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BipolarII - Weight and Mood Stabilizer (DEB)
I've been diagnosed with BPII, with mostly depression, but lots of anxiety
also. I feel mixed most of the time, with very few days of normal.... My
question is I've read that untreated BP only escalates and becomes more
severe if it goes untreated. My pdoc has informed me he thinks a mood stabilizer
would help calm the mood swings, and depression, now that we've figured
out the correct diagnosis. The first diagnosis was depression causing anxiety.
I knew all along the anxiety was not being treated with the SSRIs. Buspar
did nothing. Xanax did nothing. I've read your articles and realize you
go for the MSs. I am so afraid of gaining another 50 lbs. on an already
80 lbs too much, say on lithium. Depakote can cause blood problems. I am
currently taking Serzone that helped until recently....and I think it is
still but not with sedation, so klonopin was added (and I understand that
is used sometimes for BP swings.) Can you give me some advice on the weight
issue. I'm 216 and 5'1", just started the protein power plan, and am walking
one mile per day. Will you also address how you would treat a patient presenting
what I am? Thank you in advance for you answers. DEB
Dear Deb --
You are right, there are weight gain risks to lithium; and Depakote,
even more so. In my practice I use low doses and lower them immediately
if a person sees weight gain: there are now quite a few alternatives that
don't cause weight gain. However, I still think that lithium and
Depakote have the most obvious, well-established "track record", including
on what to watch out for. So generally for someone who looks bipolar
II, as you saw on my site, I start lithium or Depakote and add the other
one if a fully tolerable dose of the first, (i.e. low enough to avoid any
significant side effects at all, including weight and especially the appetite
increase from Depakote that is the harbinger of weight gain), isn't enough
to control symptoms. Later I taper off the antidepressant.
Check out topiramate. It's still pretty new. Dr. Ivan
has a
great
list of basic Q/A. It's the one you may have heard about that
lowers appetite: most people seem to lose a few pounds, but some can lose
as much as 5% of their weight (uh, that comes to 10+ lbs.for you).
Dr. Phelps
Published October, 2000
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