Expert: Ivan Goldberg, M.D. - 8/9/2004

Question
I was recently diagnosed with BPI, after a severe manic episode in which I became psychotic for a full week, and was manic for almost 3, which was followed by a long debilitating depressing.  These are the first signs ever of this illness, so naturally, I am having a hard time coping.  Currently, I am taking 600 mg. of Trileptal.  I realize it is extremely difficult to generalize, but here goes my question.  Have you come across any people who only have a couple of episodes in their life, or who get by on only one medication?  what is the minimum amount of "maintenance" Trileptal a person should take? Does Trileptal work better to curb mania, or depression?  I am finally coming out of the dark, and the only thing I can think is that its only going to happen again, and turn my whole world upside down.  And the worst part is...   waiting, and never knowing when it will hit.  Thankyou for volunteering to answer these questions.  

Answer
Have you come across any people who only have a couple of episodes in their life, or who get by on only one medication?

          While the natural history of BP
          disorder is multiple episodes,
          there are people who have one
          episode, take medication, and
          never have another episode.


what is the minimum amount of "maintenance" Trileptal a person should take?

          I generally treat people with 600 mg
          of Trileptal twice a day.

Does Trileptal work better to curb mania, or depression?

          Mania.

I am finally coming out of the dark, and the only thing I can think is that its only going to happen again, and turn my whole world upside down. And the worst part is... waiting, and never knowing.

          What you can know is that by regularly
          taking an adequate dose of trileptal,
          you can minimize the possibility of
          another episode.

          Best regards . . .

          Ivan
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