Psycho-Babble Medication | about biological treatments | Framed
This thread | Show all | Post follow-up | Start new thread | List of forums | Search | FAQ

Re: lithium » rjlockhart37

Posted by SLS on January 6, 2023, at 7:27:04

In reply to Re: lithium, posted by rjlockhart37 on January 5, 2023, at 21:36:30

Hi.

> but for right now im seeming to be ok

That's good. Every okay moment is a blessing.

Is hypomania your priority concern right now? Is your hypomania euphoric or dysphoric?

For a dysphoric hypomania, I have seen topiramate (Topamax) 200-400 mg/day worked wonders for a case of dysphoric / irritable hypomania. She might have been diagnosed as having Bipolar Disorder / Mixed state. I never asked her, but the symptomatology that she displayed was one of high-energy and anger. My guess is that topiramate is most effective when treating dysphoria or mixed-states in Bipolar Disorder. Its utility might be limited to a narrow spectrum of a Bipolar presentations.


If true hypomania is part of your condition, you have several choices that come to mind:

1. High-Dosage Lithium: 900-1500 mg/day.

2. Moderate Dosage Atypical Antipsychotic: Years ago, I would have recommended olanzapine (Zyprexa) if you tolerated it. However, olanzapine practically guarantees an insatiable appetite and a large increase in body weight. I think 10-20 mg/day would be appropriate. Since then, many more atypical antipsychotics have become available for which a large weight gain is not as much of a problem. If you never tried asenapine (Saphris), I would consider placing it towards the top of your list. It might reduce your hypomania and avoid or reduce depression. While taking asenapine, I experienced a significant antidepressant effect that lasted for about a week. For me, experiencing such an improvement is unusual. https://reference.medscape.com/drug/saphris-asenapine-999301. One drug that I am not sufficiently familiar with is lumateperone (Caplyta). Lumateperone might be a better choice for treating Bipolar Depression than is lurasidone (Latuda).

3. Moderate Dosage Anti-convulsant: Oxcarbazepine (Trileptal) would be my choice. It is a cousin of carbamazepine (Tegretol) for which agranulocytosis is not a side-effect. The only significant side effect of oxcarbazepine that I am aware of is hyponatremia (low sodium). https://pubmed.ncbi.nlm.nih.gov/19007842/ Other anticonvulants worth looking at are topiramate (Topamax), valproate (Depakote), lamotrigine (Lamictal). I don't have enough of a feel for the others to be able to comment on them.

4. Something suggested by others.


- Scott


Some see things as they are and ask why.
I dream of things that never were and ask why not.

The only thing necessary for the triumph of evil is that good men do nothing.

 

Thread

 

Post a new follow-up

Your message only Include above post


Notify the administrators

They will then review this post with the posting guidelines in mind.

To contact them about something other than this post, please use this form instead.

 

Start a new thread

 
Google
dr-bob.org www
Search options and examples
[amazon] for
in

This thread | Show all | Post follow-up | Start new thread | FAQ
Psycho-Babble Medication | Framed

poster:SLS thread:1121482
URL: http://www.dr-bob.org/babble/20220917/msgs/1121494.html