Posted by Simon Sobo, M.D. on September 16, 2010, at 5:58:44
In reply to Re: hrguru - Re: Anti-psychotics not mood stabilizers? » Conundrum, posted by SLS on September 14, 2010, at 8:15:16
Response to a medication is not, repeat is not, diagnostic, of anything. Much of the discussion here is based on that mistaken assumption. When I was beginning practice it was not unusual to treat panic and high anxiety patients with "major tranquilizers" The "minor tranquilizers" were the benzodiazipines. This stopped when it became clear that tardive dyskinesia was a real problem. Then suddenly drugs like Thorazine and Haldol were being called "anti-psychotics" as if that is all they did. Thorazine was originally a preanesthetic calming agent until some one thought of using it in psychiatry, The newer atypical neuroleptics didn't cause anywhere near as much tardive dyskinesia so they began to be used more and more in non psychotic conditions.
I disagree with your doc's assessment that if you use a "mood stabilizer" it will help with mood instability. I suggest you take a look at my discussion of this very point in my article "Mood Stabilizers and Mood Swings: In Search of a Definition" http://www.psychiatrictimes.com/mood-disorders/content/article/10168/54226
Mood stabilizer is a real sloppy term that seems to be applied whenever an anti manic drug is found. In my opinion SSRIs, when they work, are damn good mood stabilizers, in the sense that term has been commonly applied, when given to a non manic patient
> > My pdoc has recently suspected I have issues with mood stability. I'm not sure it fits. I haven't responded well to lamictal or abilify, except that abilify seems to work like a cup of coffee for a few days and then stops. I'm not sure the lamictal has done anything at all and I am on 400mgs now.
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> I was on Lamictal 300mg for quite awhile. It produced unacceptable cognitive impairments. When I first reduced the dosage to 200mg, I experienced an increase in the severity of depression for two days, and then stabilized. Similarly, I have recently reduced to 100mg with the same outcome. I feel no better at 100mg than I did at 300mg. I think people are fooled into raising the dosage when they experience transient improvements upon each dosage increase.
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> > I'm guessing my suspected diagnosis will change since those meds didn't work and higher doses of abilify made me feel worse.
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> That's disheartening. In what ways did Abilify make you feel worse?
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> - Scott
poster:Simon Sobo, M.D.
thread:960844
URL: http://www.dr-bob.org/babble/20100908/msgs/962573.html