Q. I have a 14 yr. old daughter who has been diagnosed with ADHD, LD, ODD, and possibly bi-polar. It is difficult to for the doctor to say for sure whether she is bi-polar because she has so many overlapping symptom: hyper, excessive talking, loud, impulsive, irritable, angry, tantrums if try to make her do something, etc. etc. We have been going to counselors, psychiatrists, etc. since she was 3. She is in a wonderful school in Atlanta for Children with her problems. At a young age (7-9) one psychiatrist prescribed every anti-depressant drug you can think of for her (lithium, Depakote, Effexor, Prozac, clonidene, and more) with no positive results, only bad side effects. I finally said ENOUGH and we took her off everything but Adderall for her ADHD. It helps with concentration, but she still has all the other symptoms listed above and all our counseling on how to discipline doesn't help a lot.

A new doctor has suggested I research the following three drugs that he thinks could possibly help her (Zyprexa-she's already overweight, Lamictal, and Topamax). She refuses to take a drug where she has to have blood drawn and believe me it's not worth it to go through that every month. Can you give me your opinion on the three drugs listed. Also in my search I came across Neurontin. What about it?

A. Topamax causes weight loss, and is touted as beneficial in bipolars. It seems to help many of our bipolar patients. It is the least repugnant of the drugs you describe from a potential side effect standpoint. It is also the medication with the least amount of clinical trials to support its use. Zyprexa is sedating and usually causes weight gain. Lamictal is mildly sedating and causes modest weight gain. It is pretty good for mood swings.