Q:  Brain Tumors & BP Behavior

I have the severe symptoms of a pituratary tumor which I have and my dr. sent me to a psychiatrist who put me on trileptal which stopped me from vomiting everyday and not sleeping AT ALL at night.  I was a mess.  Depekote and other lithium drugs did not work. I have continued to follow up on the piturtary tumor but all blood tests are negative.  I am again at a dead end but my psychiratrist said once he got to know me that he doubted that I was bipolar and needed to keep looking for physilogical answers.  I am 41 with a family.  2 children. I have heard that certain brain tumors can make you behave like a bipolar person.  Do you know of anything like this?  Thank you.
At wits end.  
Shawn
 

Dear Shawn -- 
There are certainly reasons to think that pituitary abnormalities might look somewhat like bipolar disorder.  A couple of my patients have crystal clear stories of bipolar symptoms starting after some sort of thyroid change; and quite a few have symptoms that started after hysterectomy/ovarectomy (so you can imagine that if there were some pituitary change that effectively changed ovarian function suddenly, it would be similar).  You could look closely at your thyroid status, per some data on thyroid and bipolar disorder.  Otherwise I fear I have little to add to this complicated picture you describe.  Good luck with figuring it out 

A few other ideas that might have some bearing, for you to discuss with your doctor: I have had a few folks who responded only to Trileptal, who didn't look classically bipolar either.  Both of the folks I'm thinking of responded well to the thyroid approach I describe in that essay linked above. Then one seemed no longer to be fully responding. He's doing well on low-dose Seroquel, about 300 mg total across the day.  And another responded extremely well to verapamil, a rarely used blood pressure medication that has some evidence for mood stabilizing properties, and has worked extremely well for a few patients of mine (the lead researcher on that medication says you have to use the non-slow release version, the older generic version). So there are a few other things you could consider if things are really desperate. 

Dr. Phelps