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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 3 of 3. This is the beginning of the thread.
Posted by zarathustra on January 2, 2002, at 22:19:52
I am currently on Epival 750mgs BID with little improvement in mood. There have been about two days in the last 6 weeks when something was profoundly different but the good mood left very quickly.
Am I not giving this med a fair trial? The psychiatrist said the results would be noticed within a week. Yet he says I am in the 'therapeutic window' and continues to up my dose.
Also, Is Lithium the most effective stabilizer? I have heard it is.
Andrew
Posted by Mitch on January 3, 2002, at 15:25:05
In reply to Generally, how long until Epival will work?, posted by zarathustra on January 2, 2002, at 22:19:52
> I am currently on Epival 750mgs BID with little improvement in mood. There have been about two days in the last 6 weeks when something was profoundly different but the good mood left very quickly.
>
> Am I not giving this med a fair trial? The psychiatrist said the results would be noticed within a week. Yet he says I am in the 'therapeutic window' and continues to up my dose.
>
> Also, Is Lithium the most effective stabilizer? I have heard it is.
>
> Andrew
I haven't found valproic acid (Epival, Depakote)to have much of an antidepressant effect. However, I am BPII and never needed more than 500mg/day to quell hypomanias. But, there have been people posting here (mostly BP-I I believe) that have their dosages pushed up to somewhere between 1250-1500mg/day and they have experienced antidepressant effects from it. There was also a post I read a while back that mentioned some research that showed that high doses of valproic acid tends to release dopamine or block reuptake of dopamine or facilitate dopaminergic function, etc. So, it might be worth "riding out" the experiment to see if you get those benefits at those dosages.Lithium is probably the most effective mood stabilizer generally, but there are a *lot* of folks that get little benefit from it or who have lost effectiveness with it due to stopping/starting, etc. It also is the first mood stabilizer that gets picked when trying to augment treatment resistant unipolar depression, although Lamictal is becoming popular for that.
Mitch
Posted by CalvaryHill on January 6, 2002, at 2:22:23
In reply to Generally, how long until Epival will work?, posted by zarathustra on January 2, 2002, at 22:19:52
I say switch to carbamazepine pronto. You have given Depakote a fair trial but I believe you must move on. I don't think you will like Lithium at all. It has a malevolent side-effect profile.
This is the end of the thread.
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