PCOS & Topomax
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Q:  PCOS & Topomax

Dear Dr. Phelps,

I have been diagnosed with Bipolar and Dysthymia for 10 years now. I have taken a wide variety of medications. Depakote, Lamicatal, Respiridal, Celexa, Trazadone, Wellbutrin, etc. etc. you name it, I've probably taken it. My medicine cabinet is a pill junkies heaven. You know, the whole trial and error thing. But I was never on anything for very long, until about 5 years ago when we found that a combination of Topamax and Prozac was the best we were going to get for evening out my moods.

Then just recently I was diagnosed with Polycystic Ovarian Syndrome. The doctors told me that it was a hereditary condition and it was until I was reading an article on bipolar in children and adolecents did I come to find that there may be a connection between PCOS and Depakote. Now, my question for you is, may there also  be a relation between PCOS and Topamax? Because I was not on Depakote for very long, but I have been on Topamax for over 5 years, and I was reading about the side effects of Topamax and they match the side effects of the Polycystic Ovarianx Sydrome, which ironically I have all of.

Please, Doctor, get back to be as soon as possible, because this is eating away at my heart, soul and mind. Have the pills I thought were helping to stablize my life, shredding my insides as well as my dreams of ever becoming a  mother?

Dear Ms. S' -- 
PCOS can be associated with bipolar disorder itself, is the thinking these days (that has really complicated trying to figure out whether Depakote really causes PCOS or not).  There is a tiny bit of evidence that the treatment for PCOS might actually help mood control, as you may have seen summarized in my
essay about PCOS which leads to the page about metabolic syndrome and mood; which seems very relevant to your situation.  

Be careful, of course, as metformin, the PCOS treatment, can be so effective you can get pregnant where before you could not; so if you're taking medications like Topomax which are presumed unsafe until we have more reason to think they might be all right, you have to have some means of preventing pregnancy when you start the metformin.  

Good luck getting this all figured out. 

Dr. Phelps

Published June, 2004


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