Mood Stabilizers

Article

Antipsychotic Maintenance: How Long is Enough?

Topics: Antidepressant Augmentation | Antidepressants | Antipsychotics | Bipolar Disorder | Deprescribing | Depression | Depressive Disorder | Mania | Metabolic syndrome | Mood Stabilizers | olanzapine | Psychopharmacology | Psychopharmacology Tips | Risperidone | Side Effects | Tardive dyskinesia

Your 58-year-old patient started risperidone to augment lithium 2 years ago. It got her out of a severe mania, and she has stayed well since then. Now she’s worried about long-term risks and wondering if it’s time to come off. Augmentation with an atypical antipsychotic may offer rapid relief from mania and depression, but antipsychotics’ potenti

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Expert Q&A

Assessing and Treating Traumatic Brain Injury

Topics: Bipolar Disorder | Bipolar II | Coronavirus | COVID19 | Lithium | Mania | Mood Stabilizers | Pharmacology | Pharmacology Tips | Psychopharmacology | Psychopharmacology Tips

TCPR: Lithium has been called the gold-standard treatment in bipolar disorder. Why is it not used more often?Dr. Rybakowski: That is a paradox. On the one hand, lithium is accepted as a first-line treatment for bipolar disorder, but it is also greatly underutilized. And I think there are two main reasons. One is aggressive promotion of branded mood stab

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Research Update

Two Augmentation Strategies Compared in Bipolar I

Topics: Bipolar Disorder | Lithium | Mania | Mood Stabilizers | Oxcarbazepine | Pharmacology | Psychopharmacology | Research | Research Update

Review of: Missio G et al, Trials 2019;20(1):608 STUDY TYPE: Randomized, open-label controlled trial It’s rare to see full recovery in bipolar I disorder with a single medicine, so we often depend on some combination of mood stabilizers and/or antipsychotics. Even then, weight gain and metabolic problems are deal-breakers. Some experts favor the c

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Expert Q&A

The Psychopharmacology Algorithm Project

Topics: Antidepressant Augmentation | Antidepressants | Antipsychotics | Bipolar Disorder | Bupropion | Depression | Depressive Disorder | Escitalopram | Lamictal | Lamotrigine | Lithium | Mood Stabilizers | olanzapine | Psychopharmacology | Psychopharmacology Tips | Wellbutrin

TCPR: What would be the biggest change in practice if psychiatrists followed your algorithms?Dr. Osser: One area is bipolar depression. This is a disorder where there is an exceptionally large deviation between what the evidence says and what people are doing, especially when it comes to antidepressants. They are still being used rampantly, even in pati

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Clinical Update

Oxcarbazepine: Close, but no Cigar

Topics: Bipolar Disorder | Carbamazepine | Free Articles | Mania | Mood Stabilizers | Oxcarbazepine | Pharmacology | Psychopharm Myths | Psychopharmacology

You are selecting a mood stabilizer for a 29-year-old woman with mania. If it works, she’ll need to take it long term, but with adherence rates hovering around 50% in this illness, that’s not a likely prospect. The FDA-approved options are not very high on tolerability, but what about oxcarbazepine? Oxcarbazepine (Trileptal) is often used in bipo

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Expert Q&A

Psychopharmacology in Bipolar II

Topics: Bipolar Disorder | Hypomania | Mania | Mixed Features | Mood Stabilizers

TCPR: You’ve carved out a unique practice with difficult-to-treat bipolar disorders. Tell us about the patients you see. Dr. Kelly: I see a lot of bipolar II and “softer bipolar.” Clinically these patients have chronic depression, often mixed with hypomanic symptoms. Nearly all have tried multiple antidepressants that didn’t work, stopped worki

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Highlights

Highlight From This Issue

Topics: Bipolar Disorder | Carbamazepine | Mania | Mood Stabilizers | Oxcarbazepine | Pharmacology | Psychopharm Myths | Psychopharmacology

In bipolar disorder, oxcarbazepine is slightly better tolerated than carbamazepine, but less effective. While its medical risks are different, they are by no means safer than carbamazepine’s. Its drug interactions can be a problem as well. On average, higher doses of second-generation antidepressants do not bring greater recoveries in major depress

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Research Update

Mood Stabilizers and Stroke Risk in Bipolar Disorder

Topics: Bipolar Disorder | Lithium | Medical Comorbidities | Mood Stabilizers | Pharmacology

Review of: Chen PH et al, Br J Psychiatry 2018;1–6. doi:10.1192/bjp.2018.203 Study Type: Case-crossover study People living with bipolar disorder already have a decreased life expectancy of 10+ years compared to the general population (Crump C et al, JAMA Psychiatry 2013;70:931–939). Most of these years of lost life have been attributed to cardiov

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Expert Q&A

How to Evaluate and Treat Mood Disorders in Pregnancy

Topics: Mood Stabilizers | Pharmaceutical Industry | Practice Tools and Tips | Psychopharmacology Tips | Women's Issues in Psychiatry

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Research Update

Mood Stabilizer plus Antidepressant May Protect Against Mania

Topics: Bipolar Disorder | Mood Stabilizers | Research Updates

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Article

Nuedexta for Pseudobulbar Affect

Topics: Mood Stabilizers | Natural Medications | Neuroscience in Psychiatry

Pseudobulbar affect (PBA), also known as pseudobulbar palsy, is a neurological condition in which patients have sudden outbursts of crying or laughing. While the episodes can be triggered by events that would ordinarily elicit genuine sadness or amusement, patients with PBA react with intense displays of emotion that they cannot control. The frequency o

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Expert QA

Complementary and Alternative Medicine for Mood Disorders

Topics: Mood Stabilizers | Natural Medications | Women's Issues in Psychiatry

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Article

Sleeping Pills: Which Ones for Which Patients?

Topics: Antidepressants | Antipsychotics | Benzodiazepines | Hypnotics | Mood Stabilizers

Insomnia is one of the most common comorbidities you’ll see in your depressed and anxious patients (Becker PM and Sattar M, Curr Treat Options Neurol 2009;11(5):349–357). But it is often misunderstood. Over the last several years there has been a shift in how we conceptualize insomnia co-occurring with psychiatric disorders. While the common view is

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Article

The Carlat Guide to Medications Used for Insomnia

Topics: Antidepressants | Antipsychotics | Benzodiazepines | Hypnotics | Mood Stabilizers | Natural Medications

This handy table lists the medications most often used to treat insomnia. Click here to see table

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Research Update

Robust support for mood stabilizers in borderline personality disorder

Topics: Mood Stabilizers

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Article

Lamictal: What is it Good For?

Topics: Mood Stabilizers

Lamictal (lamotrigine) is immensely popular among American psychiatrists. A recent survey found that it is prescribed more frequently than any other mood stabilizer (Clin Psychiatry News, June 2008, page 1). Now that psychiatrists have become so comfortable with prescribing it, a disturbing question is gradually emerging from the fog of therapeutic enth

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Article

Weight Gain and Mood Stabilizers

Topics: Mood Stabilizers

While we have become sensitized to worrying about weight gain caused by antipsychotics, this side effect does occur with standard mood stabilizers as well. Recently, a comprehensive literature review was published evaluating the weight gain liabilities of medications commonly used to treat bipolar disorder (Torrent et al., Acta Psychiatrica Scand 2008;1

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Research Update

Seroquel vs. Depakote for Impulsivity and Aggression in Teens

Topics: Antipsychotics | Mood Stabilizers

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