Q:  Depression after Starting Trileptal?

I'm a 37 year male and recently diagnosed with BP II (daily to weekly cycling and mixed episodes, although not terribly severe). My doc has suggested Trileptal. I told her I was concerned about it making me terribly depressed (a concern I got from reading a few online posts). She told me I may indeed get terribly depressed and, if that does happen, that I should wait it out, even for a few months, because I will "emerge" more stable. Is this a reasonable line of thinking?

Thanks for such a great website. It has helped very much.

Thanks,
Mike 
 

Dear Mike -- 
For starters, I'd agree it's possible that on starting Trileptal you'll get depressed.  But that, in my experience, is very uncommon (that's the problem with reading others' posts, you see; though I think it's great to get a sense of what's possible, it can give a skewed sample regarding what's probable).  As for your doc's answer, well, I would have gone for something a bit more reassuring myself, but I can imagine the context and she might have been trying to be really straight-up with you or something.  

Because I would actually agree with her position.  It might well be that if you got a little depressed while you were clearly getting much more stable in terms of cycling, that it might be worth "waiting it out", and indeed that would be my recommendation at that point.  But not if you were "terribly depressed" during that time. There are just more ways to do this process of adding a mood stabilizer than that.  Have a look at the recent revision of the Treatment section of my website for a glimpse of options as I see them now.  Hope that helps -- 

Dr. Phelps
 

Published March, 2004