Posted by wendy b. on May 28, 2002, at 10:37:37
In reply to Re: New Mood Stablizers /another ?, posted by JaneB on May 27, 2002, at 11:17:13
> If the second line mood stabilizers don't require blood testing does that mean they aren't as harmful? and if so why not start 2nd line first?
> JaneB
Dear Jane and others,It depends on the symptoms the patient presents to the pdoc. I was started on Neurontin as a "first-line" because my bipolar swings tend to go down instead of up. I didn't need anything as drastic as Depakote or Lithium. Mitch is right, the toxicity issues are very important. My pdoc was aware of this and prescribes neurontin to a lot of bipolars. She thinks it's good to avoid the blood-levels issues if at all possible. If the "second-line" drugs work well for the patient, and they are easier on the body, then they should at least be given a chance.
Neurontin has worked EXTREMELY well for me. I hope Johnny S's posts don't scare people away from taking the "second-line" approach from the start. Everyone does not need Depakote or Lithium if they are bipolar. They are the classicly prescribed meds, but I'm glad I don't have to take either one...
I read in a standard text on bipolar disorder that the reason they found out that Neurontin and some of the other anti-convulsants worked well for mood-swings, was that the people with epilepsy who took Neurontin noticed the dramatic improvement on their moods. And it took off from there. The fact that there are no clinical trials as yet to prove that anti-convulsants work for bipolar symptoms won't prevent me and many others from taking it...
Johnny: regarding the "placebo being better than the drug" reports, I believe they are spurious. There were a couple of discussions about those reports on here a few weeks ago. I tried to look up the threads for you, but don't think they are archived yet, so searching for "placebo" only pulled up threads from February at the latest. I'd suggest going back to the area called "Previous Periods," up above on the main board page, and looking up discussions over the last several weeks. I will also look for it. Several people expressed their reasonings why the reports are questionable in a much better way than I could.
All the best to you and to the other posters on this thread,
Wendy
poster:wendy b.
thread:107689
URL: http://www.dr-bob.org/babble/20020525/msgs/107826.html