Q. I have been treated for Bipolar for several years and have been thru many medications. I am currently on Tegretol and Lithium that seems to be working other than a manic outbreak every six months or so. What I have noticed over the past few months is that my teeth are grinding and my toes want to curl all the time. It seemed to start out mild but it is to the point of really bothering me. Can you shed some light and hope that something will help stop this?

  A. I have not heard of either medication causing those symptoms, but I have not doubt that you have them whatever the cause. In our patients with tooth grinding, we have had some good success with Serzone at anywhere from 300-500 mg at bedtime. Discuss it with your doctor. There is virtually no chance of getting manic from Serzone based on its mode of action.