Problems with Edema & Hypertension
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Q:  Problems with Edema & Hypertension

I am 30 years old and have been treated for bipolar for 3 years and depression for many years before that.  Over time I have gained quite a bit of weight (about 50 lbs).  I also have been on many, many meds.

Several months ago I started taking risperdal and developed edema and high blood pressure.  Everyone assumed it was from the risperdal and that was stopped.  When the edema and hypertension did not go away my doctor thought it was probably from the high dose remeron I was also taking.  After months of trying different doses, no remeron, a reintroduction of remeron, we found that remeron apparently was not helping although it wasn't the cause.  I changed to imipramine.  At that point I was placed on a BP med because it had reached sustained very high levels (160/95 the last day at the doctor--I had always had hypotension until this summer that that is even higher than for someone with an average norm).

Any ideas what has happened?  I am nervous about this because I am so young for this.  It's well controlled after a month on the meds, but another med does not thrill me.  I actually suspect that depakote is involved but it is the med that I most rely on for stability so I can't really mess with it to find out.  (My meds are provigil 200, depakote 2000 (level about 130), lithium 1200 (level 1.1), imipramine 100)

Dear Anon -- 
I usually try to figure out something useful to say, but in this case, I am sorry to say, I really can't comment. Sounds like you went through all the right steps to figure out where the edema (fluid accumulation) came from and nothing really looked like a clear culprit. Depakote doesn't do that, except in unusual cases (but there are some reported, as you'll see if you Google Depakote edema; probably already have?).  Good luck with your next steps. 

Dr. Phelps

Published January, 2006


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