instruction: hello doctor to start I have bipolar disorder type I social and generalized anxiety disorders previously I failed to sari medications such as zoloft prozac lexapro I tried lithium depakote and carbamazepine with no success however currently I take 50 my of lamictal and 75 my venlafaxine this treatment kind fits me because I have lessened anxiety levels for sure it is my first week on venlafaxine or and the second week on lamictal in a few days we will increase lamictal to 100 my and after two weeks to 200 my I also take tranxene 10 my if needed as well as olanzapine 10 my how come I responded to venlafaxine or so fast when I did not respond to sari I lack energy and motivation should I increase venlafaxine or to 150 if so will it have more effects on my anxiety and depressive episode
output: hello it is good to know that you are responding to your current medication venlafaxine or is an sari serotonin norepinephrine reuptake inhibitors which can be helpful when saris selective serotonin reuptake inhibitors have not been effective I note that you have been tried on different saris and mood stabilizers before with no success it is positive that you have found venlafaxine or 75 my to lessen your anxiety I will advise to continue with the titration regimen suggested by your prescribing doctor do not rush to increase the dose to 150 my as titration needs to be carefully considered after weighing up your response and any side effects as you are also on increasing dose of lamictal it makes sense to do the titration gradually have regular follow up with your prescribing doctor as you are on multiple medications and need to monitor along with medication I hope you are also having therapy counseling to manage your health I hope this helps