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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by rjlockhart98 on August 17, 2005, at 18:49:39
Lithium?
I know alot of atyprical antipsychotic (nueroleptics) like Zyprexa, Abilify and Geodon are but thats with some other symptoms like schizophrenia.
I dont really have much more to say.
Matt
Posted by Declan on August 17, 2005, at 19:54:06
In reply to What is the most effective mood stablizer?, posted by rjlockhart98 on August 17, 2005, at 18:49:39
Hi Matt
Are you thinking that a mood stabilizer might be the thing for you?
Maybe you take one already? I forget.
Declan
Posted by fires on August 17, 2005, at 22:10:55
In reply to What is the most effective mood stablizer?, posted by rjlockhart98 on August 17, 2005, at 18:49:39
I recently had a one time consult with a big time pdoc and he strongly suggested that the top 3 mood stabilizers are: Lamictal, Lamictal, and Lamictal.
Posted by willyee on August 17, 2005, at 22:41:03
In reply to Re: What is the most effective mood stablizer? » rjlockhart98, posted by fires on August 17, 2005, at 22:10:55
Personaly,i think lamictal sucks,thats just my opionion of course.
Posted by med_empowered on August 18, 2005, at 5:08:55
In reply to Re: What is the most effective mood stablizer?, posted by willyee on August 17, 2005, at 22:41:03
The term "mood-stabilizer" is kind of vague, and the "most effective mood-stabilizer" varies depending on all kinds of factors, especially the kind of mood shifts you experience and other meds that are co-prescribed. If you need a strong anti-manic med, lithium and depakote are hard to beat...they can control mania, including manic psychosis. If you tend more towards hypomania and depression, they may be overkill. Lithium is best reserved for severe unipolar depression and "classical" bipolar I (euphoric mania, depression, good recovery between epsiodes, no rapid cycling or mixed-episodes). When mixed-episodes, rapid cycling, and psychosis and panic are part of the picture, depakote is preferred. Neuroleptics are also an option--the new ones can do both mania control and depression control, but I personally dont like them all that much. Tegretol and trileptal are both good for all kinds of conditions--schizoaffective, bipolar disorders with "odd" features and lots of panic, etc. I'd recommend Trileptal--less toxicity and no blood tests. Then there's lamictal...good for depression, not so good for (hypo)mania. And Keppra...if it works for you, it can control the mood swings and anxiety with minimal negative effects on cognition and very few drug-drug interactions. There is the possibility of drug-induced depression and it hasn't been studied enough to really be considered first-line. Benzos can also be good mood-stabilizers...Klonopin in particular is used for this effect, but higher-dose Ativan can be useful in cases of florid psychosis (bipolar or schizophrenic) for behavioral control and anxiety reduction. You can also try the old-school anti-convulsants...dilantin, that kind of thing. That should probably be a last-resort though. And Surmontil and Asendin, old tricyclic antidepressants, may have antipsychotic effects that would make them (potentially) useful for bipolar disorder.
Posted by Nickengland on August 18, 2005, at 7:05:07
In reply to What is the most effective mood stablizer?, posted by rjlockhart98 on August 17, 2005, at 18:49:39
Hello Matt,
I think to answer your question, perhaps out of all the mood stabilisers each one is maybe no more effective than the other. (Although some are considered first line etc.) I know that may sound slightly confusing, but it can be hard to generalise which would be best, as everyone reacts so differently to the same drug...even when these people are 'grouped' under the same illness eg mood stabiliser for bipolar disorder.
Each individual if different..and so its a case of taking into account the needs of the specific symtoms you want to treat with a mood stabiliser vs then which particular side effects you would most likely like to avoid...then its a case of narrowing down which mood stabilser would be most effective for your individual needs, if you know what I mean? lol
For example...i'm bipolar but really didnt respond well to the 'gold standard' lithium or valproate. But of course those 2 were tried first as they are first line. Its a massive pain in the *ss, because of the trial and error game.
Personally, I found lithium, valproate and lamotrigine terrible.
Next up I found Tegretol/carbamazepine okay-ish.
After that i found Trileptal/oxcarbazepine very good indeed. Its was truely a very effecive mood stabiliser for myself and with little side effects ~ lol but actually there was a rare side effect I did get which annoyed me hugely and that was it gave me swollen kidneys so i had to stop the stuff. Great shame I really did like it. (it had a very positive effect on my mood..but the pain in the kidneys was too bad)
I'm now on Topamax and although its not so well established so to speak..it appears that its doing the trick for me. (I also take Neurontin...but this is more for anxiety as it doesn't really act as a mood stabiliser for me at all) Topamax does do the trick though in that department.
Its weird as well because although I respond to what some may think as being pretty tricky drugs in the medical evidence based treatment, for bipolar disorder (I thought I was taking a huge risk using these to keep well) but from the results so far, i'm grateful for what I've achived from them.
My mum (whos bipolar too) has been on lithium for nearly 20's ~ the doctors thought i'd respond well to this as she did. I guess it goes to show its a case of finding what is the most effective for yourself...
Hope that helps..
Kind regardsNick
Ps I find taking supplements along side the medications greatly help too.
Posted by fires on August 18, 2005, at 13:01:29
In reply to Re: What is the most effective mood stablizer?, posted by willyee on August 17, 2005, at 22:41:03
> Personaly,i think lamictal sucks,thats just my opionion of course.
Why?
Posted by willyee on August 18, 2005, at 13:39:17
In reply to Re: What is the most effective mood stablizer? » willyee, posted by fires on August 18, 2005, at 13:01:29
> > Personaly,i think lamictal sucks,thats just my opionion of course.
>
> Why?
>
>
Well again this is just my opinion,but it made me flat,angry,and worsened my depression,i found no postives about it,no mood elevation or calming or anything,nuerotion as useless as people say it is worked better for me,i would shell a dime for lamctil but then again people seem to like it so everyone surly is different in the med regard.
Posted by fires on August 18, 2005, at 15:40:37
In reply to Re: What is the most effective mood stablizer?, posted by willyee on August 18, 2005, at 13:39:17
Neurontin gave me an irregular heartbeat. Everyone is different.
Posted by Phillipa on August 18, 2005, at 17:02:10
In reply to Re: What is the most effective mood stablizer? » willyee, posted by fires on August 18, 2005, at 15:40:37
Low dose trileptal didn't do a thing for me but I'm supposed to have depression/anxiety wonder why it was RX'd. Fondly, Phillipa
Posted by henryO on August 20, 2005, at 6:29:29
In reply to Re: What is the most effective mood stablizer? » fires, posted by Phillipa on August 18, 2005, at 17:02:10
I have found Lamictal to be a fantastic. 200mg daily. No rash. No weight gain, no night terrors, good libido, less depression. Better than all previous cocktails. But hey, my brother actually likes Wellbutrin. You have to find what works for you.
Posted by theo on August 20, 2005, at 22:49:48
In reply to Re: What is the most effective mood stablizer?, posted by henryO on August 20, 2005, at 6:29:29
> I have found Lamictal to be a fantastic. 200mg daily. No rash. No weight gain, no night terrors, good libido, less depression. Better than all previous cocktails. But hey, my brother actually likes Wellbutrin. You have to find what works for you.
Just curious, all things being great at 200mg, do you find some cognitive, short term memory issues with Lamictal?
Posted by henryO on August 21, 2005, at 1:28:34
In reply to Re: What is the most effective mood stablizer? » henryO, posted by theo on August 20, 2005, at 22:49:48
As in impairment? NO. Nothing either way. One weird thing- I know some people who take 400mg, but if I go up even to 225 then I can watch my self sleep. That is, I sleep so lightly that it is just about useless. I thought if 200 was good more would be better, but I can't take any nore than 200. I have friend who's main problem seems to be mainia though, and he thinks that Lamictal messed up his memory and thinking while he was on it. I forgot about that until you asked. I want that to be about something else.
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