Posted by Ritch on July 27, 2002, at 8:55:41
In reply to Re: Depakote andLamictal actions- Ritch and Geezer, posted by Fuscia on July 26, 2002, at 20:42:18
> Hi Ritch, not Mitch, and Hi Geezer,
>
> Here is some more stuff on actions of Depakote and Lamictal
>
> "Other Mood Stabilizing Agents
>
> These new drugs (as well as the three mood stabilisers; lithium, valproic acid, and carbamazepine) are quite different from the antidepressants because they do not significantly increase levels of serotonin, dopamine, and norepinephrine in the brain. Instead, they seem to stimulate a transmitter substance called GABA (gamma-amino butyric acid) or inhibit a transmitter substance known as glutamate. GABA and glutamate are used by a large percentage of the nerves in the brain. The anticonvulsants that stimulate GABA tend to cause sleepiness. Medications in this category include valproic acid, as well as gabapentin (Neurontin), tiagabine (Gabitril), vigabatrin (Sabril), and several others. The anticonvulsants that inhibit glutamate tend to cause stimulation and anxiety. Medications in this category include felbamate (Felbatol), lamotrigine (Lamictal), topiramate (Topamax), and several others.
>
> Although it is not known for certain why or how these drugs prevent epilepsy or stablize manic-depressive illness, it is known tha the GABA system and the glutamate system in the brain tend to compete with one another. This may be why drugs that stimulate GABA or inhibit glutamate are helful for epilepsy and for bipolar illness." From the book, Feeling Good, by David D. Burns, M.D.
>
> GABA is one of the non-essential amino acids - that is, it can be made by the liver from other amino acids obtained from dietary sources. GABA acts as a neurotransmitter in the central nervous system. It is formed from another amino acid, glutamic acid. Its function is to decrease neuron activity and inhibit nerve cells from overfiring. Whereas the amino acid glutamic acid is an excitatory neurotransmitter that increases firing of neurons in the CNS." From the book, Prescription for Nutritional Healing, by Balch
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> This was informative for me for I didn't know that the different anticonvulsants used for mania in bi-polar disorder worked on either GABA or glutamate systems - I thought they all worked on the GABA system.
>
> Take care, Fuscia
>
>
>Hi Fuscia,
That is the dilemma with most of the anticonvulsant antimanic agents-they make you generally calm, but tired and flat. I have got comorbid ADHD symptoms and higher doses of Depakote or Neurontin just "blank" me out cognitively. It is similar to taking a benzodiazepine at work and having to solve a complex problem. You need to be able to hold several things in your consciousness and to reason clearly and it is tough when you forget what you are doing every few minutes! If I try to take an "activating" antidepressant to compensate for it I sleep poorly and it worsens my cycling. If I take a stimulant I sleep OK, and I don't cycle, but I get panic! So, I can be attentive, but I am either more unstable or I am panicky. I think there is an underlying (more fundamental) mechanism to explain bipolar (other than it just like epilepsy, i.e.), which when "discovered" will bring more targeted medication without a lot of this hassle.
Mitch
poster:Ritch
thread:113330
URL: http://www.dr-bob.org/babble/20020725/msgs/113916.html