General Question

aviona's avatar

Can anyone give me any advice on mood stabilizers?

Asked by aviona (3250points) March 14th, 2009

I know everyone body chemistry is different, but I’d like to hear what you have to say.

As for me, I’ve been on Topamax for a few months now and it’s been the only medication that I’ve tried that hasn’t given me the awful tremors. I’m wondering if I may be building up a tolerance to it or maybe need to add an anti-depressant to my daily regime.

Any experiences/side effects/pleasant & unpleasant experiences you wouldn’t mind sharing would be greatly appreciated.

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33 Answers

casheroo's avatar

Are you just taking Topamax for bipolar? I have never heard of just taking it alone. Usually there is another medication along side of it.
You really need to talk to your psychiatrist. Do not up your dose of anything without speaking to a doctor, because those medications need to be monitored.
I’ve never taken Topamax, something similar I have taken was Lamicatl. I never had any issues with Lamictal. I do recall having to be observed closely when I first started it, because of the rash it can cause. But, I’ve known many people who have taken Lamictal successfully. Lamictal usually goes alongside something like Lithium.
This is for bipolar. I’m guessing that’s what you’re talking about, because of your tags.

casheroo's avatar

Oh and a site I enjoy about psychiatric meds: http://www.crazymeds.us/

aviona's avatar

Yes, I am bipolar with hypomania and pretty bad depression at the moment (the catalyst being a breakup). Also, I’m sort of in between therapists and psychs at the moment.
I was recently discharged from the hospital, where they upped my Topamax dosage from 100mg/day to 150mg/day.
I did try Lamictal a while back and you just reminded me that I got a rash too! It was terrible and I think that’s why I went off it. But, yes, I think I do need something in conjunction with the Topamax, which is obviously something I will need to bring up with my psych, when I finally see one.
I just wanted to hear what some Fluthers had to say. I’ll check out that website. Thanks for responding so quickly :)

casheroo's avatar

Oh, you got the Stevens-Johnson Syndrome, from Lamictal?? I’ve heard it can happen but have never talked to anyone that actually got it. I was so scared of it because they wanted me to look over my body every day for at least the first 7 days and report any weird changes.
If the hospital just discharged you, you usually need to see a psychiatrist within a week of leaving. Have you seen one yet? I would take the 150/mg, but wouldn’t take any more until you talk to a doctor.
How long have you been on the Topamax? Have you tried any other medications for your bipolar, anything like an Antipsychotic? You can take those in conjunction with SSRIs. But it’s not always necessary.
Every body is different in the medications they need, as I’m sure you know. I hope a doctor can help you figure out what the best plan for you is!

aviona's avatar

The problem is I have Kaiser and they’re just really overbooked and there isn’t one in my area and I have to drive about 45 minutes to the closest one. But I’m working on it.
I tried Abilify and got tremors, but have never tried an antipsychotic.
I’ve been on Topamax since August.

augustlan's avatar

I was on Topamax for about 6 months, in addition to my anti-depressant. I’m not bi-polar per se, but was having trouble regulating my moods for a while. It worked very well, but I developed an eye twitch and my eyeballs started to feel very pressurized. Apparently, it can cause Glaucoma. I had to stop taking it, but have been fine without a mood stabilizer ever since. Good luck to you!

aviona's avatar

@augustlan thanks for the warning and the advice. Glad to hear that it worked for a while and that you’re functioning fine without the meds.

caeliste's avatar

A friend of mine takes Lexapro in conjunction with Lamictal and it seems to work really well. She said the Lexapro was really hell on her sex drive though.

nebule's avatar

are there any natural remedy mood stabilisers? just wondering

pekenoe's avatar

Lexapro works well in this house, we both take 100mg.

I’ve tried several and had unfun side effects with all but Lexapro.

I’ve been kinda curious though, seems to me that physicians over dose many people rather than starting with a minimum dosage and working up if need be. Also, many get the scripts from their family physician rather than talking to a doc that specializes in mental meds.

pekenoe's avatar

@lynneblundell : St Johns wart ???

How do I edit this answer and delete it so I can paste on my other one?

gailcalled's avatar

Lexapro make me vomit almost immediately, Prozac gave me grotesque nightmares, Wellbutrin (which does not suppress the libido) did nothing. I now take 50 mgs of Zoloft. Getting the psychotropic meds right is an art and not a science. Don’t stick with any meds. that are either ineffective or produce odd side effects for more than several days.

Zoloft is given in a very low dose for four weeks and then increased.

aviona's avatar

I was on St. John’s Wort for almost a year and as far as I can tell it did nothing. Also, you need to be careful while taking it because it can decrease the effectiveness of some birth control (hormonal methods).

Thanks for the advice @gailcalled and @pekenoe.

Darwin's avatar

There seems to be a huge range of combinations of medications for bipolar. My son has never taken Topamax or Lamictal, but he has taken Abilify, Geodon, Depakote, Clonidine, Seroquel, and Lexapro for it in various combinations (not all at once). The first time he took Seroquel it made him hallucinate but now, 7 years later, it works well for him. He currently takes Depakote and Seroquel for the bipolar, Tenex for his inability to control his anger, and Metadate to help him focus on school work. At this point in time, Depakote has been an excellent mood stabilizer for him.

There is a lot of information at http://www.helpguide.org/mental/bipolar_disorder_medications.htm . You might want to check it and its links out.

I personally take Zoloft and it works wonderfully for me. A coworker took Zoloft, however, and had big problems.

It really is trial and error.

wundayatta's avatar

What other meds have you been on, Aviona?

aviona's avatar

@daloon jeesh I can’t even remember them all.

They started me on Paxil because my mom had luck with that. Tremors. I got a rash on Lamictal. I’ve been on both Klonopin and Xanax for anxiety. I’ve tried Abilify and got tremors. Depakote=tremors. I either tried Neurontin or Lexapro and got tremors, too. Ay. I was considering Wellbutrin if my psych will prescribe it to me. I read pretty good reviews of it. I’ve never tried any of the seemingly “popular” ones like Prozac, Zoloft, or Lithium.

pekenoe's avatar

@aviona Sometimes the old standbys will work fine, Prozac worked for me for a few years then the effectiveness of it went downhill.

Hate the trial and error crap, tequila works well but has that “clothes fall off” side effect. Which, at my age, works well when I want to be alone :-)

wundayatta's avatar

My shrink says that Lithium is the “gold standard.” He always tries it first (and he’s some kind of knowledgeable researcher. I found him to be conservative. He makes changes slowly and deliberately, but they seem to work. The Lithium helped me stabilize, but didn’t eliminate depression. The Lithium did make my fingers tremble. Is this what you mean by tremors?

Anyway, I would ask about Lithium. I know a lot of the new drugs are seen as the latest thing, but sometimes the old standards work best. As I told you before, I am also on Welbutrin (again, with the conservativism). Finally, when my depression didn’t go away, and after many pleas from my wife, he was willing to try Lamictal, which is my miracle drug. He was reluctant to try because of the rash problem, which, he said, killed one in 5000 people who took it.

You got the rash, but have survived. How bad was it? Did it start in feet or hands, like my shrink said it would? How far did it spread? Was it itchy or burning or what?

The other interesting thing, is that my cousin and my aunt both are on Lamictal, and are having very good success. They say that drug response might have a genetic component.

Is it depression you’re fighting now? Are you trying to educate yourself so you can influence your next shrink? My shrink says Lithium is a mood stabilizer that works better on controlling mania. Lamictal works better on controlling depression. If you are having problems with the depressive side, maybe Lithium wouldn’t be so helpful to you. But talk to your shrink anyway. Who knows?

Actually, no one knows. We’re all lab rats as far as the shrinks are concerned. Sigh.

casheroo's avatar

@daloon Maybe she hasn’t had a manic episode in a while? I know my doctors tried quite a few other meds before putting me on Lithium, and I went on it after a manic episode that threw me into a suicidal phase.
Lithium gave me “tremors” too. I guess I felt the tremors were worth the benefits of the medication. My hands became unsteady and I could not even feed myself without dropping the food a couple times. It was embarassing, but I’d rather have shaky hands than want to kill myself.
I liked what Lithium did, at first. But, I had severe long term affects from it. I had to drop out of college, and could no longer concentrate. My memory went out the window. I couldn’t remember anything from the days before, so school was impossible. Reading because impossible because I could no longer comprehend or retain what I was reading. It took me months to learn to read again, once I came off of it.
I personally would never go back on Lithium, but psychiatrists tell me what happened to me was a more rare side effect.

also, @daloon The rash is an allergic reaction, they would have taken her off Lamictal immediately.

wundayatta's avatar

@casheroo—I have yet to be able to read again—printed material, anyway. I can read online, obviously. I also had the memory problems, and they are still going on. I have trouble remembering names, both of people and of concepts. That may be slowly diminishing, though. I also have a skin rash (predating the lamictal), and I’m gaining weight. So, I’ve got four of the five or six main side effects of lithium, lucky me. My tremors were never bad enough to make me drop things, although they did help me break a thing or, two. I still have trouble with a newspaper. I can’t separate the pages for a long time, and it is frustrating trying.

But, as you say, it’s a small price to pay for stability. I’m hoping to come off it someday. My shrink says we might consider it after a year of stability.

aviona's avatar

Yes, that is what I meant by tremors. I believe the rash from Lamictal started on my hands and neck. And right now I’m definitely going through a depressive stage (the catalyst being the breakup). Normally I cycle fairly quickly, but have not been “up” in several weeks.

Thank you for all the advice @daloon & @casheroo

casheroo's avatar

I’m not trying to diminish your feelings, but if the catalyst is a breakup, maybe you should try more therapy that changing your medications. Working out your feelings over a breakup might help prevent you from cycling so quickly, and you can become stable as the medication has more time to kick in.

wundayatta's avatar

@aviona, I know you think you’re addicted to this site and you want to go. All I can tell you is that I found this site and one that used to be like it very valuable in my recovery. It still helps. If you are going to be isolated in the real world, this could be very important. Don’t let the depression make you hurt yourself. Well, try not to, anyway.

aviona's avatar

Thanks for the advice, especially about not disregarding Fluther as a resource.
Yes, I definitely need to get into some therapy, but I also definitely need something to help me get out of bed in the morning and to take a shower since I apparently have lost the will to do it on my own. I used to have it. I know I did. You know, I need that jumpstart. And then the therapy can help with the emotional digging.

gailcalled's avatar

One surefire method for getting you out of bed before noon (but not into the shower) is to get a cat. Milo increases his meows, crash landings on me and general displays of annoyance if I try to sleep in.

This AM. since I am recovering from strep throat, I got up, fed and watered him and threw him outside to catch the delicious spring rodents. 30 minutes later, I noticed that he was looking in one of my bedroom windows from the outside.

He had climbed up on a roof and navigated to the one open window. I had to get up, find a Phillip’s screw driver, take off the crank, and remove the screen. I’ll get to nap later when he has his.

Laughter also helps mild depression..

adreamofautumn's avatar

just a quick sidenote to anyone mentioning anti-psychotics. I have hypomania as well (seems common in us younger folk, not sure how old you are @aviona ) and while I am not on medication due to my personal beliefs, my doctors and shrinks have told me that they generally try to avoid giving antipsychotics to people that don’t get full-blown mania because it can push the depressions even lower if it’s not the exact balance you need. Hypomania is a pain in the ass, but can usually be handled without the big gun anti-psychotics.

aviona's avatar

Thank you @adreamofautumn. Great advice. I’m 19 years old. I’ll be 20 in 2 weeks.

Just a note to everyone whose been so kind to offer me advice: I got prescribed Wellbutrin today and my psych switched me to Ativan. I’ll be staying on the Topamax. Sooo…I’ll keep you updated on how the Wellbutrin works.

adreamofautumn's avatar

@aviona good luck with the new meds. I just turned 23 myself and my shrinks tell me that people around our ages are prone to hypomania and rapid cycling at this age. We’re also particularly prone to “mixed states” due to our fluctuating hormone levels. This crap really brings the “teen angst” years to a whole new level! ;).

aviona's avatar

@adreamofautumn Well good, I’m glad to know that I’m not alone and that at least there’s some “normality” to my “abnormality.” I kid, I kid. But, really that is helpful and I’m sure hormones do play a large role in the rapid cycling.

wundayatta's avatar

Weird. I’m 52, and I got this thing when I was 51. I was rapid cycling or in a “mixed” state at the time of diagnosis. Obviouisly, these things can happen at any time of life. I would have preferred to live the rest of my life without it, but it has taught me a lot. I would not know what I know, if I hadn’t gotten it.

Garebo's avatar

I know the LSD derived SSRI’s didn’t work for me. There, efficacy statistically is about as good as a placebo. They made me fat, zombi-like with a low libido. I now rely on diet, excercise, thought control, and a large host of supplements, and it works for me. I never was diagnosed with anything beyond mild depression and social anxiety. So, serious stuff is probably require serious action, but I still don’t trust SSR’s from personal experience and after Columbine and a host of other SSRI induce tragedies.

dubsrayboo's avatar

The original drug asked about was Topomax. My psych lovingly calls it “dope-omax”. And yes, it was horrific for me. Also I found out I was allergic to Depakote. Lamictal and Lithium have been my God sends in the way of mood stabilizers. I’m on Holdal which is an anti-psychotic (I get psychotic real quick when I hit a full mania.) as well. Everyone’s combination is very different. It’s just trying to find your own silver bullet.

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