Should I Always Have BP Dx
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Q:  Should I Always Have BP Dx 

I was diagnosed w/postpartum depression 10 years ago and was given Prozac.I then was diagnosed with BiPolar and had 2 episodes while still taking Prozac.It has been 5 years since i have taken Prozac,and have had no mania.I do take a low dose of Depakote,Paxil,and Buspar as anxiety and panic have been my major symptoms.I currently believe that the mania was induced by the Prozac.Does that mean I should/will always carry the diagnosis of BiPolar disorder,or should I discuss my thoughts with my new psychiatrist?I would like to get off the Depakote as it has caused major weight gain and interferes with my concentration.I am a nursing student.

Dear Ms. P' -- 
Definitely worth discussing.  We have very little data to guide us here on advising you.  Paxil can cause weight gain too, so it might not be the Depakote, although surely Depakote is a candidate for causing that problem.  Depakote at most effective doses does not interfere with concentration in most of my patients, so I wonder about that.  Could at least as likely, in my opinion, be the Paxil.  In any case, stopping one at a time seems wise, yes?  and slowly?  and maybe keep the Depakote until last?  (that would be my recommendation, as long as weight is no longer going up).  Good luck with your nursing training; looks like you'll have plenty of opportunities when you're done!

Dr. Phelps

Published December, 2001


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