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View Full Version : Are There Any Mood Stabilizers That Aren't Horrible???


 

 

 
fineanddandy
09-18-2007, 05:32 AM
I am serious. Every mood stabilizer seems to have horrible side effects. Are there any that are easier to tolerate than others???

So far, I have tried:
1) Depakote - gained 30 pounds in a month
2) Seroquel - causes daytime grogginess, elevated heart rate, acid reflux at night, and heavy snoring (which probably means sleep apnea but I've refused a sleep study).

I've looked them all up and they all seem to have intolerable side effects. Are there any that work for you that you can tolerate???

I really appreciate the help!
Thanks In Advance

Sponsor
 



goody2shuz
09-18-2007, 09:22 AM
Hi FineandDandy.....my daughter is on Lamictal and that works out well for her. It is not only weight neutral but has a GREAT profile when it comes to side effects. Only thing is it has to be titrated up slowly due to a bad rash associated with giving it too quickly and may take time before it really starts to work. IT is also great in terms of addressing the depressive side of BP and is used to treat people with Major Depression as well. My daughter had more depressive symptoms that when treated with just an antidepressant alone triggered hypomania.

She is on the Seroquel as well (which by the way is an antipsychotic used for mania) which works well in combination with the Lamictal. IN time I am hoping that we can get her off the Seroquel and that the Lamictal will work on it's own.

Hope that you find the med that works good for you.

~ Goody:angel: :wave:

fineanddandy
09-18-2007, 11:47 AM
The bad rash thing scares me although I guess the risk of developing it is pretty small. Lamactil isn't too sedating then? It'd be really nice to be able to t-h-i-n-k!

tsohl
09-18-2007, 12:12 PM
My son takes lamictal, lithium and tegretol, and works in the area of mathematics and statistics so he can't afford to be brain-drousy. Sometimes you need to take something for awhile to let your body adjust to the changes. If he had stopped taking any of his meds at the beginning due to side effects, he would not be on anything and his life would be a MESS.

Sometimes you have to figure out if the side effects from medications are better or worse than the "side effects" that result from unmedicated bipolar disorder.

Tsohl

fineanddandy
09-18-2007, 01:08 PM
Sometimes you have to figure out if the side effects from medications are better or worse than the "side effects" that result from unmedicated bipolar disorder.

Oh yeah, I got that. I've been on Seroquel for about 4 years now. I'm just wondering if there is something else I could take that would be more tolerable.

tsohl
09-18-2007, 01:13 PM
I think it is a really individual reaction. My son could not take Seroquel but tolerates lithobid (lithium) which many cannot. In fact, with the combination I mentioned, he has been well and stable for over 2 1/2 years and has very few side effects.

fineanddandy
09-18-2007, 01:16 PM
Okay, thanks! So far, 2 votes for lamactil and one for lithium.

tsohl
09-18-2007, 01:40 PM
Actually I am voting for both. In our experience one mood stabilizer was not quite enough to prevent break-through episodes.

Lithium is still the gold standard for treating bipolar but many people cannot tolerate it. Sometimes they can tolerate it at a smaller dosage and then will add a second mood stabilizer on at also a smaller dosage than if it were used alone.

EYESTWO22
09-18-2007, 03:22 PM
......
Lithium is still the gold standard for treating bipolar but many people cannot tolerate it. Sometimes they can tolerate it at a smaller dosage and then will add a second mood stabilizer on at also a smaller dosage than if it were used alone.

Count my vote for Lithium. But before I comment about my history with Lithium, most resent studies find that only about 25% to 35% of people cannot tolerate Lithium. I started Lithium when it was first aproved by FDA in 1970. No other mood stabilizers were on the market at that time. It worked well for me ,however I did not comply and found recurrence of my episodes.
Findly,in 1984, I deceided I to comply with a regular dose. I have had stability now for 24 years.

Again....tsohl is 100% correct......Lithium is still the gold standard fot treating bipolar disorder.

Carry On,

Paige1989
09-18-2007, 04:52 PM
I'm on Lamictal and Seroquel as well. :) Lamictal has never made me drousy, but Seroquel did at first, and Seroquel actually helps me sleep if I take it right before bed (right now, I'm on 150mg., but I just increased to that a couple days ago from 100mg.). I was on Lamictal and Abilify but I was taken off of it in the hospital because the pdoc there thought it was making me manic. :S It had never made me manic, but it had never worked really well either so I didn't fight it. When he took me off of Abilify, he put me on Seroquel and in the hospital I went from 25mg. to 300mg. without a problem, but when I got out of the hospital, my regular pdoc increased it to 400mg. when the 300mg. wasn't working very well (probably because of the fast increase, at least I think so), but the 400mg. made me soooooo lightheaded and dizzy that I had to terminate Seroquel immediately. Then I was only on Lamictal for a while, but it wasn't working well on its own so after talking to my pdoc and discussing two other mood stabilisers other than Seroquel, we finally decided that a low dose of Seroquel might work for me, and so far it has. So now, I'm on 400mg. of Lamictal (max. dose according to my pdoc), 150mg. of Seroquel, 1mg. of Klonopin at night, and 1-2mg. of Ativan during the day, the latter two for anxiety.

Hope that helps a little. :)

~~Paige

fineanddandy
09-18-2007, 05:27 PM
Paige1989 & EYESTWO22, thank you both for your input. So, no bad side effects from the lithium and/or lamictal? Drowsiness? Brain fog? Hand tremor? Serious weight gain?

Paige1989
09-18-2007, 05:50 PM
With Lamictal, there is no weight gain at all. I've never experienced brain fog or drowsiness, nor hand tremor. Altogether, Lamictal side effects are very rare and the only one that really needs to be watched for is the rash associated with Lamictal. As Goody said, it has to be titrated up slowly to avoid the rash, but sometimes it occurs anyway, at which point you have to stop taking it immediately because the rash can be deadly, but not if it is stopped right away. So over all, Lamictal has very little side effects and I fully recommend it. ^_^ The only thing I've experienced is the AWFUL taste of it...I can't take it without milk. I could take it with a soda, but only if I swallow the pill really fast...if I don't, I gag and cough for a while before the taste gets out of my mouth. :S With milk, though, the taste is masked completely. And Mom can take Lamictal with water so it could just be me...I mean, she agrees that it tastes bad, but she can tolerate it where I cannot.

~~Paige

fineanddandy
09-19-2007, 04:23 AM
Thanks Paige.

EYESTWO22
09-19-2007, 07:41 AM
Paige1989 & EYESTWO22, thank you both for your input. So, no bad side effects from the lithium and/or lamictal? Drowsiness? Brain fog? Hand tremor? Serious weight gain?

Minor hand tremor was my only side effect. however I used this to monitor my serum lithium blood tests. The more tremor, the higher the reading ...above 1.0 to 1.2. (Too high). When the tremor slowed or stoped, my serum lithium was around .06 to .08 (theraputial normal).

Carry On,

fineanddandy
09-19-2007, 01:15 PM
Thanks, eyes. A minor hand tremor would be tolerable.

langlee
09-19-2007, 01:31 PM
Just to put your mind at rest even more about Lamictal, the rash is found more often in children than adults. There's always a risk, but it seems to be minimal and many (including my son) have found it to be a good med.

I believe Depakote and Zyprexa are the two worst weight offenders, although not for everyone and there may be others. You can go online and see what a med says about their weight gain indication.

Abilify is also gaining popularity and is weight neutral and some do very well with it. It carries different side effects and, as with every med, you'd have to try it for awhile to see.

Lastly, some seem to do well with Tegretol or Trileptal. They are similar and are also weight neutral but, interestingly, according to a pharmacologist's report I recently had done for my son, Tegretol is the preferred of the two, even though Trileptal is newer.

Others people mention are Neurontin and Geodon. Don't know much about either, but at least you have a pretty good list to start researching! Good luck.

Always,

Hope

christinalf
09-20-2007, 11:47 PM
Be very aware of a medication called Geodon, I had taken Geodon for only 2 days and had involuntary Tongue and Jaw movements which is rare but very serious side effect. I had started out with tongue swelling and was slurring my words and then next my tongue was hanging out of my mouth and couldnt control it and then my jaw was fully extended and then my tongue went to the back of my mouth and I was having trouble breathing....This was the far worst side effect I have ever experienced and am very scared to ever try ay medication that can have this possible side effect or try any medicine I get nervous. I just wanted to get this side effect out there and also to let people know that Depakot Er seems to be ok so far for me and I am BP yes it makes you hungry but you can be put on another drug to calm that effect...

christinalf
09-20-2007, 11:50 PM
There are several medications you have to go through to find out what is the best for you even if you have experienced bad side effects from medications.I have been through several and I have had bad side effects and now am scared as heck to try anymore but I know I need to cause of my aggression and mood swings. I think that Topamax and so far depakote er are good ones, some times you have to tolerate small side effects like headaches,nausea,hair loss,slight weight gain to have a medication that might control the conditions that you are being treated for ... well thats my opinion anyway!

tsohl
09-21-2007, 12:10 AM
Also remember that often most of the side effects go away or lessen with time. You should give each new medication a fair chance and not give up on it too soon, unless the side effects are really life-threatening or intolerable.

fineanddandy
09-21-2007, 04:21 AM
Thank you all for your help. I am in bad shape.

tsohl
09-21-2007, 02:42 PM
Hello fineanddandy,

Would you mind saying if you are male or female? I have an easier time relating if I know that much about an individual!!

I see you can't sleep. Why don't you tell us a bit more about your symptoms, what you're having problems with, etc. Have you tried taking meds in combination? That's the only thing that worked for my son. For awhile his pdoc would give him one drug, then the next month it would be a different drug. This went on for over a year. He switched pdocs and found someone who was really good at combining meds and that was the answer. He now takes 3 mood stabilizers but no longer needs anything else -- no antidepressant, nothing for anxiety or sleep. The mood stabilizers treat the bipolar disorder rather than treating a string of symptoms. I really believe this combining is the answer for many people.

Hope you're feeling a little better by now.

xxTsohl :wave:

fineanddandy
09-21-2007, 05:22 PM
Hi Toshl,

Thank you and God Bless You for caring!

I'm female, 50 years old and, unfortunately, I have a long "history". It used to be that I only had depressive episodes which, interestingly, were cyclical and alternated with periods of irritability. Lithium was tried at one point but did little for the depression. The introduction of the SSRIs were a Godsend and the depression eased for many years.

At some point, though, I started having what I would call hypomanic episodes. That's what I am having right now. These episodes begin with a couple of days of feeling better than usual and a reduced need for sleep. They quickly deteriorate into irritability, agitation, anger, insomnia, racing thoughts, etc. It is NOT a good place to be.

These hypomanic episodes have been brought to a halt in the past by Depakote on a couple of occasions. Because they happened so infrequently, I thought (and pdoc agreed) that the mania - hypomania, whatever - was SSRI induced and I stopped the Depakote (the fact that I gained 30 pounds in short order while taking it was another factor). Several years ago, when it was obvious that these hypomanic episodes were a regular feature of my life, I started a regime of Seroquel with Zoloft (depression is still the primary feature). Because I despise Seroquel, I have gradually reduced the dose.

Now I'm in trouble. I am in England and my doctor is in the States. I could go back up on the Seroquel but I hate it and I don't want to. I could fly to the States to see her but I know that starting a new med will take more than one visit. So, I am waiting to get in with a shrink here which will happen next Wednesday morning. I hope he isn't an idiot and I hope that he will listen to me. Otherwise, I'll have to fly home to see my shrink and try to go from there.

After I go so long without sleep, I start crying, I am miserable. I am there now. However, this isn't depression. This is lack of sleep. Sometimes it's difficult to convince a new doc - they think it looks like "agitated depression" and want to give me more antidepressants. I don't need antidepressants. I need something to get rid of the "hypo"mania.

The depression will follow soon enough...

Oh, and by the way, my grandfather was manic-depressive. My father, though undiagnosed, probably is as well. So, all this isn't likely to be the fault of the SSRIs.

tsohl
09-21-2007, 06:44 PM
My son prefers the name manic-depression to bipolar disorder. He thinks it is a much more accurate description of the "dis-ease."

There are a couple people on the board that are US citizens living in England who are having difficulty getting psychiatric care. I hope you have better luck at your appointment!

There are a number of people on the board who take and have good luck taking Seroquel for feelings of irritability, rage and angry outbursts. If you took it in combination with a mood stabilizer like Lamictal (lamotrigine is the name they used in the UK, I think) would it be any less objectionable to you?
Lamictal is weight-neutral and helps with the depressive side of things, so it might be a good drug for you. If you are aware of the rash, it shouldn't stop you from trying it.

Are you in England to stay or will you be coming home in the near future? I hope you can get somewhere with the new pdoc. The last thing you need is more antidepressants if you are bipolar and not on a mood stabilizer. It might tip you over into a truly manic state which would be even worse than where you are now.

Hope you can get some sleep tonight.

Take good care,
Tsohl

fineanddandy
09-22-2007, 06:01 AM
Thanks again for caring, Toshl. It really helps to have someone to talk to.

I am fortunate in that we have good international health insurance so I can see a private psychiatrist here. I shudder to think what kind of care - or lack thereof - you'd get on the NHS. The private docs that I have seen here have been good although I haven't seen a shrink here yet. We've been here just over 3 years and should return to the States next summer.

Some of this is my fault. I am taking a low dose of Seroquel. I should go up on it, but I dont' want to!!! There has got to be something better. It gives me an elevated heart rate, acid reflux at night so bad that I wake up choking on it, and such heavy snoring that I'm sure I have sleep apnea. There has got to be something better.

I have some Klonopin that I take for trans-atlantic flights. Maybe I'll try using it for sleep tonight. My shrink at home has said I can use it for sleep, but I haven't wanted to because of the addiction potential. However, I'm not likely to get addicted just using it between now and Wednesday, right?

THANKS AGAIN for talking to me!!!

PS Lamictal sounds good.

tsohl
09-22-2007, 11:35 AM
Hello fineanddandy,

I am so glad you have this international insurance. I was surprised to learn from some of the other gals on here that with NHS you rarely see a psychiatrist, usually some sort of nurse, and when they do get to see a doctor, it is a different one each visit. The other thing I learned is that even more so than in the US, there is a certain prescribing order that they follow. For example the docs must start out with a particular medication (even if you tell them you've tried it and it had bad side effects, or didn't work). After the first drug is tried, then they prescribe the second drug on the list. ETC. I got the impression that it was not common to combine medications for mental health problems as is typically done here.

Perhaps if you could get a mood stabilizer like lamictal, you could continue taking seroquel and it would be more palatable for you. And do take the klonopin. Getting some much-needed sleep has to outweigh the fear of addiction!! No one can function without regular sleep, and it is so much more important for someone with BP, to avoid slipping into hypomania or manic episode that might require hospitalization.

I'm glad you found this board. Hopefully it will distract you until your appointment on Wednesday. When you can't sleep you might want to read through the website for the National Institute for Mental Health (nimh.nih.gov). It is a branch of the NIH that oversees most research on mental health issues in the US. Their website has lots of good information on it.

Take good care,
:wave: Tsohl

fineanddandy
09-22-2007, 12:56 PM
Yes, I'm sure what you've read is right about treatment on the NHS. They have their protocols and that's it. PLEASE do not vote for anything resembling national health care in the U.S.! I know we have our own problems, but...

Hopefully, a private shrink will be more open-minded about combining meds. Or, at least I can hope that he will give me what I want - a mood stabilizer other than Seroquel to bring this hypomania to an end. If that's all I get, I'll have to take that and try to get home before long to see my doc. If I don't get a new mood stabilizer, I'll have to fly home pronto which will be difficult due to childcare issues with my husband out of town. But, ya gotta do what ya gotta do, right?

Thank you again, Toshl, for talking to me. It helps!

PS. If anyone else wants to join in, great. It's not a closed conversation.

kleighh
09-22-2007, 03:45 PM
Hi, Sorry to jump in on your conversation about good mood stabilizers but I thought it might be good to tell you what has worked for me. I was diagnoed in 2003 after receiving a diagnosis of depression for years. I have been on several different meds....lithium, depakote, zyprexa, abilify, to name a few. 2 years ago I was put on Limictal. It took awhile but it worked for me. I'm currently on Lamictal, effexor, trazadone and valium when I need it. I have been symptom-free for about 1 1/2 years. That, sadly, is a miracle for me. I was having about 8-9 months of depression and was manic for the remaining part of the year. I always fear that my symptoms will return but as months go by, I feel better about having this disorder. I hope you are able to find the right combination for you. It's amazing how much life chnges when you do. Good luck.

tsohl
09-22-2007, 07:39 PM
Hello kleighh,

Please jump in and welcome to the board. Lamictal seems to be a wonderful mood stabilizer for many. I hope it will work for Fineanddandy...and I am glad you have finally found a good combination that works well for you.

Please keep posting with your comments and questions.

xxTsohl :wave:

fineanddandy
09-23-2007, 05:35 AM
Kleighh, thanks very much for jumping in. That's exactly the kind of information that I was looking for.

whoevea
11-08-2007, 10:26 PM
i have not found one that works for me yet and i have been on so many.

right now im on lithium and i hate it. i took my last pill today and i wont take it again. all i wanna do is sleep and i am very moody !!!

also gained a few pounds and i dont want that. now that makes ya depressed:mad:

i was on topamx before and i lost alot of weight. more then i needed to. but i migfht go back on it so ican lose these pounds i gained from lithium.

i go to my doc on saturday and im gonna ask him for depakote er. i never tried that so i migfht give it a shot.

i have no social life because of my illness. people are alwAys caling and wanting me to go out but i dont. i just work and go home and go to sleep..
well im tired of it and i wanna get better !!!!
sorry this is so long but it feels good to vent.

godd luck everyone

gortian
11-09-2007, 03:42 AM
Lamictal works great for me. I haven't experienced any side effects. It works
well for the manic as well as the depressive phase.

dragon25
11-09-2007, 08:43 AM
Hello,
Lithium worked well for me but lost its effectivness after 2 years. I also had weight gain, and extreme thist, and also the terrible side effect, diarhea. I also had hand tremors. Then I changed to Depakote which threw me into mania. I switched to Lamictal and it has worked great, then later added Trileptal. I also take Seroquel. The Lamictal and Trileptal is the best thing I have been on. I vote Lamictal if you don't get the rash.





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