Posted by linkadge on August 28, 2010, at 8:06:41
In reply to here's what my ex-pdoc told me..., posted by Christ_empowered on August 27, 2010, at 21:55:31
Uppers plus downers does not equal stable.
The problem in bipolar is the oscilating pattern. Try and ballance a board on an infintesimally small fulcrum. You can never do it. If the board is just a smidge off in one direction, it will be pulled in that direction.
True "mood stabilizers" prevent depression and mania by actually pulling neurotransmission back into a center value, rather than in one direction. For instance, lithium has a stabilizing effect on the glutamate transporter; increasing it when it is low and decrasing it when it is high.
Lithium, valproate, carbamazepine and perhaps olanzapine are the best studied in this regard.
It is naive to think that bipolar can be fully managed with combinations of uppers and downers.
Linkadge
poster:linkadge
thread:960165
URL: http://www.dr-bob.org/babble/20100821/msgs/960294.html