Can BP Meds Cause Brain Damage?
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Q:  Can BP Meds Cause Brain Damage?

If a person was misdiagnosed as Bipolar and was being treated as if they were, is it possible that the medications they are taking could do permanent damage to their brain. That is if they were taking meds that changing the chemistry in their brain when nothing was wrong with the chemistry to start with.  Thank you for your time.

Dear Margaret -- 
That's a very good question.  So far I'm not aware of evidence of that part of the problem.  Some mood stabilizers can decrease bone density; several can cause metabolic changes that lead to weight gain; and there are other risks.  But "permanent damage to their brains" is not high on the list of risks.  Several of these medications can muddle your head pretty badly if you don't need them:  I often see Depakote make people feel fuzzy when the diagnosis seems, e.g. in retrospect, not accurate.  

Note that if we asked this question about antidepressants, there's a bit of evidence they can make you "permanently worse" if you do indeed have bipolar disorder:  it looks like at least in some people they can induce manic symptoms and potentially worsen the life course of the illness.  

So, it's quite appropriate to be dubious and skeptical and make sure that one's symptoms are severe enough to warrant taking some risks with medications before starting anything.  There's great evidence that psychotherapy can help depression of numerous kinds, and it doesn't carry these risks.  Time, money, maybe, and the relatively rare unscrupulous therapist, but not "permanent brain damage"!  When in doubt one can take the Mood Disorders Questionnaire.  If that comes up very strongly positive, it's an indication that bipolar disorder is relatively more likely, but even that is not a sure thing.  Learning about the common symptom patterns, and watching over time if necessary looking for such symptoms recurring, is better in my view than the MDQ test.  Good luck figuring this out. 

Dr. Phelps

Published December, 2002 


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