Q:  Sexual Dysfunction w/Trileptal ?

I have dx of Bipolar-II and am currently on depakote(1500 mg),, ativan(1.5mg) , and neurontin(600-800mg.). I tried all the mood stabilizers in the fall of 2001 with  the exception of lithium. The best response was to tegretol which seemd to really smooth my moods out.  Unfortunately, it caused me to have ejacualatory dsyfunction which was dissappointing. My uncle, who is also BP takes tegretol with good results. My doctor now is considering adding zyprexa which I am afraid due to weight gain and other side effects. Would like to try trileptal. Literature suggests that 25-30% of the time you will have same effects as trilpetal and tegretol are similar. Do you think it is worth a shot or do you know of similar cases? Not asking you to be my clinician but do you think the sexual dysfunction would be likely in trileptal? Or do I just have to try it and see. Thank you if you are able to respond to this.



Hello Mr. B' -- 
I can perhaps help just a little by pointing out that I've not seen this problem on Trileptal -- but then, I haven't heard of it from my patients on Tegretol either.  Other patients mention such problems from other medications.  So, whatever you're dealing with, it's my impression that it's uncommon.  However, on the whole Trileptal does seem to cause substantially less side effects than Tegretol, so I think there is some reason to hope you'd be successful with it.  Good luck with that. 

Dr. Phelps