The world of mood stabilizers way too often poses a survival challenge. I mean, anticonvulsants, atypical antipsychotics, and more. How in the heck are you supposed to know what to do? Thing is, if you’re struggling somewhere along the mood spectrum you really need some answers. Maybe this will help…
‘A group of medications which can treat both mania and depression; or at minimum, they treat one of the two and rarely cause the other pole to become worse in the process.’
I’m thankful, as I’ve personally and clinically seen the confusion, frustration, and fear they can generate. ‘Course, I’ve also seen some pretty amazing positive outcomes.
Contemplating what to write about this week, I visited one of my very favorite websites. That would be “PsychEducation: Treating the mood spectrum,” produced by a wonderful psychiatrist, James R. Phelps, MD.
I’ve used his material numerous times here on Chipur, as it’s well-considered, fresh, compassionate, and the good doctor doesn’t take himself too seriously. I’ll zing you a link at the end.
The Mood Stabilizers
In addressing mood stabilizers, Dr. Phelps first reviews definitions. What say we run with this one: “A group of medications which can treat both mania and depression; or at minimum, they treat one of the two and rarely cause the other pole to become worse in the process.”
He then shares a couple of general thoughts. He emphasizes that with the probable exception of fish oil and low-dose thyroid, none of the mood stabilizers he lists are known for sure to be safe during pregnancy. He goes on to say that any woman taking any of the listed meds should have a very reliable plan for avoiding pregnancy. And if in doubt, chat with her doc.
He then announces he’s removed three meds from consideration because randomized trials showed them no better than placebo in the treatment of bipolarity: gabapentin (Neurontin), topiramate (Topamax), and tiagabine (Gabitril).
Dr. Phelps provides so much great reference information. I thought sharing just two of his tables would provide some direction for those who feel a little lost. Trust me, the tables on his site are prettier, but let’s just say I couldn’t pull-off a better transfer…
Dr. Phelps’ Tables: Main Options
*along with all the traditional “antidepressants” like fluoxetine (Prozac), sertraline (Zoloft), etc., etc.
Dr. Phelps’ Tables: How Might You Choose?
|MEDICATION||WHY YOU MIGHT CHOOSE IT|
|lamotrigine / Lamictal|
|quetiapine / Seroquel|| |
|divalproex / Depakote|| |
|carbamazepine / Tegretol|| |
|olanzapine / Zyprexa|| |
|oxcarbazepine / Trileptal|| |
|omega-3 fatty acids/fish oil|| |
|atypical antipsychotics|| |
(the atypicals are low-dose boosters for specific problems (as add-ons to “real” mood stabilizers?))
So There You Have It
The world of mood stabilizers: often confusing, frustrating, and scary. However, maybe Dr. Phelps’ insight and information will help you find your way.
Be sure to check-out his Mood Stabilizers page. Hey, his tables are nicer and there’s more info. And I’ll bet once you’re on his site you won’t be able to leave for a while.
As always, take the time to peruse hundreds of Chipur titles. And if you’d like to read the Chipur articles featuring Dr. Phelps’ work, type Dr. Phelps in the search box.