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Re: OK, try a cholinesterase inhibitor + AD » Chairman_MAO

Posted by AMD on June 3, 2004, at 14:10:53

In reply to Re: OK, try a cholinesterase inhibitor + AD » saralyn, posted by Chairman_MAO on June 3, 2004, at 13:04:07

I will look into this, but at this point I have ZERO trust of my psychiatrists or mood stablizing medicines in general. My experience thus far as been

mood stablizers == stupid pills

Yeah, you're not depressed or manic because you don't have the freakin' brain cells any more.

Dammit! Can you tell I'm frustrated? I want this to END! Starting mood stablizers was the worst decision in my life. My life has been up and down hell since I first started them in October. I thought these were supposed to HELP!?!?!


>
> This is definitely in the realm of the experimental, but I think there's a lot of promise here. Cholinesterase inhibitors ENHANCE cognitive function and SUPRESS appetite. Try Aricept (mentioned here) or Reminyl + Wellbutrin, which is a good AD to use in bipolars. Alternatives for sparing cognitive function on the AD side abound, such as Parnate, desipramine, Strattera, etc.
>
>
> Biol Psychiatry. 1999 Apr 15;45(8):959-64. Related Articles, Links
>
>
> Donepezil in treatment-resistant bipolar disorder.
>
> Burt T, Sachs GS, Demopulos C.
>
> Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, USA.
>
> BACKGROUND: A considerable percentage of patients with bipolar disorder do not respond or do not tolerate conventional treatment. Cholinesterase (ChE) inhibitors have been suggested to possess depressogenic and antimanic properties. METHODS: We report a case series of treatment-resistant bipolar patients (n = 11) to whom we administered the ChE inhibitor donepezil. Four patients met criteria for current manic episode, 5 for mixed episode, 1 for hypomanic episode, and 1 for major depressive episode. Donepezil was added to current medication on an openlabel basis. Ratings were based on a retrospective chart review. RESULTS: Of the 11 patients, 6 (54.5%) demonstrated marked improvement (improvement in CGI-S > or = 2), 3 (27.2%) demonstrated slight improvement, 1 did not respond, and 1 did not tolerate the medication. Among those patients who had marked improvement (i.e., responders, n = 6), improvement was observed within 2 weeks or less in 5 of them (83%). Patients experienced only minor side effects. CONCLUSIONS: These pilot data suggest the efficacy and safety of donepezil in the treatment of bipolar disorder. To our knowledge this is the first published report on the use of donepezil in the treatment of mood disorders. Controlled, randomized, double-blind studies are necessary to validate these preliminary observations.
>


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poster:AMD thread:352826
URL: http://www.dr-bob.org/babble/20040602/msgs/353423.html