Q. I was hospitalized Aug.1999 after what the doctors termed a "psychotic break" after 4 weeks of treatment on LUVOX and 1 week of Celexa.( Orig. Dx was OCD). I eventually tapered off my Depakote and was on 25mg's of Seroquel till..... I just got out of UCLA hospital after I started drawing houses on my wrists and arms. I was experiencing severe anxiety and depression and dissociation. UCLA did a med adjust of Seroquel from 25mg to 200mg/day. I have severe "psychotic" episodes and bouts of depression. The Seroquel is helping with impulse a little, but I still have an empty, depressed feeling. Still want to harm myself. I have no desire to eat. The head of the psychiatric department suggested Topamax, only to tell me after he diagnosed me that Seroquel was the drug, and nothing else was needed except "ALOT" of therapy. Can this be right? I mentioned EFFEXOR, as well, and he said no. I want the depression to stop. Could he be right about Seroquel being the only drug? Maybe he's afraid of what an SSRI did to me?? What are your thoughts? My case has been a long road thus far, and it still looks bleak.....

A. I would continue with their treatment plan. I do not want to interfere with your care, and do not know enough about you to make a reasonable diagnosis. If things do not work on your current medication, then ask for a change. Topamax is good for mood swings, and causes weight loss, whereas the other antiepileptic agents used in psychiatry (Neurontin, Depakote, Lamictal, etc.) cause weight gain.