Q:  Having Multiple Side Effects, Is This Normal?

I just got diagnosed with bipolar disorder last week, and was prescribed Topomax 25mg, Welbutrin XL 150mg and Zolfot 50mg along with my current medications for hypertension of Hyzaar and my Hypothyroidism of Synthroid 125mg.  I have been having side effects of dry mouth, no appetite, no concentration, numbness of my hands, arms, feet and legs,  inability to focus on specific tasks, and imbalance/dizziness.  Upon discussing this with my Nurse Practioner, she did not seem worried about these side effects.  I am.  Is this normal?  Will It go away?  Also will I be able to work though the side effects as they present themselves now.

Thanks!


Dear Ms. S' --

Well, that's interesting. There is a pretty big mismatch between the diagnosis and treatment approach, but this may reflect something that your nurse practitioner knows about you. If you get a really good result from this mix of medications, that's what really matters. If not, I think it would be reasonable to familiarize yourself with the standard treatment approach to bipolar disorder. Here are several of the "Treatment Guidelines "which have been published, or a more basic summary of treatment approaches from my point of view, or finally a list of all the medications considered as "mood stabilizers".   Some of the sensations you describe could be side effects of these medications; for example, the numbness in your hands and feet could be from Topamax. 

Dr. Phelps