Dear Dr. SerVaas: Please tell me more about lamotrigine and bipolar disorder.

Marian Walden
Inkster, North Dakota

Dear Dr. SerVaas: In high school, I was told I had a nervous breakdown. Later I was told I was manic-depressive and now, at age 77, I am bipolar.

I feel I have led a very full life--two years of college, 53 years of marriage, and five wonderful sons. I am on lithium and Paxil.

N.W.
Muncie, Indiana

Dear Readers: Your encouraging letter gives hope to people and their families coping with the potentially devastating mood disorder. Tragically, one out of five untreated manic-depressives commits suicide. And statistics suggest that 70 percent of those who commit suicide have manic-depression, or bipolar disease.

The good news is that early diagnosis and treatment can save lives.

"Once you learn what you are living with, you are less prone to commit suicide," said Dr. Kay Redfield Jamison, a researcher, writer, and professor of psychiatry at Johns Hopkins who knows firsthand about dealing with the roller-coaster emotions that manic-depressives endure. "Since manic-depression is genetic, you really want kids to know that there is a certain risk. If they start getting depressed, they know that they've got an illness that can be treated; they can go to a doctor and get good care."

Some anti-depression drugs can make bipolars worse. Therefore, it is extremely important for the psychiatrist or primary care provider to recognize bipolar symptoms. Because it is a genetic disorder, a thorough psychiatric family history is essential.

As mentioned in the Sept./Oct. '03 "Medical Mailbox," research shows that lamotrigine (brand name Lamictal) is safe and effective in preventing mood swings in people with rapid-cycling bipolar disorder. The prescription drug is manufactured by GlaxoSmithKline and approved to help manage epilepsy.

In a study of 349 patients, data show that lamotrigine is particularly effective for preventing depressive episodes.

Because "most persons with bipolar have much more time ill with depressive symptoms than manic symptoms, these results have the potential to substantially improve care of persons with this illness," said co-investigator Dr. Charles Bowden of the University of Texas Health Science Center at San Antonio.