Q. I've had depression for since I was 9. I've been on almost every antidepressant and antipsychotics. Currently, I am on 60mg Celexa, 10mg Pamelor and 25mg of Seroquel (when I feel anxious). My diagnosis has always been major depression with suicide attempts. One therapist suggested that I had BPD. I know I do now. My question is---can this combination of drugs cause mania? My therapist believes that I am now hypomanic. But, I like it. This combination seems to be working for me, and I don't want to become depressed again. One more question---can this combination speed up my heart? I am now seeing a Doctor for a fast heartbeat and heart palpitations.

  A. Pamelor can cause hypomania and increased heart rate in some, but not all folks. Talk to your doctor about alternatives to this if it is an issue. There are a number of trials that show tricyclic antidepressants, of which Pamelor is one, can cause rapid cycling and/or mania.