Posted by ed_uk2010 on February 6, 2015, at 16:23:03
In reply to worst mixed episode, posted by b2chica on February 6, 2015, at 15:03:34
> gabapentin (has worked well in the past, but they took me off it right now)
> trileptal (ataxia and locked in syndrome)
> topamax (headaches and Rapid cycling)
> lamictal (rapid cycling)Hi B2,
Sorry to hear you're so unwell. Mixed episodes are most commonly treated with Depakote and antipsychotics, sometimes with lithium as an adjunct. The drugs you list above are anti-epileptics but not necessarily mood stabilisers. Gabapentin is useful for some types of anxiety - it has no proven role in bipolar disorder. Topamax has no proven role in bipolar disorder. Trileptal is possibly useful in mania, based on limited evidence. Lamictal is often of some use in bipolar depression only. Pregabalin (Lyrica) is useful in focal epilepsy, neuropathic pain and some types of anxiety, like gabapentin - it is not a mood stabiliser as such. In fact, I believe Pfizer were fined for inappropriately promoting gabapentin as a mood stabiliser.
Established mood stabilisers include Depakote and lithium. For a mixed state, combinations are often needed. Lithium alone is rarely sufficient.
I think you should start by considering Depakote. You could continue Zyprexa alone or add a little perphenazine if you've responded well to it before. Lithium also needs to be considered, especially if you're having a lot of suicidal thoughts.
Let us know how you get on.
poster:ed_uk2010
thread:1076072
URL: http://www.dr-bob.org/babble/20150129/msgs/1076076.html