bipolar disorder, Dr. Paul Markovitz  Q. 2 years ago I went on PAXIL for depression. It helped me, but then I had uninterrupted sleep, wake early, drink lots of coffee etc. It eventually made me into a stupid, overly gregarious person. I was then told I have bipolar disorder and was put on Depakote. I have never, ever had a high in my life except on an antidepressant. I have always felt a heaviness about me and have always been a complete worry wrote and unable to concentrate or have follow through. I'm presently on LUVOX and 400 mg. Neurontin. I now shiver and sweat all day and have all over joint pain. Can somebody be bipolar even though a manic episode has never occurred except while on an antidepressant?

  A. There is data that antidepressants can induce mania. All of the data that is controlled, however, suggests that only the tricyclics do this. There is enough anecdotal data to suggest some people do get manic from serotonin reuptake inhibitors like Paxil, Prozac, Zoloft, Luvox, or Celexa. It is possible that antidepressants did uncover mania in your case. An alternative may be to try Serzone as 500 to 600 mg at bedtime. It sedates some so is good for sleep, improves sleep more than most antidepressants, and probably has the least chance of causing mania (if any chance at all). The only caveat is that Serzone is not very good if you are obsessive compulsive. If you are, you probably do not have bipolar disease anyhow.