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Dr. Vikas
Dr. Vikas, Doctor
Category: Medical
Satisfied Customers: 2208
Experience:  MBBS; MD
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hi, i have been diagnose with bipolar 12 years ago, only

Resolved Question:

hi,

i have been diagnose with bipolar 12 years ago, only valporic acid work
with me .but i gain more than 15 kilograms.
every time i try to find something to help lossing wight, i discover it can't
be combine with my medication.

i need any good supplement and something for sever headache not banal
or asprin pls.

kindest regards,
yara
Submitted: 1 year ago.
Category: Medical
Expert:  Dr. Vikas replied 1 year ago.

Dr. Vikas :

Hello Yara,

Dr. Vikas :

Is it possible for you to tell, which other mood stabilizer you have already tried till now?

Dr. Vikas :

It is very true that Sodium Valproate can cause significant weight gain as a side effect in patients taking it.

Dr. Vikas :

but there are some other mood stabilizers which do not cause weight gain and are also very effective in controlling Bipolar disorder

Dr. Vikas :

I will wait for your reply now so that we can discuss further.

Customer:

hi,

Customer:

i try tegretol , lamtical , zepraxia , zeldox , i end up with with sever side effects very high concentration of lactic acid or loosing the ability to control my tongue

Customer:

i met a proffeser this summer in germany and he suggested lithium , but i believe it is the same

Customer:

regard the wight issue and the the headache

Customer:

no

Dr. Vikas :

Thanks for your reply.

Dr. Vikas :

yes, you are very correct as Lithium can also cause significant weight gain. It also has a lot of other serious side effects

Dr. Vikas :

Now, it is also very true that sodium valproate can cause significant weight gain.

Dr. Vikas :

Unfortunately, there are no supplements (OTC / herbal) which can help you in loosing weight to the best of my knowledge.

Dr. Vikas :

The best strategy to control sodium induced weight gain is daily exercise and strict diet regime which probably you must have already tried.

Dr. Vikas :

So the other possible options for you in my view are as follows

Dr. Vikas :

1) switch over to another mood stabilizer which dose not cause weight gain. - A very good option is to discuss with your doctor about trying Aripiprazole (Abilify) which is a very effective mood stabilizer and does not cause weight gain. It is US FDA approved for treating Bipolar disorder.

Dr. Vikas :

2) Adding Topiramate to the current treatment regime. Topiramate is a voltage- sensitive sodium channel modulator which can be useful in controlling Valoproic adid induced weight gain. It can cause weight loss within 3 month of starting the treatment and can be given in combination with Valproic acid by your doctor.

Dr. Vikas :

3) There are some Anti-obesity medication or weight loss drugs that reduce or control weight like Orlistat but as seen in most cases once the medicine is stopped, patient again start gaining weight.

Dr. Vikas :

You can discuss with your doctor about these options, specially about switching over to Aripiprazole or adding Topiramate.

Dr. Vikas :

Now regarding headache, is it possible for you to tell me more about it.

Dr. Vikas :

Since when it is happening?

Dr. Vikas :

site?

Dr. Vikas :

one side or both side?

Dr. Vikas :

throbbing / pulsatile or felt like a chronic tight band on head?

Dr. Vikas :

total duration of headache, how many days in a month?

Dr. Vikas :

is it associated with nausea / vomiting / light or sound sensitivity?

Dr. Vikas :

worsen by movement / relieved by rest?

Dr. Vikas :

any family history of headache?

Customer:

it used to be three times a week, no it is every signle days

Customer:

no just headache

Customer:

resting can not relive me , only on specific type of panadol (the red one) can stop it

Customer:

yes there is a history in my family, but different type of headache my father only if he exposed to the sun

Customer:

my mother because she has some dental issue

Dr. Vikas :

how would you rate it on a scale of 1-10 (1 - mild, 10 - very severe)?

Dr. Vikas :

have you ever been diagnosed as a case of migraine?

Dr. Vikas :

are you there yara?

Customer:

no i am not

Dr. Vikas :

ok, thanks for your reply

Customer:

you most welcome doc

Dr. Vikas :

see, for headache of moderate to severe category aspirin is not very useful as it is a light analgesic.

Dr. Vikas :

so for how many days a month you are having headache?

Dr. Vikas :

is it for more than 15 days per month?

Customer:

in the last 3 months , almost every day

Dr. Vikas :

and you will label it is mild / moderate / severe?

Customer:

moderate to sever

Dr. Vikas :

any history of head injury / any medical illness / taking any other medicines?

Customer:

nothing except depakene

Dr. Vikas :

what about your eye sight?

Customer:

it is perfect

Dr. Vikas :

what is your age?

Customer:

42

Dr. Vikas :

and since when you are having headache?

Customer:

one year

Dr. Vikas :

under gone any investigation like CT scan?

Customer:

since last year

Customer:

no sir

Dr. Vikas :

have you consulted any doctor for your headache till yet?

Customer:

no body, i always believe it is a side effector depakine

Dr. Vikas :

do you think that the headache is increasing in severity and frequency gradually or not?

Customer:

yes

Dr. Vikas :

OK, see, headache is not a frequently reported side effect of Depakene as seen in clinical practice.

Dr. Vikas :

you are having headache since last one year, moderate to severe, which is increasing in severity and frequency so firstly you should discuss with your doctor about undergoing an investigation like CT scan or MRI to rule out any other possible cause of headache

Customer:

one of the top side effect mention even in internet is the headache almost 20%

Customer:

Ok

Dr. Vikas :

we usually recommend investigation in a patient above 40 years of age who is experiencing first headache after 40 years of age.

Dr. Vikas :

side effect usually do not persist for a year

Dr. Vikas :

and increase in severity or frequency

Customer:

i see

Dr. Vikas :

so discuss with your doctor about getting a CT scan or MRI done

Customer:

what about becoming more nervous

Dr. Vikas :

nervous about what?

Customer:

despite the fact i am very calm person

Dr. Vikas :

you mean, you become very anxious?

Dr. Vikas :

experience anxiety?

Customer:

not anxiety

Customer:

anger and nervous , i can't stand even my self

Dr. Vikas :

Aripiprazole can be useful for these symptoms also, the medicine I mentioned earlier

Dr. Vikas :

so your doctor can also consider adding a low dose of Aripiprazole, if he or she don

Dr. Vikas :

don't want to stop Valproic acid

Customer:

ok sir thank you very much

Dr. Vikas :

you are most welcome

Dr. Vikas :

do you have any other question to ask?

Customer:

no sir thanks again

Dr. Vikas :

:)

Dr. Vikas :

I really enjoyed working with you. Please feel free to request me again when you come back to ask another question. You can Bookmark my profile link in your browser. ( http://www.justanswer.com/mental-health/expert-drvikas/ )

Dr. Vikas :

If your doctor decide to go for a investigation, if possible please do let me know about the result and we can discuss again.

Dr. Vikas :

I really enjoyed working with you. Please feel free to request me again when you come back to ask another question. You can Bookmark my profile link in your browser. ( http://www.justanswer.com/mental-health/expert-drvikas/ )

Dr. Vikas :

If you do not require further assistance,please rate one of the positive ratings (3,4,5 / smiley faces) as this is the only way how we are compensated for our time and expertise.



Please take a moment to rate the answer.


Kind regards


Vikas

Dr. Vikas, Doctor
Category: Medical
Satisfied Customers: 2208
Experience: MBBS; MD
Dr. Vikas and 2 other Medical Specialists are ready to help you
Expert:  Dr. Vikas replied 1 year ago.
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