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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by Racer on November 26, 2008, at 15:25:40
Trileptal is out. Lamictal is out. (And since Trileptal is out, I'm guessing Tegretol is also out.)
Please -- if you have experience of weight neutral mood stabilizers, post 'em here.
(And please -- "weight neutral" is the key phrase here. And the two listed above are out for good reasons.)
Thanks, in advance, for any and all responses!
Posted by overtheedge on November 26, 2008, at 17:21:42
In reply to Any such thing as weight neutral mood stabilizer?, posted by Racer on November 26, 2008, at 15:25:40
I have been on abilify for 4 yrs and have not put on any weight. i take 20 mgs a day along with zoloft 100mgs a day.
Posted by cactus on November 26, 2008, at 21:21:42
In reply to Any such thing as weight neutral mood stabilizer?, posted by Racer on November 26, 2008, at 15:25:40
> Trileptal is out. Lamictal is out. (And since Trileptal is out, I'm guessing Tegretol is also out.)
>
> Please -- if you have experience of weight neutral mood stabilizers, post 'em here.
>
> (And please -- "weight neutral" is the key phrase here. And the two listed above are out for good reasons.)
>
> Thanks, in advance, for any and all responses!Low dose of clonazepam, it has been an amazing mood stabilizer for me. I know your body doesn't like benzo's but the modafinil/clonazepam combo I have been on for the last 6 months has been the most amazing combo I have ever been on over the last 15 years.
I'd heard people say clonazepam has mood stabilizing effects, even my pdoc said it and for me it true. I then researched it and found out it does and is used off label for it. Just like most anti epileptic meds are.
I have never suffered from the clonazepam depression syndrome, I've heard a lot of people do, but it's never been a problem for me personally and I was on it before I started modafinil for OSA, which together quashed the residual depression I had lurking in the background that has been on and off for years.
I have had severe bouts of depression and when it was really bad I was never on clonazepam. Good luck racer. C
Posted by desolationrower on November 26, 2008, at 22:02:43
In reply to Re: Any such thing as weight neutral mood stabiliz » Racer, posted by cactus on November 26, 2008, at 21:21:42
Thyroid hormones might help. They aren't weight-neutral, but they're the good kind of 'not weight neutral.'
-d/r
Posted by azalea on November 27, 2008, at 8:14:55
In reply to Any such thing as weight neutral mood stabilizer?, posted by Racer on November 26, 2008, at 15:25:40
Lithium is weight neutral for some.
> Trileptal is out. Lamictal is out. (And since Trileptal is out, I'm guessing Tegretol is also out.)
>
> Please -- if you have experience of weight neutral mood stabilizers, post 'em here.
>
> (And please -- "weight neutral" is the key phrase here. And the two listed above are out for good reasons.)
>
> Thanks, in advance, for any and all responses!
Posted by bleauberry on November 30, 2008, at 11:13:28
In reply to Any such thing as weight neutral mood stabilizer?, posted by Racer on November 26, 2008, at 15:25:40
Magnesium.
Fish oil.
While neither has the knock-out power of a pharmaceutical in a larger section of patients, they do have knock-out effectiveness in a smaller section of patients. So definitely worth looking at. Fish oil is common knowledge so you know about that. Most people are not aware of magnesium's potential.
There is the possibility of combining several mood stabilizers, all at subtherapeutic doses, to get a synergistic "more than all added together" effect, with counteracting side effects. A weight gainer plus a weight loser, both at very low doses.
Posted by Justify on December 1, 2008, at 10:10:49
In reply to Re: Any such thing as weight neutral mood stabiliz » Racer, posted by cactus on November 26, 2008, at 21:21:42
Cactus,
Just curious, what do you consider to be a low dose of clonazepam?
THX
> > Trileptal is out. Lamictal is out. (And since Trileptal is out, I'm guessing Tegretol is also out.)
> >
> > Please -- if you have experience of weight neutral mood stabilizers, post 'em here.
> >
> > (And please -- "weight neutral" is the key phrase here. And the two listed above are out for good reasons.)
> >
> > Thanks, in advance, for any and all responses!
>
> Low dose of clonazepam, it has been an amazing mood stabilizer for me. I know your body doesn't like benzo's but the modafinil/clonazepam combo I have been on for the last 6 months has been the most amazing combo I have ever been on over the last 15 years.
>
> I'd heard people say clonazepam has mood stabilizing effects, even my pdoc said it and for me it true. I then researched it and found out it does and is used off label for it. Just like most anti epileptic meds are.
>
> I have never suffered from the clonazepam depression syndrome, I've heard a lot of people do, but it's never been a problem for me personally and I was on it before I started modafinil for OSA, which together quashed the residual depression I had lurking in the background that has been on and off for years.
>
> I have had severe bouts of depression and when it was really bad I was never on clonazepam. Good luck racer. C
>
>
Posted by cactus on December 1, 2008, at 15:54:04
In reply to Re: Any such thing as weight neutral mood stabiliz, posted by Justify on December 1, 2008, at 10:10:49
0.25-0.5-1mg a day even though I'm on a much higher dose at the moment, which I'm tapering off. It's totally weight neutral for me and has been great. I no longer need this high dose so it's time to lower it.
Posted by Justify on December 1, 2008, at 18:50:45
In reply to Re: Any such thing as weight neutral mood stabiliz » Justify, posted by cactus on December 1, 2008, at 15:54:04
Do you take it once daily of B.I.D? I take .75 @ night and wonder if it matters due to the long half life. I was thinking about switching it to day time.
> 0.25-0.5-1mg a day even though I'm on a much higher dose at the moment, which I'm tapering off. It's totally weight neutral for me and has been great. I no longer need this high dose so it's time to lower it.
Posted by Tony P on December 1, 2008, at 21:38:52
In reply to Re: Any such thing as weight neutral mood stabiliz, posted by Justify on December 1, 2008, at 18:50:45
Perspectives sure differ! I take 2-3 mg clon./day and consider it a low dose for me -- but frequently get comments from pharmacists & drs. that that's a high dose. I have a pretty high tolerance to benzos generally: at one time I was taking up to 6 mg Ativan in 1 or 2 doses for performance anxiety, and it was just enough!
I hadn't thought of it as a mood stabilizer, but that makes perfect sense. I will likely need to wean myself from it soon, as my high tolerance makes me a candidate for addiction problems. The last pdoc I saw recommened I go back on Lamictal, which I'll post about separately.
Posted by Tony P on December 1, 2008, at 21:43:40
In reply to Any such thing as weight neutral mood stabilizer?, posted by Racer on November 26, 2008, at 15:25:40
Racer, I'm curious. Did you find Lamictal had an effect on your weight -- if so which way?
I am w-a-y overweight now (+50 lb in the last 9 months) from a combination of Remeron, Cymbalta, a sedentary lifestyle & poor diet. I may need to go on Lamictal soon (not sure about dropping either of the other drugs) so it's a major concern for me.
Tony
> Trileptal is out. Lamictal is out. (And since Trileptal is out, I'm guessing Tegretol is also out.)
>
> Please -- if you have experience of weight neutral mood stabilizers, post 'em here.
>
> (And please -- "weight neutral" is the key phrase here. And the two listed above are out for good reasons.)
>
> Thanks, in advance, for any and all responses!
Posted by JadeKelly on December 3, 2008, at 10:34:50
In reply to Any such thing as weight neutral mood stabilizer?, posted by Racer on November 26, 2008, at 15:25:40
> Trileptal is out. Lamictal is out. (And since Trileptal is out, I'm guessing Tegretol is also out.)
>
> Please -- if you have experience of weight neutral mood stabilizers, post 'em here.
>
> (And please -- "weight neutral" is the key phrase here. And the two listed above are out for good reasons.)
>
> Thanks, in advance, for any and all responses!Hi Racer,
My son has taken Depakote for 15 years, and never gained, or lost that I know of. Of course he was a growing boy, but he was always at his ideal weight. Depakote dose was for epilepsy and has stayed the same except for growth spurts.
He did rapidly gain weight with Risperdal and Abilify. Those were for teenage onset of Bi-polar I. He's now on Seroquel, 300mg daily for that. I can't say for sure if its weight neutral, because he has lost a lot of weight since being off other A/psych meds. If I had to geuss, its pretty close to or is weight neutral, for him.
So many of these drugs effect different people in un expected ways. Depakote IS doubling as a mood stabilizer, so. Hope that helps!
Btw-he takes 1500 mg depakote daily/ plus the 300mg daily of Seroquel. I know they use Seroquel off label but not sure if for mood stabilizer. He's within 15 lbs (over) of his ideal weight He's also not very active.
Good luck, Jade
Posted by Racer on December 3, 2008, at 23:31:31
In reply to Re: Any such thing as weight neutral mood stabilizer? » Racer, posted by Tony P on December 1, 2008, at 21:43:40
> Racer, I'm curious. Did you find Lamictal had an effect on your weight -- if so which way?
>
>I wasn't on Lamictal very long -- only long enough to get up to 200mg and find that it increased my depression.
That's not the real reason I can't answer you, though: I was in treatment for anorexia nervosa, so I was gaining weight at that time. I was also taking other drugs which I know put weight on me. So, I gained weight while I was on it -- but can't say that it had any effect whatsoever...
Sorry I couldn't be more helpful.
Posted by Vincent_QC on December 4, 2008, at 7:50:40
In reply to Re: Any such thing as weight neutral mood stabilizer? » Tony P, posted by Racer on December 3, 2008, at 23:31:31
Well, by experience, I can say that Topamax (Topiramate) often help to loose some weight...So maybe ask for a little bit of it. It's an agent used to manage partial seizures for epilepsy...and they give it often for anxiety, social phobia... I always gain weight with every drugs that toutch the bains, especially antidepressants, anticonvulsives, antipsychotique, anxiolytics, name it...but Topamax is the only one who succed to let me loose some weight, but it was not a good drug choice to help with my cognitive problems...I had to stop because I was loosing my short-term memory...
Lamictal is also ok...some people gain weight, others loose weight...but be carefull with that one, especially when you begin this drug...I know someone who take more of the dose it had to take the first week and he endup at the hospital...
In other hands, you have to look at what you eat also...My own problem is that I can't stop eating when I uste a drug to help me with social phobia. I eat more sugar and fat and that's not good. I will have to do another strict diet soon (Liquid protein with tons of Vitamines, potassium and water), all of this because I gain more than 40 pounds on the Cipralex (take it from the end of august to the end of october on 20mg/day)...Now that i'm switch on Nardil, I feel the same, I can't stop eating. I also take the newer Seroquel XR version, 50 mg to help me to sleep at night, and that's another weight gain drug. That's a never endind circle. Some people complaint about the weight gain, others not... My experience teel you that if I gain weight, I loose a lot of self-esteem cause my apparence is very important ( I had a gastric by-pass to loose weight in the past)...and my social phobia problem is connected with my body image and the way I look...so a gain of weight as a side effect can't be accepted as a good choice of treatment...but now that I try everything in the market to help me, I have no choice and take the Nardil again and try to stop eating and doing a diet and some exercise...Long story sorry!!!
Posted by desolationrower on December 4, 2008, at 14:23:02
In reply to Re: Any such thing as weight neutral mood stabilizer?, posted by Vincent_QC on December 4, 2008, at 7:50:40
I would really try a different hypnotic than seroquel if you have weight problems.
-d/r
Posted by Vincent_QC on December 6, 2008, at 9:36:30
In reply to Re: Any such thing as weight neutral mood stabilizer?, posted by desolationrower on December 4, 2008, at 14:23:02
> I would really try a different hypnotic than seroquel if you have weight problems.
>
> -d/rSeroquel is not an hypnotic...at a small dose 25mg, he just act on the histaminic and a1-adrenoretseptoram...mean that you will sleep like a baby on it.
For the weight problem, taking a small dose like 25 mg of seroquel, will not make you gain weight.
And remember that Seroquel is non-habit forming... As an example, when you begin to take Rivotril (Clonazepam), at fisrt, you feel really tired...and that side effect fade away with time, 2 weeks normally, mean that your gaba brains begin to be less sensitive to the hypnotic effect of these benzodiazepine...
The same apply to the ZZZZZZ drugs or Ambient, or Lunesta...whatever you call them...they are all metabolite from well know benzodiazepines like Valium, Rivotril, Ativan...
So if I look at what I write before, and I realize that I already take 4 mg of Ativan a day...that'S completly absurb to think that a 15mg pills of Zopiclone will help me to fall asleep and stay asleep all night long, since my Ativan 4 mg/day is 4 or 5 times more powerfull that the ZZZZZZ drugs...and the ZZZZZ drugs have SHORT half-life...mean that after 2 hours, they don't continu to have effect on your system...so if you have to go to the bathroom, good luck to be able to sleep again...and the last thing, they are really habit forming...Even if someone here will tell you the contrary...that's not true...a lot of studies show that after only 4 or 5 days taking a ZZZZ drugs (benzodiazepine deriative), they all loose thir hypnotic effect. You will just end up increasing the dose to reach the same effect...and that's a never ending circle !!!
Trust me, on Trazodone or Seroquel, in the minimum effective dose you can try(you have to find it...do some test, one night at 10mg, after maybe at 15 if your sleep didn't improve, after 20 mg...)until you find the good combination of the numbers of hours you can sleep in a row, and the energy level you will have the day after.
I'm sure you don't want to feel like a zombie the day after. Yeah, Ambient or Lunesta stay only 2 hours in your body, yeah you will probably have more hungover effects at first on Trazodone or Seroquel, but at least you will never became addicted on them...and your tolerance level will never descrease on Trazodone or Seroquel, even after months on them to sleep.
Anyway, that's my point of view... for someone with just a temporary insomnia problem, and not having an addiction problem to a benzo drugs before, you can go with the ZZZZZ drugs...they will have a good effect on your sleep for sure...But if you already take a benzo pill, i'm sorry but you will never find a ZZZ drugs who will help you...You will have more chance to sleep more with a cheap pills like Unisom2 or any sleep pills avaible on the tablets of your pharmacy...
Good luck ;-)
Posted by desolationrower on December 6, 2008, at 15:32:59
In reply to Re: Any such thing as weight neutral mood stabilizer? » desolationrower, posted by Vincent_QC on December 6, 2008, at 9:36:30
ok well 'hypnotic' means a drug which induces sleep. maybe that is different in english.
And i don't think there is a dose-relationship to quetiapine and weight gain, even small amounts may be a problem and contribute.
Quetiapine and long-term weight change: a comprehensive data review of patients with schizophrenia.
BACKGROUND: To assess the magnitude and pattern of weight change during long-term treatment with the atypical antipsychotic quetiapine. METHOD: Data were collected from patients with a DSM-IV diagnosis of schizophrenia treated with quetiapine in the AstraZeneca clinical trials program from July 1993 to May 1999. Weight changes in patients treated for 12, 52, and 104 weeks were analyzed; the primary parameter was the change in weight at week 52. RESULTS: In total, 352 patients were treated with quetiapine for 52 weeks. The mean weight gain at this timepoint was 3.19 kg; median weight gain was 2.5 kg. Overall, 37% of patients gained >or= 7% of their baseline body weight; however, the degree of weight gain was inversely related to baseline body mass index in this cohort. In patients treated with < 200 mg/day of quetiapine, mean weight gain was 1.54 kg, compared with 4.08 kg for 200 to 399 mg/day, 1.89 kg for 400 to 599 mg/day, and 3.57 kg for >or= 600 mg/day; median weight gain was 0.95 kg, 3.40 kg, 2.00 kg, and 3.34 kg, respectively. Analysis of longitudinal weight changes indicated that most weight gain (> 60%) occurred within the first 12 weeks of quetiapine treatment, with modest changes after 6 months. CONCLUSIONS: Long-term treatment with quetiapine monotherapy is associated with moderate weight gain. Most weight gain occurs within the first 12 weeks of treatment and has no clear dose relationship.Trazadone has had mixed results as far as weight.
There have been a few studies showing eszopiclone does not induce tolerance long-term.
-d/r
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