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Best Mood Stabiliser in Bipolar

16 replies

Jumpeduppantrygirl · 21/02/2023 11:29

My 18 year old daughter was diagnosed with Bipolar last year after her first psychotic episode. She has been prescribed olanzipine and sertraline but her mood is incredibly fluctuant. She is cycling between depression and hypomania around every 4-6 weeks but is also often experiencing mixed presentation. They seem reluctant to px a mood stabiliser and keep tweaking her olanzipine/sertraline with little effect. Tomorrow, we are going to ask at her med review for a mood stabiliser, and I wanted to ask for people's experience on the various different ones?

OP posts:
XDownwiththissortofthingX · 21/02/2023 12:02

Hi OP.

I do not have personal experience of mood stabilisers because I am not bipolar. I was misdiagnosed as having a bipolar condition at one point, but that isn't really relevant as I was being medicated for a condition I did not have.

I do however have extensive experience of working with people with a Bipolar diagnosis, and also I socialise with them regularly as a consequence of meeting so many down the years. Everything I say to you is obviously anecdotal, and I am not in any way an authority on medications, but I will say that from my own observations and the discussions I have had with people who are prescribed the more traditional mood stabilisers such as Valproates, they do tend to 'work' to stabilise mood to a degree, but they often have a 'chemical cosh' effect and usually come with an array of unpleasant side-effects. Most people I know who have been on them long-term are dealing with the physical consequences of ingesting a toxic substance, associated lethargy, and are concerned to a varying degree about the ultimate impact on their long-term health.

The more atypical mood stabilisers can also come with side-effects, but they are not as toxic to the body as old-fashioned 'salts', and don't present the same risks to long-term health. I'd suggest you ask for a discussion about more of the atypical types and possibly try those for a period because they often are a case of trial and error and going through several before finding the one that 'works' for a specific individual. This is often the case when they are prescribed for other conditions as well, so it's a hallmark of these drugs rather than something specific to Bipolar conditions. Personally I would have gone through the whole gamut before I considered Valproates, and I was fortunate that at the time when I was misdiagnosed the psychiatrist in charge of medication also felt the same way and never entertained the idea of them.

Do you have any local Bipolar support groups or such? The ones I was involved with usually have a ton of insight into this sort of stuff and they are invariably open and welcoming to relatives with questions, even if the person with the diagnosis gets nothing from the group and has no wish to attend.

HazardaGuest · 21/02/2023 16:11

I have bipolar and the nhs just went through a list of mood stabilisers. When I said I couldn’t tolerate the side effects of one they moved me to the next. It was the worst time of my life.
I am now seen privately (through the priory) and am just on Quetiapine. My dose goes between 100mg and 300mg depending on mood. I have a three year cycle where I am well for just over two years and then depressed for about 10 months. I am able to function, I just do a lot less when depressed. I have kids, job etc
When I went private the nhs doctor was suggesting I try sertraline. The first thing the private doctor said was that it isn’t recommended for bi
polar patients.

MammaWeasel · 21/02/2023 16:15

Aripiprazole has been a ģodsend to me, along with sertraline

Novita · 21/02/2023 16:19

Lithium is by far the best I have tried. It stops mixed states that have been my worst episodes. No hospitalisations since I started it.

Jumpeduppantrygirl · 21/02/2023 17:45

Thank you all for taking the time to reply. Your lived experience is invaluable to me.

@Hazardaguess do you struggle with tiredness on quetiapine? But then, I suppose if you did, you would just take it at night.

OP posts:
DRS1970 · 21/02/2023 17:55

Priadel (lithium) is the best in my opinion. The regular blood tests are a small inconvenience compared to the benefits I get from taking Priadel.

Theyweretheworstoftimes · 21/02/2023 17:56

Lithium. It's an old one but an effective one. I don't take it myself but a family member has had very good outcomes with it. They are not based in the UK so no idea if it's available here but would assume so.

SofiaAmes · 21/02/2023 17:58

My ds is bipolar and has tried pretty much every mood stabilizer out there. Different people react differently and need different doses. Lithium worked well for him (only available once he turned 18 in the USA). Quetiapine made him dopey and drowsy. Aripiprazole made him anxious and gave him tics even at low amounts. Lamotrigine and Lurasidone worked well for him. Respiridone and Haldol (the psych hospitals like these ones) did really evil things to his body (gained a third of his body weight and his cholesterol doubled in 3 weeks and a few other really awful hormonal effects). You have to taper up and down with a few of the medications, but in general it was obvious within a few weeks if it was working.

It's important to note that if they say "it doesn't do anything" that often means that it's working because they feel stabilized.
Also, the most important way to live a healthy life with bipolar is to be cognizant of your triggers. Things like lack of sleep, poor eating habits, over stimulation are often triggers. It's important to get a handle on those triggers as medication alone won't do it.

Blastedusername · 21/02/2023 18:01

Hello.
I take risperdal and have taken it for years. It healed me after I had been on haloperidol at 19 for a hypo-manic episode.

BellaBella38 · 21/02/2023 18:02

Lamotrigine absolutely changed my life.

MaMisled · 21/02/2023 18:02

I take Lamotrigine to stabilise my frequent mixed episodes ( plus Trazodone and Diazepam prn). I stopped taking ariprazole 6 months ago. Lamotrigine has definitely lessened the severity of episodes and is weight neutral, if that matters.

NoCatsToday · 21/02/2023 19:03

I've been on Lithium for the last 30 years. It's kept me largely sane.

HazardaGuest · 21/02/2023 19:04

I think I’ve taken all the ones listed on this thread with bad results.
The Quetiapine does make me sleepy, it’s great, I take it an hour before bed and get straight off. In the past lack of sleep has made me ill so I’m ok with that.
When I am in a period of wellness I know when it is time to have the dose reduced as I start to feel drowsy I’m the morning. My gp is very supportive having seen me over a long time and is happy to tweak the dose when I ask.

colouringindoors · 01/03/2023 23:14

For many with Bipolar traditional SSRIs like Sertraline can cause/exacerbate mania.

Speaking from experience with a family member who is now on Quetiapine which is effective. Took some adjusting time of evening dose to minimise morning groggyness.

HazardaGuest · 02/03/2023 13:32

@colouringindoors out of interest do you know what dose they take and whether they stay on the same dose long term?

CuppaWhiteTea · 02/03/2023 13:51

Lithium is the only one that really works for a close member of my family. She’s had bipolar for over 50 years and has been on them all at some point. Back on lithium again now and swings drastically reduced. Very best of luck finding the right one for your DD.

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