bipolar disorder, Dr. Paul Markovitz  Q. My step-daughter is currently taking lithium, Depakote, Risperdal for her bipolar disorder. She has experienced extreme weight gain over the past 9 years because of these medications. She is considered a rapid cycler I have heard about a medication due to be released in 2002 called aripiprazole. What would that medication replace exactly, the anti-psychotic only or does it help with the bipolar symptoms too?

As you may know her weight is an ongoing issue and she is desperate to try something that may help her to loose some of the excess. She is consistent about taking her medications and at her age of 24 has been good about refraining from alcohol and drugs.

  A. Actually, you do not have to wait. First, there is a medication out now called Geodon from Pfizer that works like Risperdal (same as aripiprazole), and it causes little to no weight gain or sedation. It is great when it works, but does not work for everybody (no medication ever does).

Second, there is a fine anticonvulsant out that works like Depakote called Topamax. If the Topamax works, it causes weight loss. Talk to her doctor about both of these options.