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Re: lamotrigine dysphoria anyone?

Posted by kaleidoscope on May 27, 2007, at 12:50:28

In reply to lamotrigine dysphoria anyone?, posted by linkadge on May 27, 2007, at 10:36:36

Hi Link

>Has anyone noticed acute dysphoria from lamotrigine? Like a sudden onset blah/mild irritability.......

Irritability has been reported as a side effect of lamotrigine.

My impression of lamotrigine.......

1. Fewer side effects than most antiepileptics.

2. First line treatment for certain types of epilepsy (especially partial seizures).

3. Often not very effective for depressive disorders. May provide some benefit as a maintenance treatment for bipolar disorder but the obligatory slow dose titration makes it an inappropriate treatment for a severe depressive episode.

4. Lamictal is expensive. The price of generic lamotrigine in the UK is falling.

I'm more concerned about topiramate (Topamax)............

1. Very little (or no) evidence of efficacy in any psych disorder. No convincing evidence of efficacy in bipolar disorder.

2. High incidence of side effects, some of which are severe.

3. Exceptionally expensive.

4. Topiramate is an effective treatment for certain types of epilepsy. It is also proven to be an effective agent for migraine prophylaxis.

5. Topiramate may be overused in psychiatry because of its tendency to cause weight loss......at the cost of many side effects and unproven efficacy in bipolar disorder.

My impression of gabapentin and pregabalin............

1. Some efficacy in partial epilepsy.

2. Some efficacy in GAD for pregabalin.

3. No evidence of efficacy in bipolar disorder.

Valproate (Depakote)........

1. Effective in most types of epilepsy.

2. Very useful in the treatment of acute mania.

Levetiracetam (Keppra).......

1. Effective in epilepsy.

2. No evidence of effectiveness in bipolar disorder.

Tegretol.........

1. Very effective treatment for partial-onset seizures.

2. Some evidence of efficacy in bipolar disorder (as an antimanic). Depakote is much better proven.


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URL: http://www.dr-bob.org/babble/20070524/msgs/759798.html