Q. I was diagnosed with major depressive disorder and co morbid panic disorder 2 years ago and was treated with paxil CR, clonazepam and trazadone. This was a perfect medication combination. I found out that I was pregnant and had to stop these medications for the first trimester. I was fine for those 3 months. At the start of the second trimester I was having horrible anxiety which led to depression and was sent to a different psychologist who re evaluated me and diagnosed me with Bipolar 2. I was on zoloft at the time of diagnosis and the zoloft made me agitataed and amplified my panic which led to more depression. I was taken off of the zoloft and put on seroquel and have been taking the seroquel for over a month now and It has not been good. I alternate from feeling fine to being more depressed and having more anxiety sometimes within the same day. I am currently seeking another psychiatrist due to the poor communication skills i observed with the last one and my obgyn/GP suggests that I am not bipolar 2 and should stop using the seroquel and begin using prozac and BuSpar. With all the changes I have been through I am scared to change meds but also terrified to remain on the seroquel, because it has truly brought out the worst in me. Is there a chance that I am not bipolar 2 and the seroquel has done me more harm than good or am i walking into trouble with the SSRI medications? Im confused and need help.

A. Seroquel is usually only prescribed for more severe cases of bipolar disorder, although not always. This drug does not seem to be working for you and I am not sure why. It could be because it’s just not the right drug for you or it could be because you are not bipolar. With such limited information it is difficult to know.

Why not tell your new prescribing doctor about the combination that worked for you in the past? Maybe you can go back to the paxil CR, clonazepam and trazadone trio of medications. It is important to make this information known to your new doctor.

Lastly, I want to caution you about using medication as your only form of treatment for depression and anxiety. If you only rely on the medication to treat these issues you risk never really addressing the true cause of the depression and anxiety. You might want to consider counseling in addition to medication. The combination of the two, medication and therapy, is often the best approach to treatment for most psychiatric disorders. Take care.