What's the best mood stabilizers??

I was diagnoised with Bipolar Disorder this spring, and I have been taking both Zoloft and Depakote. My question is: " What is more stronger or more better, Lithium or Depakote??

[Jikan]

Namaste,

There are of multitude of medications that are used as mood stabilizers with lithium and depakote being the primary ones.

Both are good at controlling symptoms, but lithium puts restrictions on your diet and depakote doesn't. But depakote can cause considerable weight gain.

If your doctor placed you on depakote, he/she did so as the first line of defense and will try other mood stabilizers if depakote does not work.

Different medications effect individuals differently so there may be a need for a change in medication and/or dosage.

The main thing is to be patient becase it may take some time to find the proper combination of medication(s) to control your disorder.

Let us know how you are doing and take care of yourself!

Michael

[monkeyc]

I would like to call out the comment that Lithium puts restrictions on your diet.  It does not..

The myth that all patients who take lithium gain weight or need to change diets or restricts them is a favorite of some doctors and online sources, in fact other MS drugs are far more likely do do that (you noted Depakote which has almost guarentee of weight gain )  - Ive taken lithium for over 2 years now and have not gained weight and it has not restrcited my diet on bit - I eat what i want when I want and I can even drink alcohol as long as I am moderate and stay well hydrated.  There are not many MS that will give you the ability to have a glass or wine or a beer every now and then without serious problems.  (not that drinking is a reccomended course for BP's, I am lucky in that I dont have an issue with alcohol and dependancy - if you are going to drink alcohol SPEAK TO YOUR DOCTORS)

There are reasons why you may need to modify your diet with Lithium if you do not maintain enough salt in your body or are on a low sodium diet but the main difference lithium will be for most patients is an increase in water consumption as proper hydration is vital.

Too many people read side effects lists and think Lithium must be some horror drug - when the reality is it has been around for over a century and thus the list of noted side effects is going to be large but Lithium is safer than many MS drugs and particularly some of the Anti Psychotics which have side affects that are terrifying to read about.

The main reason why Lithium isnt prescribed as often as it used to be is simple (and most honest pdoc's will tell you this) - its generic and cheap and pharma companies dont make any money from it.

No it wont work for everyone and all drugs need to be prescribed by a doctor I wouldnt use a doctor who let me choose my own meds anyway.  

Sorry but I often see a lot of people around the traps who are anti lithium for no real reason other than their doctor told them the old one about weight gain and diet restrictions before putting them on a drug with the same effect that costs 3 times the per dosage costs and has the exact same side effects as Lithium or worse.

[PenelopeAnn]

Ditto on what monkey said. I think I have been on every mood stabilizer and the one I am on now is the one that worked miracles for me. I take Lithobid. It is the slow release form of Lithium. Many years ago, I was tried on regular Lithium and had severe tremors before I could get to a dose that would help my moods. The others either didn't help, or they had intolerable side effects- I'm just one of those people. The mood stabilizers I've been on are Tegretol, Neurontin, Lithium, Depakote, Topomax (topamax), Trileptal, Lamictal, Abilify, and now Lithobid. I love Lithobid. I haven't noticed any side effects.

[jimgreg]

the mood stabilizer has to be the one that works for you..some might not work for someone on here but then it might be the best for you..now i was put on lithium..i got lucky with it..it helps me and no side affects yet..i only been on it 7 weeks...lithiem is a good me and very old at that..i been studing on it ..they have had alot of years to study this one..wheres another me wasent studied as long..i was on seraquil for 2 yrs it helped me sleep and calmed the manic but not as good as the lithium..lithium has alot for you to learn about..HEY JUST ASK ON HERE THERS ALOT OF US ON IT..LIKE MONKEYC HES BEEN ON IT FOR YEARS AND LOVES IT..I THINK THIS WOULD HELP YOU OR WHOEVER...thanks for listing   james  anytime call on me

[Jikan]

Namaste,

Apparently, my comment concerning restrictions on diet was taken too literally and referred to hydration and sodium diets. Sorry for the confusion.

Michael

[monkeyc]

Michael I did not mean to come off as attacking I just grow sick and tired of the anti lithium attitudes I see in some places in favour of X and Y drug and I was having one of those days, apologies if this sounded harsh.

However when you say Diet Restrictions its going to be taken literally as it implies Lithium places you on a restricted diet which it does not in 99.999% of cases - this is the problem, people read that and go I wont even think about asking if lithium might work cause it makes you fat and you cant eat what you want and thus they miss the oportunity to ask about a drug that is not only cheap its also very effective and unllike many of the new drugs also not psychoactive.

As I said I was touchy but from where I sit there's often a negative anti lithium bias in Bipolar forums and hey its hard not to understand why with add for ablify playing on the page or when you go into the Doc's office and hes got the Lamactil Pen and the Geodon clock on his desk....

[irishwriter]

i have been on lithium for two months now 1200 and blood level .97. I have no side effects, just drink a lot of water and was able to have a few drinks at wedding i attended. my only problem is that it is taking ages to kick in for me. am told it can take a long time so i'm trying to be patient. you need to find the meds that work for you. that's one of the downsides (and there are upsides!) of this disease in that the treatment is so individual. I have been living with this for thirty years and over the years tried many different treatments but this is the first time on a mood stabiliser so i keep on hoping it will work sooner rather than later. best of luck with whatever you start taking, i hope it works for you.

[cowgirlnerd]

I am also new to the diagnosis of BP, but my pdoc put me on Lamactical and it's been really good for me.  Of course, I haven't taken anything else, but it has stabilized my moods so I don't have suicidal thoughts these days, and my mania is a lot less than before.

My advice is to ask your pdoc on ALL of the side affects that might occur, and discuss the problems you might have had with other medications in the past.  Also, if you begin taking a medication that makes you feel, at all, not well, or have irrational thoughts, contact your ER or pdoc, right away.  Sometimes it's, honestly, trial and error to get the right combo.  

I took every anti-depressant, anti-anxiety, etc., imaginable until getting this diagnosis.  
Bottom line, ask questions, ask questions, ask questions, and let your pdoc know if your meds are not working for you.  What works best for you - that's most important.  It might take awhile to find that combo, so be patient and chin up.  

Best of luck!

[elius]

It is true that "Dietary changes, particularly those containing caffeine and salt, may affect lithium levels and increase your risk of developing lithium toxicity."

This is important info as many P-Docs (such as mine) will neglect to tell you this.  

Lithium is absolutely the drug that has worked the best for me, but it certainly depends on an individuals brain chemistry.  Depakote worked for me for 2 years, until I had suicidal thoughts directly related to the drug.

Anyway, just wanted to post in response to the dietary restriction discussion above, as this probably would've been good for me to have been aware of when I went from drinking a pot of coffee a day to quitting caffeine last month ! You can read more about dietary restrictions here: http://www.livestrong.com/article/533186-lithium-diet-restrictions/#ixzz1fsNhwzv2

[PinkEarMuffs]

hey I've been using Lithium Carbonate for well over a few years,it starting breaking out my face to the point where I was embarrased to litreally look at someone and talk,did some quick research at other mood stabilizers,nothing came up other than Topamax(which worked wonders for me,however my Insurance would not cover it nor do a Prior Authorization due to age restrictions)in addition asked my doctor what was the difference between Carbonate and Citrate,he stated the price.So,essentially now I use Lithium Citrate Solution 5ML 8MEQ 3x a day and just added Proactiv,it's really been helpful,besides it doesn't hurt to laugh as much as I have been laughing,I will tell you though,Lamictal had me literally having full two hour conversations with myself,it's terrible.I would not test that **** on an animal.Do you know of any Mood Stabilizers that do not cause weight gain
or have too many side effects(diet restrictions)?My roommate needs one because she as well uses Lithium Citrate Solution,has gained alot of weight,not to mention been in and out of the hospital like it's the thing to do,and mood swings like a revolving door.I am on Skype,user ID is:itismedeanna and Ear Muffs on FB,for now thank you and I will research some more tonight myself.Just want to help her,as well as myself,more so her.Again,thank you monkeyc,make it a great night and day.
Regards,
Deanna**

[Anonymouse88]

It depends on what kind of bipolar she has, and side effects are something that you don't know what you'll get until you try the med.  I'm on Lamictal, and it's done wonders for me.  The only issues I've had are acne, which is pretty well under control at this point, and a brief period of it screwing with my birth control making me spot for several weeks.  Changing to a higher dose pill fixed it.  Since I don't depend on the birth control for not having babies, and I'm not having any sort of sexual relations right now, I don't have to worry about it being less effective in that department (my main reason is getting rid of nasty PMS moodiness and horrible cramps, which it does quite nicely).  

Most of the anticonvulsants are weight neutral, with the valproates being a notable exception.  Trileptal is off label, but everything I've read says that it's like Tegretol (carbamazepine), but with fewer side effects.  Lamictal is approved as an add on for bipolar I, but it does more with depression than with mania, so it depends on which symptoms are landing her in the hospital.  Out of the atypical antipsychotics, Geodon and Abilify are the ones that are the most weight neutral, and not everyone will gain on the others.  She should talk to her doctor about adding something on or switching meds (which I'm surprised they haven't tried, given multiple hospitalizations).

[JMNS]

lithium is a great drug.  The only time that I had side effects of upset stomach, and word retrieval, feeling slowed down - was when my levels were too high.  brought the dose down and not a problem. I have always kept every single psych appointment and every lab appointment.  My thyroid levels went out of whack because of the lithium,

I did NOT gain weight on that drug.  I lost 10lbs. one month due to extreme stress.  You will find you are super thirsty.

Virtually no side effects...however, it is not working completely for me, so am currently titrating Depakote up and will eventually be coming off of lithium. :(  Currently at 1350mg with a serum level of .9

I think it is a good drug. Oh BTW,  I have Bipolar Disorder NOS, rapid cycling - mixed episodes.  if that makes any difference.