Relationship of seizures and bipolar disorder
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Relationship of seizures and bipolar disorder - Cindy

Q: Dear Dr. Phelps, I am 42 years old and was last year diagnosed with recurring major depression. Last month my psychiatrist diagnosed me with Bipolar II. I am now taking neurontin 600mg. per day (he wanted to start me on a low dose) 45 mg of remeron and 75 mg of trazadone. I am also taking primedone for a sezuire disorder I've had since I was 16. I have wondered about the correlation of epilepsy and major depression and bipolar disorder. My seziures are cause from scar tissue in the left temporal lobe area caused from birth or early childhood. Do you know of any correlation? Thank you, Cindy

Dear Cindy --

There is some relationship between seizures and bipolar disorder all right, we just don't know what.  Consider that 4 out of the 6 medications that have clearly been shown to be "mood stabilizers", with lithium as the "gold standard" for that class, are antiseizure medications (Depakote, carbamazepine, lamotrigine, and topiramate; as opposed to lithium and Zyprexa -- that's all 6.  Some people would count verapamil, a calcium channel blocker blood pressure medication).  Many bipolar researchers refer to the "kindling" model of bipolar disorder, borrowed from epilepsy research as a model for the way seizures -- and bipolar disorder -- behave.  Bipolar disorders have appeared after head injuries, like seizures. And estrogen can make bipolar disorder worse (reference pending: discussed with a hormone/mood specialist at recent conference in San Diego), just as it can make seizure disorders worse.  I have basically come to think of some versions of bipolar disorder as "slow seizures" in the emotion centers of the brain.  See that proposed way of thinking in the Moods section of the Brain Anatomy portion of my website, including the PET scans there (not your scan, as your seizure focus is in your temporal lobe; you should look instead at the section on the hippocampus, nearly complete).

Dr. Phelps

Published September, 2000

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