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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by Gia36 on September 17, 2012, at 22:45:50
DX is major depression, but anti-depressants make me vgetative. Also tried Wellbutrin and stimulants. It's possible I have a Bipolar depression.
Regardless of DX, I can't find any real guidelines on the logic of taking one mood stabilizer over another (except side effects).
Lamictal was the only one I ever tried, but I had a strange reaction to it. My face then arms started twitching, escalated to jerking/spasms. Quit immediately. Klonopin gives me a headache and malaise.
I can try Lithium. Try Lamictal again (bad reaction was years ago and the ER doc wasnt sure if that was the direct cause).
The white blood cell, weight, and kidney side effects of Lithium scare me.
Anyone have a recommendation?
I'm so glad I found you guys-you guys are great!!
Posted by jono_in_adelaide on September 17, 2012, at 23:00:11
In reply to 1st Mood Stabilizer-What Would You Start With?, posted by Gia36 on September 17, 2012, at 22:45:50
I guess it depends as you say on ballancing side effects, cost, efficiency. I also think you need to be prepared to try more thasn one drug to find what fits best.
Carbamazepine might be worth a look?
Posted by Phillipa on September 17, 2012, at 23:45:24
In reply to Re: 1st Mood Stabilizer-What Would You Start With?, posted by jono_in_adelaide on September 17, 2012, at 23:00:11
Trileptal even I didn't get any side effects from it. Phillipa
Posted by Gia36 on September 17, 2012, at 23:53:20
In reply to Re: 1st Mood Stabilizer-What Would You Start With?, posted by jono_in_adelaide on September 17, 2012, at 23:00:11
Any suggestions why i would choose that one over Neurontin? The other one i thought of firsthand was Topomax.
Posted by Gia36 on September 17, 2012, at 23:54:11
In reply to Re: 1st Mood Stabilizer-What Would You Start With?, posted by Phillipa on September 17, 2012, at 23:45:24
Never heard of that one. I'll look it up.
Posted by brynb on September 18, 2012, at 9:39:15
In reply to 1st Mood Stabilizer-What Would You Start With?, posted by Gia36 on September 17, 2012, at 22:45:50
Hi Gia36,
I think stabilizers are pretty similar to ADs; everyone has a different reaction and thus different opinion.
I'm not sure if I have straight MDD or Bipolar 2, but the best stabilizers for me (used with Lexapro) are Trileptal (like Phillipa said), Tegretol, and what I'm currently taking, Lithium (seems to be good for those of us who have more prominent depression than other symptoms). Topamax exacerbated my anxiety, Lamictal made me feel worse, and Gabapentin made me manic (and it made me gain about 20 pounds, a lot when your baseline weight is 105!).
Good luck :).
Posted by emily elizabeth on September 18, 2012, at 18:14:22
In reply to 1st Mood Stabilizer-What Would You Start With?, posted by Gia36 on September 17, 2012, at 22:45:50
I was originally dx'd MDD, but it has been updated to BP II. Lithium was helpful to me and the good news is that often if you are using it to augment and more for depression than mania, you can get away with a lower dose (i.e., fewer side effects).
Although not a mood stablizer per se, I had great results with Abilify. I am wondering if the fact that it is considered somewhat activating might make it a good choice for you.
I'm doing well on Lamictal now after a failed attempt with it a few years ago. So, it is possible that you will have a different experience this time around.
Good luck,
EE
Posted by Raisinb on September 18, 2012, at 20:11:08
In reply to 1st Mood Stabilizer-What Would You Start With?, posted by Gia36 on September 17, 2012, at 22:45:50
My symptoms are similar to yours. I've tried Lamictal, Lithium, Abilify, Trileptal, and Symbyax (a combo of Prozac and zyprexa).
Since lithium has probably the most research to back it up, I'd start with that. Many people do well on it. It gave me horrible side effects (brain fog, cystic acne, and constipation) but there are many people who tolerate it really well.
Trileptal and Abilify didn't do anything for me. My pdoc says Trileptal doesn't seem to help anybody much, but that's just his experience. Abilify is very expensive but the drug reps give out savings cards to pdocs, which can get you a month free then a copay of thirty bucks a month for eighteen months thereafter. Without insurance it's 700-800 dollars for a month's supply. My pdoc says Abilify is "the s***t" and helps tons of his patients dramatically.
Lamictal helped when combined with an SSRI, but not without one. I've also tried seroquel, which didn't do anything but make me groggy.
I finally settled on Symbyax, which is helping. You may have to try three or four before you find one is right for you, but the good news is there are many options.
Posted by SLS on September 18, 2012, at 22:53:12
In reply to Re: 1st Mood Stabilizer-What Would You Start With? » Gia36, posted by Raisinb on September 18, 2012, at 20:11:08
Don't forget to look at Latuda (lurasidone) for bipolar depression. It will probably be approved for this indication eventually. It is an antipsychotic with antidepressant properties. Right now, only Seroquel is approved as monotherapy for the treatment of acute bipolar depression. Symbiax is polytherapy, of course. Lamictal is approved only for maintenance as a mood-stabilizer.
Latuda is a potent 5-HT7 receptor antagonist. This is a property that is thought to convey antidepressant effects. The only other psychotropics that I am aware of that do this are sulpiride and amisulpride - two antipsychotics that are not available in the US.
- Scott
Posted by Raisinb on September 19, 2012, at 15:43:20
In reply to Re: 1st Mood Stabilizer-What Would You Start With? » Raisinb, posted by SLS on September 18, 2012, at 22:53:12
Hi Scott,
Thanks, I actually didn't know about that drug. I'll ask the pdoc about it.
This is the end of the thread.
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