Expert: Ivan Goldberg, M.D. - 9/20/2007

Question
Dear Doctor Goldberg;
         I am a 48 year old female diagnosed and treated for bipolar disorder since the age of 16. I am currently and have been taking 900 mg. of Lithium and for about 1 year, Lamictal. Every month about the same time I still get severe depression that lasts up to two weeks sometimes. I also get severe migraine headaches that seem to be concentrated in my right eye. I had a complete blood teat done about 1.5 years ago and everything, including my hormone levels were normal as I did have a partial hysterectomy, leaving my ovaries when I was 32 years old. I currently go to a mental health clinic psychiatrist/ doctor and a councilor. I have tried many, about 8, different anti depressants but none seem to work.For almost 10 years it is now to the point that the depression is very, very, bad that I cannot stand to live like this, but I am not suicidal by any means. What I am trying to resolve is: 1] Is there any better remedy for my depression and 2] No one seems to know why I get these migraine headaches. I am very religious, do not smoke or drink alcohol. Please, can you help!! Thank you so much for your time.

Answer
Hi . . .

People with bipolar disorder are MUCH more likely to have migraine headaches than those without bipolar disorder.  Often the key to controlling both disorder is a combination of anticonvulsants that have both mood stabilizing and antimigraine activity. I have no idea if it is right for you, but I often have success with the combination of Depakote and Topamax.

Best regards . . .
Ivan
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