Mood Disorder Meds that aren't antidepressants

[RussellSue]

I am curious what people with bipolar or schizoaffective have taken for mood stabilization that has worked. Lithium worked well for me but it also caused me some thyroid issues. I may end up back on it, regardless, because it did work so well, but I've never been on any other medication that was worth taking with regards to depression or mood swings. I have especially had problems with antidepressants.

Has anyone found anything that has worked that isn't an antidepressant?

 

[EveHarrington]

I’ll reply even though I wasn’t specifically asked as I’m not in those categories.

my doc says I have a “bipolar expression” even though I only swing from depression to normal. I don’t go manic or hypo manic (and I don’t care what they say, I refuse to believe than anxiety or anger is just another expression of mania). Having said all this, my diagnosis is PTSD and major depression. (And I do question my doc about this maybe once a year or so. The diagnosis never changes.)

I take Trileptal and it works quite well for controlling my mood instability. I am on a low dose, as most people take more than I do. (150mg/morning, 300mg/evening)

I am also on gabapentin. Even though it’s in the same “family” it’s not a strong mood stabilizer. It helps me with anxiety.

 

[RussellSue]

I’ll reply even though I wasn’t specifically asked as I’m not in those categories.

Sorry, sorry... I hadn't considered that there might be others who had insight into this.

I am actually much more prone to depression than mania, though I do have both. My mania is typically not scary, anymore, whereas my depression is. Thank you for your response. I take gabapentin and it also helps me quite a bit. I will mention Trileptal to my doc next week with this in mind.

 

[EveHarrington]

Oh, I do want to add that Trileptal helps with my anxiety, too. I bounced between Trileptal and gabapentin before ending up on both of them at the same time. Trileptal had a bit of an adjustment period for me as it made me exhausted, but my body adjusted after a number of months and this is no longer an issue.

I’ve been on Topamax as well and it made me so stupid. It worked well the first time I took it, but I don’t think docs prescribe it as a first line mood stabilizer anymore.

I have tried a few others but can’t talk about how effective they were as I had to discontinue them due to side effects.

 

[somerandomguy]

Tegretol and Lamictal, while technically anticonvulsants, are also used frequently as mood stabilizers.

 

[Survivor3]

Queteapine and olanzapine are quite common.

 

[RussellSue]

Thank you all. I am sort of wondering now after spending the last year tapering down from a therapeutic dose of Lithium if I might not be able to stay on a lower dose of Lithium and my current dose of gabapentin -- and maybe add something else if needed (or maybe swap the gabapentin because it bugs my stomach) -- without having further damage to my thyroid. As it stands, my goiter appears to be nearly gone and I was only completely off Lithium for a few weeks -- I have been on some amount of Lithium all year and the goiter has been reducing in size the whole time.

I did not know gabapentin was used for bipolar. No doubt me taking gabapentin for the last nine or ten months is what saved me from an earlier meltdown. I was taking it because of hip injuries. I knew it helped my anxiety, but I didn't realize the rest.

All of this happened because while I was stabilized on Lithium, my mood disorder diagnosis was removed and replaced with PTSD. I was told I did not appear to have any mood disorder. When I started developing a goiter, I figured getting off the Lithium was worth trying because, well, I didn't have a mood disorder -- I was under the impression that my depression was trauma-related. Obviously, this was not completely true because I've been having about 95% of all possible bipolar symptoms pretty much daily for several days. Sure, I have trauma, but there's clearly more to this.

Actually, today is much better than the weekend was. I have restarted a low dose of Lithium and I have hopes that what happened over the weekend was as bad as it will get and is over, as well.

Again, thank you. I appreciate having meds other than antidepressants to discuss with my new doctor. They always reach for those and I have little experience outside of Lithium and apparently gabapentin in terms of stabilizing my mood.

 

[MrMoonlight]

My psychiatrist told me a few days ago that she wants to get me off gabapentin and replace it with Lithium. Just the name of that med scares me ... thought of Thorazine. I know it's not that but I worry about taking what I see as a really heavy medication. I trust my team but this move makes me worry.

I live in the desert and lithium has heat warnings ... my thyroid is already messed up and I take meds for it ... I worry this med will wipe me out. I worry that it will make me a zombie.

 

[RussellSue]

I worry that it will make me a zombie.

Everyone is different, of course, but Lithium was the single most effective medication I have ever taken. I also lived in the desert for all but about 18 months of the seven years I was on it with no problems -- I was very good about forcing myself to stay hydrated, though. I am scared of meds, in general, but I am a lot less afraid of Lithium now compared to others. I was never a zombie on it, either, which was a huge improvement over a lot of things.
I hope that if you make the switch it works for you.

 

[MrMoonlight]

Thank you so much RS. I'm glad to know you make it through the desert for so long ... I guess I'm future trippin' a little but I take these meds really seriously. Gabapentin has helped so many things from pain to anxiety ... my psychiatrist spoke about a couple of other meds that could help with pain, tendon pain, migraine etc ...

I just don't know anything about lithium ... I already take meds for depression ... I guess those will remain.

RS did lithium just even you out ... did it help you with anxiety?

 

[RussellSue]

RS did lithium just even you out ... did it help you with anxiety?

I don't think it directly affected my anxiety. What it did do was seemed to insulate my marbles so that when they got going, they weren't crashing into one another, anymore -- that's how I think of it. My emotions tend to feel like they constantly make impact in my brain. The Lithium cuts that feeling of crashing whiplash way down. Not feeling those intense crashes seemed to be what helped my anxiety. And that's how it evened me out, as well. I never felt tired or drugged.

 

[joeylittle]

I've got some of that lithium stigma too, @MrMoonlight. And, I'm also always considering giving it a shot.

@RussellSue - there have been a number of recent studies indicating the effectiveness of low-dose lithium for a number of things. I think your curiosity about restarting it and titrating up slowly, seeing how low a dose (in conjunction with the gabapentin) can work for you.

@MrMoonlight - something that I do find helpful to remember - Lithium (the psych medication) is a salt. A naturally occurring salt. It was first used as a psychiatric medication in the late 1800s, then fell out of favor, then became more common after a doctor in the late 40s discovered it really did address depression and mania.

Lithia water is water from a natural spring that contains Lithium salts. It was bottled for consumption around the turn of the 20th century. And it was the main "medicinal" ingredient in the soda we know now as 7UP.

It's one of the most natural medications available. It has worked for many many people. The side effects can be difficult when it is taken at higher doses, and the dosing needs to be monitored because of how we metabolize the salt...but it's as basic as a psych medication can get.

Just the name of that med scares me ... thought of Thorazine. I know it's not that but I worry about taking what I see as a really heavy medication

Lithium can be a heavy medication when it's taken in the higher doses, that one would use as a mono therapy for schizophrenia. But that (and often in combination with a drug like thorazine) is used to manage severe symptoms of psychosis. When it's dosed lower, as it is for bipolar as for depression - it isn't meant to have that kind of "doping" effect.

Anyway...these are the things I tell myself, when I work on talking myself into trying Lithium. So, if any of them are useful....great.

@RussellSue - I think the only other thing that wasn't mentioned, that I know is an atypical antipsychotic called Latuda (lurasidone). It also has a very wide dosing range, for the same spectrum of things that Lithium is used for - so depression, bipolar, schizoaffective, schizophrenia. I think it's main benefit over Lithium is that you don't have to monitor it for toxicity. And of course, like everything - it works for some, not for others...