including bipolar disorder, as well as seizure disorder. By taking this medication, it does not create epilepsy in one’s brain. It is important to use it carefully because if one abruptly stops the medication, the brains reaction to the sudden withdrawal of the medication can be significant irritability at that moment along with a seizure at that moment. Hope that clarifies things for you. Best wishes!

Lance Steinberg MD, Inc.
Assistant Clinical Professor
UCLA (Geffen) NPI
1(818)224-3540

It sounds like you suffer from various forms of OCD. sometimes certain thoughts or images or sounds or smells or any stimulus can trigger your mind to reflexively respond with images, thoughts, feelings, etc. these reflexive responses are usually very upsetting and can sometimes linger on in the form of ruminations and further anxiousness. OCD is generally a familial disorder that runs in families and is believed to be a manifestation of a complicated neurologic system of a persons brain. On one hand it causes anxiety, until certain compulsions or behaviors are done, or certain thoughts take place. By ultimately doing certain thoughts or actions, the stress and tension and anxiety get better; however, OCD can make an individual feel imprisoned.
OCD is so very common, most of us consider it a common variation of being quite human! The amazing thing is that a form of therapy is unbelievably successful in helping with both the unwanted thoughts as well as behaviors. Please search for a specialist in cognitive behavioral therapy with exposure response prevention and mindfulness. This treatment is highly highly highly helpful! Sometimes medicine may also be used in addition. Find an expert in this form of therapy, commit to it, and you will hold the key to your freedom! Also, it’s good to remember that medication‘s like selective serotonin reuptake inhibitors may dramatically alleviate a lot of OCD symptoms. Lots and lots of hope! Feel free to contact the international OCD foundation. Good luck!

Lance Steinberg MD, Inc.
Assistant Clinical Professor
UCLA (Geffen) NPI
1(818)224-3540