Treating epilepsy and bipolar at the same time
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Treating epilepsy and bipolar at the same time

Q: My sister is diagnosed manic-depressive.She initially was placed on lithium with good results. Unfortunately, soon after, she was also diagnosed as epileptic and was placed on dilantin therapy. Is it true that she can no longer take her lithium due to a drug interaction and if so, are there drugs available that she could take to treat her manic-depression along with her dilantin?

Dear Aida --
Your question may imply that you've already figured out this is true?  Yes, it is possible that the same medications she need for "epilepsy" could treat her "manic-depressive".  Depending on the types of each that she has, they could actually be two manifestations of the same thing, as you also may have figured out (e.g. "temporal lobe epilepsy" and "bipolar II" or even some versions of "bipolar I").  These medications are called "anticonvulsants" as a group, and Dilantin is one of them; but 4 others are known to also treat bipolar disorder, where Dilantin does not.  These are: carbamazepine (Tegretol, Carbatrol, and probably the newer version called Trileptal); valproate (Depakote, Depakene); lamotrigine (Lamictal), although that's very tricky to use by itself and may not be sufficient as a mood stabilizer by itself; and topiramate (Topomax), which can be attractive because it causes weight loss where Depakote, which is among the first we usually turn to, causes weight gain -- but be careful there, because Topomax is new too, not clearly adequate by itself as a "mood stabilizer".

Dr. Phelps


Published November, 2000

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