Posted by med_empowered on November 30, 2005, at 1:32:39
In reply to whats the best treatment for rapid cycle bipolar?, posted by arina on November 30, 2005, at 1:07:06
hey! A lot of rapid-cyclers don't respond well to lithium...lithium really seems best for "classic" bipolar I (euphoric mania, severe depression, good recovery between episodes). Rapid cycling is a little trickier. Depakote helps some, as does Tegretol (Trileptal, which is alot like Tegretol, could be a good option). Some docs swear by antipsychotics (the new ones..seroquel, abilify, geodon, zyprexa, etc.). Id avoid antidepressants...you might also want to avoid Lamictal, since it can push people into (hypo)mania. Keppra, a very new anticonvulsant, might be a good option..it mixes well with other drugs and doesn't mess up thinking like other drugs do. The downsides are expense, lack of data, and it occasionally pushes people into depression.
From my experience, I'd try to start with Trileptal (no blood work needed, minimal start up side effects). If possible, try adding a benzo--Klonopin might be good. That helps with anxiety and mood-stabilization. Trileptal doses vary wildly, but for Bipolar you're probably looking at 600-2400mgs..personally, 900 was good for me without causing "flatness." Taking care of anxiety and sleep issues can also help, too...it helps you keep "an even keel," so you'll probably see fewer major episodes. Good luck!
poster:med_empowered
thread:583598
URL: http://www.dr-bob.org/babble/20051126/msgs/583602.html