Psychotropic Medication & ENT Issues

[den76]

Hi Everybody,

So I'm a new member here, but I've read forums a few times before. I've long been interested in diving, especially since taking two trips to Puerto Rico in which I did a lot of snorkeling and wished I could start diving as well. The reason that I haven't just gone for it is health. I want to see a physician regarding diving with the following issues, but first I wanted to gather some opinions here. Thank you in advance for your insights & sorry for the length of this post.

1.) I have bipolar disorder. In past years this affected me through sleep problems, but in recent years my sleep (tonight is an exception lol) and other issues have been very stable. I've graduated with my bachelor's degree, married, and had a successful move to another state with my wife. In addition, I'm beginning a career in consulting and have strong relationships with family and friends. The reason I say all this is to show that I'm stable (assumptions & misconceptions of bipolar are sometimes astounding), and I believe I would be safe in the water regarding decision-making.

So my real concern is psychotropic medications I'm taking and diving. I'm taking Lithium Carbonate (very common & proven drug), and Lamictal (lamotrigine). If anyone has any information on diving & these drugs, I would really appreciate it.

2.) I was born with a deviated sceptum (divider between nostrils). I've had surgery to straighten it in order to improve breathing. The surgery has mostly worked great. I don't know why this would prevent me from diving safely, but I thought I would mention it since it's an ENT issue.

3.) When I was in high school, I was swimming with a friend and dove to about 12 feet when my eardrum ruptured. Fairly painful, as I'm sure some of you know lol. However, my ears have been fine before and after that instance. Again, not sure if this matters, but I'm trying to be thorough.

So I really hope I'm able to dive, and I know that doctors have the final say. As much as I want to dive, I want to do it the right way and be honest, especially since I know that lying on the forms can be dangerous for both yourself & fellow divers.

Thanks again.

 

[doctormike]

So I really hope I'm able to dive, and I know that doctors have the final say. As much as I want to dive, I want to do it the right way and be honest, especially since I know that lying on the forms can be dangerous for both yourself & fellow divers.

Thanks again.

Hi, Den...

I haven't the slightest idea about #1 (no clue what effects those meds would have on diving). But I can comment on the ENT issues.

#2 - almost no one has a completely straight nasal septum, but I can't think of any reason why just having a deviated septum or septal surgery would necessarily make it impossible to equalize your sinuses (the septum is not near the opening of the Eustachian tubes, which allow equalization of the nose). It is possible that you could still have some problems equalizing the sinuses, especially if you have other nasal problems. The only way to tell would be to try it, perhaps in a swimming pool, to see if you can swim to the bottom without a lot of pain in your face.

#3 - a perforated eardrum often heals by itself, or can be patched by surgery. In both cases, once the ear is completely healed, it usually functions normally. The question in this case would be whether or not you can effectively equalize your ears, which depends on the function of the Eustachian tube. An ENT doctor can give you some information about the status of your eardrum and any chronic ET issues, but again, the only way to know if it works would be to try it in a pool.

Once you are comfortable that you can equalize just by swimming underwater, you should also realize that you might have problems equalizing if and when you try scuba diving. You need to be prepared for this, and not to "push through" any pain you feel on descent. Some people have difficulty equalizing but can do it with training and slow descents, but obviously this is an important part of learning to dive.

If you tell me where you are writing from, I may be able to recommend an ENT doctor in your area for a checkout. Of course, you could see the person who did your septal surgery if you are still in that area.

Hope this helps!

Mike

 

[DocVikingo]

Hi den76,

And I can speak to #1. I'd recommend that you start by reading this --> Doc Vikingo's Depression & Diving

As regards lithium carbonate, it is most commonly prescribed for Manic Episodes & Bipolar I Disorder (aka "manic-depressive disorder"). Its prescription for depressive-spectrum disorders not involving a manic or hypomanic component, such as Major Depressive Disorder & Dysthymic Disorder, is much less common & open to some controversy.

Side effects of lithium of interest to the diver include stomach pain/discomfort; diarrhea; tremors, tics, twitching or muscle spasms; frequent urination; & thirst.

As regards lamotrigine, it & similar drugs of the anticonvulsant variety are not infrequently used in combination with other psychotropic meds to help regulate mood, particularly in cases of Bipolar I Disorder; lamotrigine was approved for such use by the FDA in ‘03. Side effects of lamotrigine of interest to the diver include drowsiness, blurred vision, double vision & clumsiness/unsteadiness/poor coordination.

It is prudent that the possible adverse effects of both of these drugs be minimal or well-controlled before considering scuba. Also, the diver on these meds must stay very hydrated

Regards,

DocVikingo

This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice to you or any other individual, and should not be construed as such.

 

[den76]

Thanks to both of you for your detailed and helpful responses. Sorry, I kind of forgot about my post on here. I'm not sure when I'll be able to pursue all of this, but this information will be helpful when I do.