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Treating epilepsy and bipolar at the same time
Q: My sister is diagnosed manic-depressive.She initially was placed
on lithium with good results. Unfortunately, soon after, she was also diagnosed
as epileptic and was placed on dilantin therapy. Is it true that she can
no longer take her lithium due to a drug interaction and if so, are there
drugs available that she could take to treat her manic-depression along
with her dilantin?
Dear Aida --
Your question may imply that you've already figured out this is true?
Yes, it is possible that the same medications she need for "epilepsy" could
treat her "manic-depressive". Depending on the types of each that
she has, they could actually be two manifestations of the same thing, as
you also may have figured out (e.g. "temporal lobe epilepsy" and "bipolar
II" or even some versions of "bipolar I"). These medications are
called "anticonvulsants" as a group, and Dilantin is one of them; but 4
others are known to also treat bipolar disorder, where Dilantin does not.
These are: carbamazepine (Tegretol, Carbatrol, and probably the newer version
called Trileptal); valproate (Depakote, Depakene); lamotrigine (Lamictal),
although that's very tricky to use by itself and may not be sufficient
as a mood stabilizer by itself; and topiramate (Topomax), which can be
attractive because it causes weight loss where Depakote, which is among
the first we usually turn to, causes weight gain -- but be careful there,
because Topomax is new too, not clearly adequate by itself as a "mood stabilizer".
Dr. Phelps
Published November, 2000
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