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Bipolar Disorder/Combination of Valproate + sertraline for bipolar disorder

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Expert: - 9/11/2009


Question
Sir,

Good day!

I suffer from bipolar disorder. My psychiatrist has been treating me with a combination of Tab. Sodium valproate 2000 mg at night [SR Tab.] & Tab. Sertraline 100 mg in morning, For last 4 years.

Could this combination cause worsening of my disease in long term, like rapid cycling/ mixed states/ treatment-refractory disease over years?

Thanks & Regards,
Naveen.

Answer
Hi . . .

In people with bipolar disorder sertraline can cause:

rapid cyccling;
mixed states;
a switch to mania or hypomania.

When treating a patient with bipolar disorder who is depressed I most often treat them with a combination of lithium and Lamictal (lamotrigine).

Best regards . . .

Ivan
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Bipolar Disorder

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Ivan Goldberg, M.D.

Expertise

I am a psychiatrist/psychopharmacologist with many years of expereince in treating individuals with depressions, manic-depression (Bipolar Disorder), other mood disorders,. I am especially interested in the psychopharmacologic treatment of individuals with so called "treatment-resistant" syndromes.

Experience

I have been on the staff of the National Institute of Mental Health, Columbia's College of Physicians and Surgeons, and the Columbia-Presbyterian Medical Center. I am currently in full-time private practice in New York City.

A.B. Johns Hopkins University
M.D. N.Y.U. College of Medicine

I am the creator of Depression Central:http://www.psycom.net/depression.central.html

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