Q: Bipolar Disorder & Seizures
Would BiPolar cause intermittent seizures??? My friend seems to be
having seizures. Her doctor claims she is having seizures associated with
BiPolar.
I do not believe this to be true. She began these seizures when she began
taking zoloft. Is this the cause??? I do believe it is so. Could it be due to
high stress??? Please get back to me on this subject.
Tina
Dear Tina --
Let's start with a few pieces of information.
1. Zoloft, like other antidepressants,
"lowers seizure threshold". That means that someone who has a tendency towards
seizures, from a head injury for example, who does not have seizures routinely
but is "close", can be tipped into having regular seizures when given Zoloft.
Many medications do this.
2. "High stress" is of course rather
difficult to define, but to my knowledge has not been shown directly related to
their frequency of seizures. Think of that person who has a tendency towards
seizures, but is not having them routinely; can "high stress" type them into
having regular seizures? If "high stress" is associated with not sleeping well,
then the "sleep deprivation" could definitely increase the frequency of
seizures. That is a well-recognized connection. How about high stress but
normal sleep? Again, you can imagine how hard it is to separate these out on
her research basis.
3. It is bipolar disorder in itself
associated with having seizures? This one is a little more complicated. There
is certainly some sort of relationship between the two. However, could a person
who has a tendency toward having seizures, but his not having them routinely,
began having them regularly when symptoms of bipolar disorder suddenly appear?
To my knowledge, this has not been demonstrated (note that this is a different
question than simply asking whether or not people with bipolar disorder are more
likely to have seizures than those who do not have bipolar disorder).
As for your questions, I hope the above
information may prove useful, though it is not a specific "answer". Very
quickly, your questions become moot, as the focus must turn to treatment. Since
several medications used for bipolar disorder are "anticonvulsants", originally
developed for the treatment of seizures, it does not require figuring out
"bipolar versus seizures" -- one can treat both at the same time, not
necessarily knowing exactly which one was the basis for the seizures. Indeed,
one particular option, lamotrigine, has recognized antidepressant effects as
well as anti-seizure effects.
May I add, however, a caution: be careful
about how you proceed. Many doctors do not react well when struck over the head
with information. I even composed a little essay on
how to talk with
doctors, to address this. Good luck with the process.
Dr. Phelps
Published April, 2008
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