Prior to my diagnosis, I was placed on Zoloft for depression.  The Zoloft precipitated a crippling manic episode topped off with a 65 lb. weight loss in 1.5 month.  I am hesitant to go on any medication after the "Zoloft incident" and have opted to take 10 grams of fish oil & 1 T of lecithin daily until I find a physician/psychiatrist I trust to do blood work.  I am resistant right now to taking Lithium for a number of reasons including the fact that I had my gallbladder removed 3 years ago leaving my liver in a vulnerable state due to increased bile production.

 My questions are:  1) What is your opinion of the effectiveness of fish oil in the treatment of bipolar disorder?  2) Can you give me suggestions of tests I should make sure a physician requests when I have blood drawn?  3) Can you give me some guidelines to find a psychiatrist well-versed in bipolar disorder who won't just thrown me on medication?  3) Do you perform any clinical trials that I could become involved in because I am very impressed with your website (PsychEducation.com).
Thank you.


Dear B' -- 
1. Here's my little essay on Omega-3 fatty acids (fish oil).  Interest there hasn't gone away but I'm not aware of anything new.   There is a Stanley Foundation study ongoing at this time. 

2.  Testing: make sure there's a "TSH", thyroid stimulating hormone, test.  Otherwise a blood count and a 20 item chemistry panel are pretty routine.  The latter checks liver function as well as kidney function.  Note that unless I'm missing something, which is possible but would surprise me in this particular case, lithium is not really handled by the liver; it is excreted "as is" by the kidneys.  If you're going to worry about an organ system as far as lithium goes, it probably should be your kidneys not your liver. 

3. In my experience so far, there's no solidly researched well accepted treatment for bipolar cycling except medications.  You can review my essay on non-medication approaches in the "treatment details" section of my website  including psychotherapy, exercise, and social rhythm therapy including "dark therapy".  

3b) Clinical trials: thanks for the compliment.  No, I'm more an educator than a researcher, as temperamentally it seems I don't have the patience required to ask a question and wait a year or so for the answer!  

Dr. Phelps