Expert: Ivan Goldberg, M.D. - 7/23/2004

Question
I am a 30 year old female.  I was diagnosed with bipolar disorder about 6 years ago.  I was given Lithium and Depakote to control my episodes as my doctor said that I was classified as a rapid cycler.  However, the meds did not seem to help and they kept increasing the dosage to no avail.  About two years ago I lost my job and henceforth my insurance.  I am no longer taking the meds as I cannot afford doctors visits and presciptions.  My symptoms seem to be getting worse as time goes by.  My memory and temper are being severely affected.    Is there anything that I can do to stall or help these symptoms?  Please Help.

Answer
Hi . . .

People who have a rapidly cycling version of bipolar disorder generally do best when taking mood stabilizing medication. While lithium might help some, it usually is a more reliable mood stabilizer in people with NON-rapidly version.  The following are among the medications and combinations that are useful for controlling rapid cycling:

Tegretol
Tegretol + Depakote
High dose thyroid therapy
Trileptal
Trileptal + lithium
Lamictal + Lithium <-- often works when nothing else does

You should trey t find sa doctor who is fasmiliasr with these treatments.

Best regards . . .

Ivan
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