Expert: Ivan Goldberg, M.D. - 5/2/2009

Question
I have not officially been diagnosed with bipolar , my psych appt is June 19th.  I am currently going through the mental Health center so I am seeing a therapist who is sure I am bipolar 2 , she suggests while waiting for June 19th I go see my reg dr. to start a bipolar med.


My appt with my reg Dr. is WED, and she hinted at a drug called SEROQUEL. I was wondering if you could tell me in your expertise and experience what might be a 1st choice, perhaps you could name a few choices you might use for a patient that i could show my Dr.

My symptoms were always depression for 10 months of the year but as of late the hpomania (never full mania) has been here and even mixed states I believe.

Last week it was irritability and crying.
I do not know very much about biploar , no one in my family has been diagnosed . There are so many drugs out there , how does a dr. decide which to try 1st?

I wouldn`t want one that causes weight gain , I lost 100 lbs over the past year with a gastric bypass.

So i really would appreciate your opinion on top drugs to start off with and I can print and show my dr.               Hey it doesn`t mean she`ll listen to you though, does it?

Thanks so much.

Answer
Hi . . .

Seroquel is an antipsychotic medication that has recently been used by some psychiatrists as a treatment for people with bipolar depression. While I have no doubt that it sometimes effectively relieves depression, its use has been associated with weight gain, diabetes and increased cholesterol levels. I usually reserve the use of Seroquel for people with psychotic symptoms.

When it comes to the treatment of people with bipolar depression I usually prescribe the combination of lithium and Lamictal. This combination often helps people with bipolar depression while inducing minimals side effects.

Best regards . . .

Ivan
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