Q:  Options for Losing/Controlling Weight?

my wife is on a cocktail for her bpd-which of course is increasing her weight-we were chatting with her shrink today about some other options to help her lose or control the weight she has gained---- some suggestions were some that you make-ie supplementing thyroid with her cocktail-she is on lithium carbonate-lamictal--we were also using tobomax , but she got a terrible rash reaction -and both her primary and psychiatrix- topped the tobomax-this was done prior to lithium-could the topomax be added again or even substituted for the lamictal?????Ther is also anoth new anticonvulscent on the market that can cause anorexia-but out shrink was very cautious about adding this to her regime---we need help desperately---soon her weight gain will be a more pervasive problem than he bpd-not medicall of course-but emotionally---pleas suggest if you can---thanks


Dear Mr. L' --
(I've gotten behind on letters; pardon the brevity of this reply)
If you've seen my summary on weight gain and bipolar treatment, you've seen most of my tricks. The new anticonvulsant you mention is probably zonisamide. There is a recent "open trial" (no control group; usually makes the medication look better than it will look later) of this medication that was strongly positive (not published yet); and an older open trial from Japan.^{Kanba   However, there is also a case report of mania induced by zonisamide,Charles though causation in this illness is always hard to establish. That's the only other "trick" I know of, besides switching to things like lamotrigine and Trileptal that are not associated with weight gain.}

Dr. Phelps

Published October, 2003