Meds Classification

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MEDICATIONS
by CLASSIFICATION

One thing you learn quickly when you become involved in any bipolar on-line or face to face support group is: We are all similar and have similar experiences, but, we are all different. This holds most true when it comes to our medications! There is NO right medication mix for each and every one of us. This page will attempt to give you some general information on the many medications used to treat bipolar disorder. If you are taking a medication, and do not find it listed here please contact Bipolar World, so we can add it.

It is beneficial to have a basic understanding of how the brain works to have a good appreciation of how medications are thought to work. I recommend visiting Dr Phelps' site ( http://www.psycheducation.org ) and reviewing three articles: The Brain Chemistry of Depression: Inside Cells; The Brain Chemistry of Depression: Stress Hormones; and Brain Tours.

There are several sources available on the web for more detailed information about medications. My favorite one is http://www.rxlist.com . It is the site that is available on our main medication page as well. If you go to that page ../Meds_Trt/Medications/medications.htm and scroll to the bottom of the page, you will find a search engine. Just enter the generic or brand name of your medication and you can access complete information about your medication. (this will link you directly to the rxlist.com site)

Mood Stabilizers/Anti-Seizures

Names (generic) & brand	Action	Dosage Range	Major Cautions
(valproic acid, divalproex sodium) Depakote, Depakene. Epival,	increased concentrations of gamma-aminobutyric acid (GABA) in the brain, GABA blocks impulses from one nerve cell to another and prevents mania 2 in plain English: Makes the brain slow down and thus prevents mania by preventing over-activity of the brain nerve cells	divided n 2 - 3 doses children = 15-20mg/kg adults =250-1000mg per day although higher doses have been used successfully, lab tests should be done on a frequent basis to monitor for toxicity	be sure to speak to your pharmacist or physician for a listing of prescription and over-the counter medication interactions
(clonazepam) Klonopin	enhances the activity of GABA 1 in plain English: Makes the brain slow down and thus prevents mania by preventing over-activity of the brain nerve cells	divided in 2 - 3 doses children = 0.01 - 0.03 mg/kg/day adults = 0.75 - 4 mg per day	benzodiazepine derivative with side effects similar to valium
(lithium carbonate) Lithobid, Carbolith, Duralith, Eskalith, Eskalith CR, Lithane, Lithonate, Lithotabs, Cibalith, PMS-Lithium Carbonate, Lithium Citrate	alters sodium transport in nerve and muscle cells which in turn decreases catecholamine levels 1 in plain English: Makes the brain slow down and thus prevents mania by preventing over-activity of the brain nerve cells	individualized according to blood levels generally in adults 300-600mg three times a day or 600-900mg of slow release twice a day dosage ranges have not been established in children younger than 12	initial blood work and daily blood work until therapeutic serum blood levels are determined then periodic blood levels every 3-6 months toxic levels can develop quickly notify MD immediately if severe side effects occur
(lamotrigine) Lamictal	inhibits sodium voltage channels 1 in plain English: Makes the brain slow down and thus prevents mania by preventing over-activity of the brain nerve cells	increasing doses over a 4 week period in 2 divided daily doses children 2 - 12 = wk 1 & 2: 0.6mg/kg/day; wk 3 - 4: 1.2mg/kg/day maintenance: 5 - 10mg/kg/day to maximum of 400 mg/day adults = wk 1 & 2: 50 mg/day; wk 3 & 4: 100mg/day; maintenance 300 - 500mg/ day	report any rashes IMMEDIATELY to your doctor
(gabapentin) Neurontin	although it is related to GABA, it's exact action is unknown 1 (check out the rxlist.com site for further information)	900 to 1800 mg/day and given in divided doses (three times a day) using 300- or 400-mg capsules dosage ranges have not been established in children younger than 12	Dosages up to 2400 mg/day have been well tolerated in long-term clinical studies. Doses of 3600 mg/day have also been administered to a small number of patients for a relatively short duration, and have been well tolerated.
(carbamazepine) Tegretol, Epitol, Mazepine, Novocarbamaz, Apo-Carbamazepine	reducing polysynaptic response and blocking the post-tetanic potentiation. Carbamazepine greatly reduces or abolishes pain induced by stimulation of the infraorbital nerve in cats and rats. It depresses thalmic potential and bulbar and polysynaptic reflexes, including the linguomandibular reflex.1 in plain English: prevents over-activity of the brain nerve cells	divided doses 2 - 4 times a day and increased slowly children under 6 = 10 - 20mg/kg/day not to exceed 400mg/day children 6-12 = 200 - 1000mg/day children 2-15 = 1000mg/day maximum adults = 400 - 1200mg/day	be sure to speak to your pharmacist or physician for a listing of prescription and over-the counter medication interactions
(oxcarbazepine) Trileptal	inhibits voltage sensitive sodium channels resulting in stabilization of hyper-excited neural membranes, inhibition of repetitive neuronal firing, and diminution of propagation of synaptic impulses.1 In plain English: Makes the brain slow down and thus prevents mania by preventing over-activity of the brain nerve cells	initial 8 - 10mg/kg per day in divided doses maintenance doses 20 - 29kg = 900mg/day 29.1 - 39kg = 1200mg/day above 39kg = 1800mg/day	most patients were unable to tolerate doses of 2400mg/day can deplete blood sodium levels, blood levels should be taken on a regular basis
(topiramate) Topamax	First, action potentials elicited repetitively by a sustained depolarization of the neurons are blocked by topiramate in a time-dependent manner, suggestive of a state-dependent sodium channel blocking action. Second, topiramate increases the frequency at which g-aminobutyrate (GABA) activates GABA _A receptors, and enhances the ability of GABA to induce a flux of chloride ions into neurons, suggesting that topiramate potentiates the activity of this inhibitory neurotransmitter. This effect was not blocked by flumazenil, a benzodiazepine antagonist, nor did topiramate increase the duration of the channel open time, differentiating topiramate from barbiturates that modulate GABA _A receptors. Third, topiramate antagonizes the ability of kainate to activate the kainate/AMPA a-amino-3-hydroxy-5-methylisoxazole-4-propionic acid non-NMDA subtype of excitatory amino acid (glutamate) receptor, but has no apparent effect on the activity of N-methyl-D-aspartate (NMDA) at the NMDA receptor subtype.1 In plain English: Makes the brain slow down and thus prevents mania by preventing over-activity of the brain nerve cells	increasing doses over an 8 week period check out the rxlist.com link below for detailed information http://www.rxlist.com/cgi/generic2/topiram_ids.htm	can increase pressure in the eye, report vision problems immediately
NOTE:	Not all anti-seizure medications are used for the treatment of bipolar disorder or other mental illness. Never take any medication or come off medications without your doctor's approval

Anti-Psychotics

Names (generic) & brand	Action	Dosage Range	Major Cautions

Anti-Depressants

Names (generic) & brand	Action	Dosage Range	Major Cautions

Anti-Anxiety

Names (generic) & brand	Action	Dosage Range	Major Cautions

Updates on
Recent medication
Trials

M100907 produced by the Aventis Corporation. Development was discontinued based on phase III trial results. www.hmrpharma.com/hmrir/news/develop799.htm

ORG522 produced by the Organon USA Inc. It was in phase II of pharmaceutical studies in 2000. The classification was anti-psychotic. I can not find any further information on clinical trials. (Currently the only mental health medication that Organon is producing is Remeron and RemeronSolTabs, antidepressants.)