# In your opinion what is the best Bipolar/BPD drug?



## Arisa1536 (Dec 8, 2009)

Out of all the members on here who are taking a drug for the treatment of a form of mood disorder, be it Cyclothymia, bipolar 1 or 2 or Borderline personality disorder, what has been the most effective drug for you in terms of tolerability, efficacy and side effects

I know there is no miracle cure for any illness but overall is there a drug you would recommend that did significantly improve your moods and issues?

The Drugs my pdoc mentioned to me were

Zyprexa (olanzapine) 
Seroquel as per usual
Lamictal lamotrigine (which i like the sound of)
Abilify (aripiprazole)
Mirtazapine remeron


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## Noca (Jun 24, 2005)

I only suffer from unipolar depression but I have read many anecdotes/done my own research/my own opinion and came up with Carbamazepine or Lamictal mixed with an antidepressant. They aren't stupid anti-psychotics, help both poles of depression, and they both lack weight gain as a side effect(talking about the fore mentioned drugs)

IMO Zyprexa should be reserved for ONE and ONLY one purpose; to stimulate appetite in order to gain weight to achieve a healthy BMI in combating anorexia/other ED/or for HIV/AIDS patients. There are better choices that leave this one in the dust every time for any other indication. This is due to Zyprexa being IMO the strongest appetite stimulant in use on earth, EVER! Even compare it's own side effect profile of the incidence of weight gain to any other drug. As well the diabetes type II risk is most likely higher than any other atypical out there. Eli Lilly is being sued currently for millions for this reason.


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## swim (Apr 4, 2011)

NOT mirtazapine :flush
I'd rather Lamictal as I've read it's also indicated for uni depression and has minor side effects than other mood stabilizers, such as carbamezapine.
A neurologist once wanted me on carbamezapine and I bounced the prescription.


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## Duke of Prunes (Jul 20, 2009)

I know somebody on olanzapine (presumably not at a high dose, there's no schizophrenia or any other psychotic illness) and he's a mess. He can barely talk or function in daily life, he's emotionless (he's on SSRIs as well, but I know people who are on SSRIs alone and they're not THAT emotionless so that doesn't explain it) and he's basically 'out of it', not at all in touch with reality. Surprisingly, he isn't fat or diabetic, but his brain is basically gone.

Stay away from that crap, seriously, in fact, stay away from antipsychotics in general. It's scary what they do to people. If the only alternative is dangerous, psychotic behaviour, then it's acceptable as a last resort, but unnecessarily dosing people with antipsychotics is no better than a reversible lobotomy (unless taken long-term in which case the damage can be permanent).


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## jim_morrison (Aug 17, 2008)

Dr House said:


> As well the diabetes type II risk is most likely higher than any other atypical out there. Eli Lilly is being sued currently for millions for this reason.


 Woah the Zyprexa Settlement was massive 



> Zyprexa, Lilly's best-selling drug, has been the subject of federal and state investigations into whether the company marketed the medicine, approved for schizophrenia and bipolar disorder, for unapproved, or off-label, uses. Lilly resolved a marketing investigation in January with the U.S. Justice Department, promising to pay $1.42 billion, including about $362 million to more than 30 states.


http://www.bloomberg.com/apps/news?pid=newsarchive&sid=aUgLzDmvzVK0


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## CD700 (Apr 22, 2010)

I have atypical depression and Social phobia but my doc gives me seroquel XR to help sleep and i love it
It makes me sleep like a baby, with no drowsiness once i wake up and no side effects
The original plain old seroquel i would not take again, it knocks you out quick and keeps you drousy the next day for ages


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## Arisa1536 (Dec 8, 2009)

Wow thanks for the responses 
I did not know about that olanzapine case :afr
And blakeyz are you on the new sustained release seroquel?
The old seroquel is intolerable for me

And Swim, yeah i wont be taking mirtazapine its evil


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## rockyraccoon (Dec 13, 2010)

For mood disorder I have tried 3. The first was Lithium and I could not stand that drug. It actually created insane mania out of me. Bad, bad, drug. Then I tried Lamotrigine, but got the dreaded rash from it. It's gone now, so I'm ok. Now I've been on Valproic Acid (Epival). It seems to work a little for my irritability (that is how I experience mania). It's a pretty clean drug, but a little sedating. I haven't gained any weight on it.

I just mentioned some of the classic mood stabilizer drugs. I know that there are anti-psychotic meds that are prescribed off label for mood disorders, but that's another topic.


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## jim_morrison (Aug 17, 2008)

A quick youtube video overview of bipolar disorder by Doctorofmindmd;





At one point he states "you want a mood stabilizer first, then you add the antidepressant".

As for the meds your pdoc mentioned;

Zyprexa, Seroquel and Abilify are Aypical Antipsychotics

Lamictal is an Anticonvulsant-type mood stabilizer

And Mirtazapine is an antidepressant which is not a mood stabilizer at all.


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## JohnG (Sep 3, 2010)

jim_morrison said:


> And Mirtazapine is an antidepressant which is not a mood stabilizer at all.


Serotonin acts as mood stabilizer too, and Mirtazapine works very good on it.

Lamotrigine is good too. (mood stabilizer+antidepressant proprieties over 200 mg)

Screw antipsychotics.


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## jim_morrison (Aug 17, 2008)

JohnG said:


> Serotonin acts as mood stabilizer too, and Mirtazapine works very good on it.


You mean serotonin-2A receptor blockade? Yes that property of mirtazapine may allow it to help with mood stabilization, but other properties of mirt may/may not be good for bipolar (studies are lacking AFAIK for mirt & bipolar disorder).


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## Bacon (Jul 4, 2010)

I know Seroquel is used as a fix it all drug. But Seroquel works really well. Its technically for my depression, But i get Bipolar and Derealization and paranoia and it helps alot. It is very sedating and relaxing. Works well in keeping my mood stabilized.


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## A Sense of Purpose (May 8, 2011)

Bacon said:


> I know Seroquel is used as a fix it all drug. But Seroquel works really well. Its technically for my depression, But i get Bipolar and Derealization and paranoia and it helps alot. It is very sedating and relaxing. Works well in keeping my mood stabilized.


How long have you been on seroquel for? Do you have any signs of the EPS (uncontrolled twich, shaking, tremmor)?


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## Bacon (Jul 4, 2010)

A Sense of Purpose said:


> How long have you been on seroquel for? Do you have any signs of the EPS (uncontrolled twich, shaking, tremmor)?


Nope. When i take it i feel relaxed sleepy and at ease and i don't get mad as easily.


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## Arisa1536 (Dec 8, 2009)

Seroquel is a NO go for me, i will never take it again
I know its used for anything and everything including bipolar but i wont take it because i have been on it that many times and all its done is created massive hunger and weight gain, stomach cramps and horrendous migraines oh add to that sleep paralysis and the drug is deadly.

I think the general opinion seems to be that lamictal is a good choice when mixed with an antidepressant so i hope to add it to effexor XR

rocky, you mentioned you are able to tolerate Epival? thats brilliant :yes as i know you have a hard time finding the right medical combo.

The rest of the drugs mentioned are basically antipsychotics? 
and mirtazapine sounds like it would make my mood worse rather than better

Anyone have any experience with benzos for bipolar???


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## rockyraccoon (Dec 13, 2010)

Arisa1536 said:


> Seroquel is a NO go for me, i will never take it again
> I know its used for anything and everything including bipolar but i wont take it because i have been on it that many times and all its done is created massive hunger and weight gain, stomach cramps and horrendous migraines oh add to that sleep paralysis and the drug is deadly.
> 
> I think the general opinion seems to be that lamictal is a good choice when mixed with an antidepressant so i hope to add it to effexor XR
> ...


I tried benzos in the past. A few years ago, before I was put on anti-psychotics, my doc had me on just Oxazepam at 60 mg. This drug was an absolute miracle. It completely wiped away my depression, anxiety, insomnia, irritability, all in one. But my doc at the time only gave it to me for a month. Anyway, I told my psychiatrist to put me on it about a month ago, but for some reason it did not work this time around. Maybe it's because of all the other prescription meds floating in my system.

If you take Lamactil check your whole body everyday for the rash, I'm talking right after you start the med. The rash hit me at 25 mg within 2 days. But, and this is interesting, there was still Epival in my system, and it is very specific to not mix Lamactil and Epival. So maybe that's why I got the rash.


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## Bacon (Jul 4, 2010)

Arisa1536 said:


> Seroquel is a NO go for me, i will never take it again
> I know its used for anything and everything including bipolar but i wont take it because i have been on it that many times and all its done is created massive hunger and weight gain, stomach cramps and horrendous migraines oh add to that sleep paralysis and the drug is deadly.
> 
> I think the general opinion seems to be that lamictal is a good choice when mixed with an antidepressant so i hope to add it to effexor XR
> ...


TRUE iv gained a few LBS on seroquel! Makes you so hungry! xanax munchies are hell, u litteraly eat untill you pass out. Gained freakin 13 LBS on seroquel -.-. i started Vyvanse today and it destroys my appetite so hopefully i can loose some weight.......Because weight gain does nothing for my depression but make it worse.


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## Arisa1536 (Dec 8, 2009)

Yup weight gain indeed makes depression ten times worse :yes
What is Vyvanse if you do not mind me asking? or is there another word for it that i may know? 

Rocky, so perhaps it was the mixture of Lamactil and Epivall together that caused your rash?
Atleast you got mood stabilizers, its a battle and a half trying to actually convince the pdocs i do need some help for my moods

For some reason doctors only want to issue meds that make you gain weight as they think i only have anxiety therefore sedating meds that are not benzos like remeron, seroquel and antipsychotic crap are what they keep telling me about 
I am pushing for either lamactil if it is indeed a form of bipolar i have or bupropion if its atypical depression as it can be mixed with effexor

I do not know why doctors are so skeptical of bupropion but remeron and potentially dangerous drugs like olanzapine, risperidone and haldol are ok???


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## TyrosineKinase (Jan 20, 2010)

I'm currently on lamictal for migraine prophylaxis but I have to say, it has been the only medication that has lifted at least a little bit of the depression. While the effect is very subtle in my case, it has done a better job than any of the antidepressants or antidepressant combinations I have ever tried.


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## Bacon (Jul 4, 2010)

Arisa1536 said:


> Yup weight gain indeed makes depression ten times worse :yes
> What is Vyvanse if you do not mind me asking? or is there another word for it that i may know?
> 
> Rocky, so perhaps it was the mixture of Lamactil and Epivall together that caused your rash?
> ...


adderall is 75 Percent Dextroamphetamine and 25 percent LevoAmphetamine. Adderall lasts 4 Hours. Vyvanse lasts a long time! Like 12 hours!

Its simmilar to Adderall XR. Made by the same company to extend the patent its for ADHD. Its *Lisdexamphetamine, *Its DextroAmphetamine Binded to a Protein. Basically a way for the company to extend the patent and make money of it. Adderall is a mix of amphetamine salts and Dextroamphetamine. Vyvanse is Pure DextroAmphetamine Binded with a protein to get *Lisdexamphetamine.*


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## A Sense of Purpose (May 8, 2011)

TyrosineKinase said:


> I'm currently on lamictal for migraine prophylaxis but I have to say, it has been the only medication that has lifted at least a little bit of the depression. While the effect is very subtle in my case, it has done a better job than any of the antidepressants or antidepressant combinations I have ever tried.


*ears prick up* - For *migraine prophylaxis*?  Interesting, i wasnt aware that lamictal had potential to do that.... Im guessing its similar to Topamax. Maybe ill suggest it to my pdoc in 3 weeks time


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## Noca (Jun 24, 2005)

A Sense of Purpose said:


> *ears prick up* - For *migraine prophylaxis*?  Interesting, i wasnt aware that lamictal had potential to do that.... Im guessing its similar to Topamax. Maybe ill suggest it to my pdoc in 3 weeks time


I assume all anticonvulsants have that potential to some degree.


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## A Sense of Purpose (May 8, 2011)

Dr House said:


> I assume all anticonvulsants have that potential to some degree.


Yeah now that i think about it, it does make sense. My neuro is anoying in that he never explains what he is giving me and why/how it works.

I just presumed that anything like topamax was rubbish for me and put anything like it in the "not for me" box. Maybe i need to pursue this line of meds to see some benefits.


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## Noca (Jun 24, 2005)

A Sense of Purpose said:


> Yeah now that i think about it, it does make sense. My neuro is anoying in that he never explains what he is giving me and why/how it works.
> 
> I just presumed that anything like topamax was rubbish for me and put anything like it in the "not for me" box. Maybe i need to pursue this line of meds to see some benefits.


It's what I've always suggested to ppl for migraine prevention(not treatment).


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## ugh1979 (Aug 27, 2010)

Has anyone tried Oxcarbazepine for stabilising their moods? It's pretty much Carbamazepine with less side effects.


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## Arisa1536 (Dec 8, 2009)

Topomax is balls :flush
horrible stuff and made my severe tension headache worse
Its now being used to treat mood disorders which is crazy :blank

@*TyrosineKinase* thank you for your post :squeeze
If lamictal can help migraine as well as ease the manic symptoms of bipolar i am very much going to push the issue with my pdoc next week

*Ugh1979* i have this link if you want to read it on Oxcarbazepine

Its primary Uses are for the:
In treatment of epilepsy
Bipolar disorder

Side effects

Oxcarbazepine causes d*izziness, drowsiness, blurred or double vision, fatigue and may cause headaches, nausea, and vomiting*. It can also cause *hyponatremia *(2.7% of patients)Also people experience an intense craving for salty foods (such as potato chips) and *increased impulsiveness* have also been noted. Other side effects include *stomach pain; tremor; rash; diarrhea, constipation, decreased appetite; and dry mouth*. 
Skin issues *sensitivity to sunlight* also may increase, and patients could experience severe sunburns as a result of sun exposure. The frequency of adverse effects rises above a daily dosage of 1200 mg. Some patients reported a sensation of incontinence after taking the drug, although the sensation was *false.*

source
wiki/Oxcarbazepine


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## A Sense of Purpose (May 8, 2011)

Arisa1536 said:


> Out of all the members on here who are taking a drug for the treatment of a form of mood disorder, be it Cyclothymia, bipolar 1 or 2 or Borderline personality disorder, what has been the most effective drug for you in terms of tolerability, efficacy and side effects
> 
> I know there is no miracle cure for any illness but overall is there a drug you would recommend that did significantly improve your moods and issues?
> 
> ...


Arisa you may find this useful. I came across it when viewing some bipolar style videos on youtube and found this post by a psychiatrist that discusses the different types, response rates and types of meds best suited to each phase. You may already know some of the info but it might be helpful.


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## SAgirl (Nov 15, 2003)

I thought lithium was the drug most used to treat bipolar.


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## Arisa1536 (Dec 8, 2009)

Lithium is not an option for one my pdoc said no and secondly the weight gain and lethargy would make me more depressed. 
Its also more commonly used in bipolar 1 with more manic episodes and with me i have more lower depressive episodes so i would need something less sedating 

Thanks for the youtube clip *senseofpurpose*
i also do not like the side effects



www.webmd.com said:


> Common side effects of lithium can include:
> 
> Hand tremor (If tremors are particularly bothersome, an additional medication can help.)
> Increased thirst
> ...


I already have hypothyroidism which was acquired from medication

then again i cannot be certain which form or mood disorder i have until i am properly diagnosed, at this stage i have only been assessed and typical bipolar meds like seroquel and klonopin have not been effective but i have not tired lamictal yet


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## A Sense of Purpose (May 8, 2011)

Arisa1536 said:


> Thanks for the youtube clip *senseofpurpose*
> i also do not like the side effects
> 
> I already have hypothyroidism which was acquired from medication
> ...


The whole scenario of side effects is such a horrible thing to have to deal with. It can leave you scared to try a medication, severely scared when you experience some of the more serious ones, and is quite mentally draining to think that it may help you, but at the cost of things like acne, weight gain, movement disorder... Sigh, one of the many joys we all battle.

Getting the right info and treatment is so crucial. Hope all goes well


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## medicine pie (Jun 7, 2011)

I'm on topiramate (brand name topamax) it's a mood stabilizer (originally fomulated to treat a and epilepsy) and anti-convulsant and also happens to be a miracle weightloss drug, seriously I have no appetite and am eating next to nothing.

SWIM takes lamotrogine he says if he went off it he'd kill himself so I figure it works for him...

In terms of anti-psychotics I used to be on respiridone which probably helped with my bipolar but made me gain weight. I'm gonna go with the majority and say ****em

Ellie x


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