![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by Markwell on July 1, 2023, at 16:31:03
Are there any new bipolar treatments coming soon? It doesnt seem like there has been anything new in decades.
Posted by SLS on July 1, 2023, at 21:38:55
In reply to New bipolar treatments, posted by Markwell on July 1, 2023, at 16:31:03
> Are there any new bipolar treatments coming soon? It doesnt seem like there has been anything new in decades.
Hi.
What is it about your disorder that you are having difficulties with?
- Scott
Posted by Markwell on July 2, 2023, at 11:24:58
In reply to Re: New bipolar treatments » Markwell, posted by SLS on July 1, 2023, at 21:38:55
I'm using lithium and nothing else and I have anxiety and a little depression. I'm able to work but just not functioning well.
Posted by SLS on July 2, 2023, at 14:18:19
In reply to Re: New bipolar treatments, posted by Markwell on July 2, 2023, at 11:24:58
> I'm using lithium and nothing else and I have anxiety and a little depression. I'm able to work but just not functioning well.
That doesn't sound like much fun.
1. Why are you taking lithium?
2. Are you bipolar? How do you know?
3. How would you describe the improvement that lithium provides you with?
4. If lithium helped initially, is it still helping just as much?
5. What dosage of lithium are you taking?
6. How long have you been taking lithium?
7. Which, if any, antidepressants have you tried? Which one worked best? Which one made you feel worse?
8. Have you ever tried Prozac? If so, what were the results? It is not unusual for people with depression/anxiety to require 60 mg/day.
9. How do you feel about taking a combination of four or more medications? Are you willing to do it?Anxiety can drive depression.
Depression can drive anxiety.
- Scott
Posted by Markwell on July 3, 2023, at 6:53:15
In reply to Re: New bipolar treatments » Markwell, posted by SLS on July 2, 2023, at 14:18:19
I take 900 mgs of lithium. I tolerate it ok. I have a bipolar 1 diagnosis. I've tried every antipsychotic known I just don't tolerate them we'll. I guess my point is I'm using a medicine from the 1960's and there doesn't seem to be a novel medicine on the horizon. I guess my question is...is there a novel medicine on the horizon?
Posted by SLS on July 3, 2023, at 9:12:56
In reply to Re: New bipolar treatments, posted by Markwell on July 3, 2023, at 6:53:15
> I take 900 mgs of lithium. I tolerate it ok. I have a bipolar 1 diagnosis. I've tried every antipsychotic known I just don't tolerate them we'll. I guess my point is I'm using a medicine from the 1960's and there doesn't seem to be a novel medicine on the horizon. I guess my question is...is there a novel medicine on the horizon?
Hi, Markwell.
A few more questions:
1. Are you looking for a drug that prevents you from switching into mania?
2. Can you describe your worst manic episode?
3. Are you an ultra-rapid cycler without treatment - switching every few days to every few weeks? Months? Not at all?If you are looking to stabilize your mood and prevent acute manic episodes, there are a few anticonvulsants that come to mind.
1. Oxcarbazepine (Trileptal). This drug is a sort of sister drug to carbamazepine (Tegretol). I would try oxcarbazepine first. It is not sedating like carbamazepine is, and does not carry the liability for a dangerous side effects called agranulocycis. Agranulocytcosis refers to a deficit of a type of white blood cell called granulocytes. With carbamazepine, blood tests are necessary to count of granulocytes. This side effect is not as frequent as first thought. Like with other potential side effects to be monitored, it's good to get a blood test before starting treatment in order to perform a comparison to subsequent tests. If agranulocytosis doesn't emerge by 6 months, it is unlikely to. Blood tests are no longer needed so frequently.
Oxcarbazepine has a side effect that should be monitored. It involves a condition known as hyponatremia - reduced sodium levels. It is recommended that one monitor blood levels of sodium regularly. Hyponatremia can be asymtomatic (causes no symptoms), but sometimes reaches a point of severity to cause damage to the nervous system. The incidence of this reaction is about 5 percent.
Other drugs that have mood-stablizing properties are calcium channel blockers.
"A systematic review of calcium channel antagonists in bipolar disorder and some considerations for their future development"
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5030455/
In addition, sodium channel blockers can provide improvements in bipolar disorder. These include valproate (Depakote), topiramate (Topamax),and lamotrigine (Lamictal) are the first to come to mind.
From here, I think lamotrigine might be the ideal choice. It is widely accepted as having rather robust antidepressant effects. In my experience, low dosages of lithium make lamotrigine work better. The ideal dosage for me is 300 mg/day. If I increase the dosage to 450 mg/day, I relapse.
I hope this helped. Do you think using an antidepressant destabilizes your condition or provokes mania?
- Scott
Posted by Hugh on July 7, 2023, at 10:22:30
In reply to New bipolar treatments, posted by Markwell on July 1, 2023, at 16:31:03
Have you done a search here?
https://www.clinicaltrials.gov/search?cond=Bipolar%20I%20Disorder
It has been proposed that molecular hydrogen be studied as a treatment for bipolar disorder and schizophrenia. Scroll down to the hydrogen studies in this researchgate link.
This double-blind study had people drink 600 milliliters (20 ounces) of hydrogen-rich water (HRW) daily for four weeks.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5806445/
Hydrogen is also being studied as a treatment for Parkinson's, Alzheimer's, cardiac arrest, spinal cord injury, and diseases of the cardiovascular system, the digestive system, the respiratory system, the urinary system, the reproductive system, for skin and tissue disorders, neuropathies, and for cancer. And as a treatment for TBI and for methamphetamine-induced neurotoxicity.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5731988/
I started using hydrogen therapy a week ago. (I have unipolar TRD.) I bought a machine from Amazon that produces hydrogen gas for inhalation, and it also produces hydrogen-rich drinking water. I've been inhaling hydrogen through a nasal cannula and I've been drinking hydrogen-rich water. I like how it makes me feel. I'll post more about my experiences with hydrogen in a month or two. Tablets are available online that produce hydrogen-rich water. Hydrogen water ionizer machines are $25 and up. My machine that produces hydrogen-rich water and hydrogen for inhalation is $559.
Posted by TriedEveryMedication on July 17, 2023, at 9:36:06
In reply to New bipolar treatments, posted by Markwell on July 1, 2023, at 16:31:03
> Are there any new bipolar treatments coming soon? It doesnt seem like there has been anything new in decades.
There's a novel drug combo that recently met its phase III trial goals
https://www.clinicaltrialsarena.com/news/karuna-karxt-primary-endpoint/
https://karunatx.com/pipeline-programs/karxt/
There's another drug that appears to work differently getting closer to approval
Posted by TriedEveryMedication on July 17, 2023, at 9:38:57
In reply to Re: New bipolar treatments, posted by TriedEveryMedication on July 17, 2023, at 9:36:06
https://www.clinicaltrialsarena.com/features/features-schizophrenia-trials-to-watch/
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.