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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 Mr. Scott on January 29, 2002, at 19:09:21
Apparently not all bipolars are created equal (we knew that). But the Phenytoin usage for mania is interesting especially since I believe it is generally more easily tolerated than some of the other Anticonvulsants..
Thought these could be provoking of discussion..
Scott
Phenytoin as an antimanic anticonvulsant: a controlled study.Mishory A, Yaroslavsky Y, Bersudsky Y, Belmaker RH.
Stanley Center for Bipolar Research, Ministry of Health Mental Health
Center, Ben Gurion University of the Negev, Beersheva, Israel.OBJECTIVE: Phenytoin, a classical anticonvulsant, shares with antimanic
anticonvulsants the property of blockade of voltage-activated sodium
channels. The authors therefore planned a trial of phenytoin for mania.
METHOD: Patients with either bipolar I disorder, manic type, or
schizoaffective disorder, manic type, entered a 5-week, double-blind
controlled trial of haloperidol plus phenytoin versus haloperidol plus
placebo. Of 39 patients, 30 completed at least 3 weeks and 25 completed 5
weeks. RESULTS: Significantly more improvement was observed in the patients
receiving phenytoin. Added improvement with phenytoin in scores on the Brief
Psychiatric Rating Scale and Clinical Global Impression was seen in the
patients with bipolar mania but not those with schizoaffective mania.
CONCLUSIONS: Blockade of voltage-activated sodium channels may be a common
therapeutic mechanism of many anticonvulsants given for mania, and phenytoin
may be a therapeutic option for some manic patients.
J Psychiatr Res 1998 Sep-Oct;32(5):261-4 Related Articles,An open label study of gabapentin in the treatment of acute mania.
Erfurth A, Kammerer C, Grunze H, Normann C, Walden J.
Dept. of Psychiatry, LMU University Hospital, Munchen, Germany.
Recent anecdotal single case reports have suggested that the new
antiepileptic drug gabapentin might be effective in the treatment of manic
episodes and in the prophylaxis of bipolar disorder. In the present open
trial, 14 patients with acute mania were treated for up to 21 days with
gabapentin in a dose range from 1200 to 4800 mg/day. Six patients were
treated with gabapentin as add-on medication and 8 patients were treated
with a high dose of gabapentin alone. Gabapentin was both efficacious and
safe when applied in combination with other drugs such as lithium and
valproic acid. All patients in the add-on group and 4/8 patients on
gabapentin monotherapy finished the 21 day protocol. Analysis of the scores
of the Bech-Rafaelsen Mania Assessment Scale (BRMAS) of these patients
showed that the mean BRMAS score declined from 37.7 to 7.8 on day 21 in the
add-on group and from 27.8 to 9.0 in 4/8 patients finishing 21 days in the
monotherapy group. It is suggested that gabapentin monotherapy might be
useful in selected patients to treat modest but not severe manic states. In
addition, gabapentin in conjunction with other effective mood stabilisers
seems to be safe and efficacious in the treatment of severe mania.PMID: 9789203 [PubMed - indexed for MEDLINE]
Posted by TSA West on January 29, 2002, at 19:40:15
In reply to Not all mania created equal, posted by Mr. Scott on January 29, 2002, at 19:09:21
Hello. Thank you for alerting people to this, Mister Scott...
I tried huge doses of phenytoin for depression for about 2 weeks with no results. I know some other guy who got no results too. But anything is possible for other people....
All the studies on phenytoin for any disorder other than epilepsy were funded by zillionaire Jack Dreyfus who claims to have gotten a fix from depression after 1 dose of 100 mg of Phenytoin.
Its too bad because Phenytoin has few or no side-effects in many people, including me....
--TSA West
Posted by Mr. Scott on January 29, 2002, at 19:51:50
In reply to Re: Not all mania created equal » Mr. Scott, posted by TSA West on January 29, 2002, at 19:40:15
> Hello. Thank you for alerting people to this, Mister Scott...
>
> I tried huge doses of phenytoin for depression for about 2 weeks with no results. I know some other guy who got no results too. But anything is possible for other people....
>
> All the studies on phenytoin for any disorder other than epilepsy were funded by zillionaire Jack Dreyfus who claims to have gotten a fix from depression after 1 dose of 100 mg of Phenytoin.
>
> Its too bad because Phenytoin has few or no side-effects in many people, including me....
>
> --TSA WestInteresting TSA! Thanks for that info..
What has worked for you so far?
Scott
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