Posted by Ritch on May 27, 2002, at 8:45:33
In reply to New Mood Stablizers Unproven, posted by JohnnyS on May 26, 2002, at 23:24:14
> Hey Everyone,
>
> Could someone help me with this. So far, this is the status of the new anticonvulsants in psychiatry. Anyone with more informative, please add to it. Thank You.
>
> 1. Neurontin: Studies shows placebo better than neurontin for bipolar disorder, company has abandoned FDA approval.Often when a drug is studied for "bipolar disorder" it is being tested soley as an *antimanic* medication (to treat an acute manic episode). There are a lot of other symptoms associated with chronic bipolar disorder that don't involve acute manic spells which Neurontin may be effective at treating, such as anxiety and agitation. Often Neurontin is used in combination with lithium or depakote for those reasons.
>
> 2. Lamictal: One study with mild to moderate efficacy in bipolar depression. I think in phase III study.I think there has been some success with individual patients with treatment-resistant *unipolar* depression as well.
>
> 3. Topomax: I read on "Psycheducation" web site by Dr Phelps that preliminary studies were poor and that the company is stopping seeking approval by the FDA.As with Neurontin, Topamax may be useful in some patients who are also on "first-line" medications.
>
> Many doctors still use these meds as first line over lithium and depakote when studies are negative. Does anyone know why this is. Thanks.
>
> JohnnyS
I think it would be unlikely if a patient who had never been previously diagnosed with bipolar disorder and was experiencing an acute manic episode (for the first time) would be given the above medications. Usually "2nd-line" treatments are used when the patient cannot tolerate Depakote or lithium (for medical reasons, i.e.), or they simply have failed to respond. More often than not I think the "2nd-line" meds are used to augment "first-line" meds. However, I suppose the wisdom of that could be questioned as well.Mitch
poster:Ritch
thread:107689
URL: http://www.dr-bob.org/babble/20020525/msgs/107719.html