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Diagnosed with bipolar rapid cycling

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i have just been diagnosed with bipolar rapid cycling a week ago, i have been on over 10 different antidepressants since 1999 and am currecntly on moclobomide for depression which apparantly isnt good for rapid cycling i am also epileptic and take keppra 2000mg daily, i have been advised i will be changed over to sodium valporate (epilim) which i was on previously for epilepsy but came off it due to pregnancy, my cpn has told me to wait for an appointment with a neurologist for a change of meds but i am at point break now, my children have had to go to my mums 3 days ago and im currently on a bad low, i have an appointment with my epilepsy nurse tomorrow and am going to ask to change to epilim immediately as i cannot go on like this, how long roughly will it take for the epilim to start to work and will the changes increase the likelyhood of fits, i am currently down throughthe day then manic at night and cant sleep even with sleepers i am totally exhausted, please help

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replied August 25th, 2010
Epilepsy Answer A15621
Hi, welcome to the ehealth forum and I am glad to help you.
You seem concerned by rapid cycling bipolar disorder and the role of valproic acid.
Rapid cycling Bipolar disorder is the one in which four or more episodes of either depression or mania occur in a given year.Rapid cycling has a female preponderance, and occurs with greater frequency premenstrually, at the puerperium and at menopause. Tricyclic antidepressants and MAOIs(Moclobomide), both of which increase functional monoamines norepinephrine, dopamine and serotonin, are known to precipitate mania or rapid-cycling in an estimated 20-30% of affectively ill patients.
Valproic acid may be better than lithium for patients who experience rapid cycling when deciding upon appropriate mood stabilizer.Lamotigine is also a good choice for rapid cycling disorder with preponderance of depression. It takes 5-7 days for the levels of valproic acid to reach therapeutic range. The chances of fits is not increased because when the levels of valproic acid are building up in the body, keppra shall be slowly tapered. Most important, you should not attempt any self medication changes without consulting your neurologist and the same is not possible online.
Hope this addresses your query. Take care.
Note: This post is not to emphasise final diagnosis as the same cannot be made online and is aimed just to provide medical information and no treatment suggested above be taken without face to face consultation with health care professional.

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