Posted by SLS on August 6, 2009, at 7:14:56
In reply to Re: Mixed Hypomanic Episode + Medication Changes, posted by morganpmiller on August 5, 2009, at 22:34:55
Trileptal, the sister drug of Tegretol, might be an interesting choice here. There is some evidence that it can quell the SSRI discontinuation withdrawal sydrome. Of course, it is a mood stabilizer as well. That said, I think there is more evidence for Depakote being used in mixed-states. This might, however, reflect a bias towards not studying Tegretol as closely because of the necessity for taking regular blood tests to screen for agranulocytosis while taking it.
With Depakote, you can start with loading doses of 1000mg or higher, then change to the target dosage. For me, I found that I needed 1000-1500mg of Depakote to treat mania. I thus used a loading dose of 2000mg (1000mg b.i.d.) to get started. I don't recommend doing this unless your doctor is familiar with this dosing strategy.
Although Depakote has not received as much attention to treat SRI withdrawal, it still might work given that it, like Tegretol and Trileptal, inhibits sodium channels and potentiates GABA neurotransmission, abeit through different mechanisms; the effects of which are to reduce the excitability of glutamate neurons.
- Scott
poster:SLS
thread:910491
URL: http://www.dr-bob.org/babble/20090801/msgs/910544.html