bipolar disorder, Dr. Paul Markovitz  Q. . I a 36 year old male, bipolar (mainly manic episodes since 18). Last episode was a severe depression in 1988. No episodes since then. Medications: Lentolith 800mg and 600mg Tegretol morning and night. I lead an active normal life. Recently saw a urologist who indicated that tegretol may be responsible for my very low sperm count. What information do you have to support this and if so, is there a replacement medication for tegretol in my case.

  A. I am not aware of Tegretol causing low sperm count, but it could be true. Ask your doctor for the reference on this for your own use. If it is true, there are a number of other anticonvulsants that work like Tegretol, but they may not work as well, not work at all, or even work better. These include Depakote, Lamictal, Neurontin, Topamax, and Gabatril. Talk it over with your treating doctors before doing anything rash. DO NOT stop any medications without reviewing the risks and benefits with your doctors.