Posted by ed_uk2010 on August 29, 2010, at 13:04:08
In reply to Re: here's what my ex-pdoc told me... » ed_uk2010, posted by Dinah on August 28, 2010, at 15:42:35
>Mood stabilizers are anti-seizure meds aren't they? Do they have some stabilizing effect on electrical activity in the brain?
Hi Dinah,
The term mood stabiliser is normally used to refer to a mixed bag of different anti-seizure meds and lithium.
Depakote is particularly useful for acute mania. It can also be helpful for 'rapid cycling' bipolar disorder and mixed states. Its preventive efficacy in the long term is not so clear. It is not normally helpful during depressive episodes. Depakote is widely used in epilepsy, especially for the prevention of 'grand mal' seizures.
Tegretol is sometimes effective for acute mania. It is not normally a first line medication in bipolar disorder. It is a very useful medication for preventing partial seizures.
Trileptal is an anti-seizure med which may have similar efficacy to Tegretol in bipolar disorder, but has received less study. It often causes fewer side effects than Tegretol.
Lamictal is another anti-seizure med. It is quite different to Depakote because it has more of an effect on depression, and less anti-manic activity. The gradual titration period when starting treatment means that it's not very useful for severe/acute mood episodes. It seems to be quite useful as a maintenance treatment to prevent relapse into depression, once the depression has been treated with other medications. It is not suitable for acute mania, but may have some preventive action against relapse into mania, at least in some patients.
Topamax, Keppra, Neurontin and Lyrica are all effective anti-seizure medications. Topamax and Keppra can cause severe psychiatric reactions in some patients. They have no established role in bipolar disorder. Neurontin and Lyrica appear to be modestly effective for generalised anxiety disorder (GAD) but they are not mood stabilisers.
Lithium is not an anti-seizure med. It is effective for acute mania and has preventive activity against relapse when continued in the long term (normally at lower doses). The preventive activity of lithium is quite well established (which is not the case for some of the other meds used in bipolar disorder). Lithium is more effective at preventing manic relapse than depressive relapse. Some types of depression do respond to lithium (unipolar as well as bipolar).
Atypical antipsychotics are increasingly used in bipolar disorder. Seroquel is effective for acute mania, and may be somewhat effective for the depressive phase too. The same applies to Zyprexa and Abilify. Although atypical antipsychotics do seem to stabilise the mood, they are not normally referred to as mood stabilisers. They are very useful for acute mania. Their preventive efficacy in the long term is not well studied.
>They also are used prophylactically for migraines.
Depakote and Topamax are both effective for migraine prevention but this does not apply to all anti-seizure meds.
poster:ed_uk2010
thread:960165
URL: http://www.dr-bob.org/babble/20100829/msgs/960438.html