What effect does marijuana have on BP?

Q: My P-doctor found your site and thinks he may now have a diagnosis for
(BPD11). I have been medicated for thirty years for depression - after
considerable ECT in a state institution at the age of 20 for a mistaken
dianosis of schitzophrenia (I discovered years later that the episode
leading to that diagnosis was caused by someone putting a cap of LSD
into my

I would like to know what, if any, effect smoking cannabis (1x"joint" a
and the taking of quite large doses of Grandpa headache powders
asprin & caffeine) may have on the medications suggested - lithium and

Thank you

Dear George --
People seem to use marijuana as a mood stabilizer: it helps keep the "mood swings" from being so severe.  It also seems to have an antidepressant-like effect, decreasing the severity of negative mood phases (sometimes it looks to me like it does that by just dulling everything).  And, almost everyone I've treated seems to decide after a while that "mood stabilizers"  -- ie. the ones made by pharmaceutical companies -- work better overall.  That is, they "vote with their feet" and stop the marijuana in favor of the medications.  Of course, I could have lost track of the folks that "voted" the other way, but I don't think there are too many of those, if any at all.

For some people, one joint a day can interfere with getting life on track; e.g. motivated to solve persistent problems.  I'm not sure if it has any more specific negative effect in bipolar folks.  Some psychiatrists would probably be more adamant about the need to stop; I just tell people to figure it out for themselves -- stop for a while so you can see what things look like, then resume cautiously if you want to

As for Grandpa, the caffeine is another common "self-medication": people use caffeine in several forms to treat their profound fatigue that is associated (usually) with the "depressed" phases of bipolar disorder.  I'm not sure what 9Paractamol is; and aspirin probably doesn't affect things one way or the other, except that we usually recommend it not be used with Depakote as the latter can decrease blood platelets somewhat (the blood cell fragments that make blood clots) and aspirin interferes with clot formation a little, so the two of them can cause a problem neither one alone would cause.  On the other hand, if you take lithium we tell folks not to use non-steroidal anti-inflammatories like Motrin (ibuprofen); so sometimes it can seem like there's only Tylenol (acetominophen) left to treat headaches and stuff.

Dr. Phelps

Published March, 2001