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  • N&PD Moderators: Skorpio

Fuck Mania.

I'm interested to see how Levetiracetam matches up against other AEDs for the treatment of bipolar disorder. It's just got such a cool MoA. And there are initial indications that it may be very effective in the treatment of HPPD, which makes it even more unique.

So far, it seems to produce significant benefits as an adjuvant, but good RCTs aren't available yet.

Preliminary observations on the effectiveness of levetiracetam in the open adjunctive treatment of refractory bipolar disorder.

Potential of levetiracetam in mood disorders: a preliminary review.
 
Does levetiracetam have much psychoactive potential? It seems like something that'd cause little sedation- a major problem with bipolar meds.

The other question that popped into my head was what sort of things do they look for in an animal model of mania?
 
^ To my knowlege, Levitracetam is just another one of the 'racetam family of Nootropics that somehow got turned into an anticonvulsant/anti-seizure medication. (So it shouldn't posess sedative qualities).

I wouldn't touch this one with a 10-foot pole though... all the 'racetams I've tried have done the opposite of ketamine for me, ie. plunge me into the deepest (suicidal) states of depression I've ever encountered.

Is your rationalle about the sedation due to structural similarity to GABA? I believe Piracetam itself is technically a GABA analogue, and so are its derivatives. It seems like this particular arrangement loses its affinity for GABA agonism.
 
Im bipolar 2 and out of all the meds ive tried lamotrigine is the best by far. It also has hardly any side effects for me besides the occasional bit of insomnia. It's the best drug for controlling depression, rapid cycling and those horrible mixed states. But i still get occasional bouts of hypomania that sometimes go right up into full blown mania that can have psychotic like symptoms with it. Seroquel stops that and seroquel also seems to have some anti-depressant action of it's own.

I was on 300mg's of seroquel a night but ive since stopped because the hypomania subsided. Although it's been acting up abit lately so i may go back on it. One side effect that i hate about seroquel is the nighttime sweating it gives me. I'll wake up covered in sweat and feeling almost dehydrated because ive sweated so much. Ive heard one other person say that they get the sweating thing from seroquel as well. Does anyone know why seroquel can do this?

The other bipolar drugs ive tried are divalproex, carbamazepine, risperidone and gabapentin. Divalproex didnt work at all hardly and actually made my depression worse. It also did nothing for the rapid cycling or mixed states. Carbamazepine i actually took for trigeminal neuralgia but it made me so physically ill that i had to stop taking it after about 2 weeks or so. I don't remember it helping my mood at all.

The risperidone i took to help a mixed state and it actually seemed to make it worse. I almost killed myself the second day on the drug in a sort of psychotic mixed state. Gabapentin is a joke of a mood stabilizer for me atleast. It did nothing to help my mood and it seemed to make my depression worse. I still take it everyday for neuropathic pain but without the lamotrigine i get horribly depressed. Lamotrigine has been a lifesaver for me for sure.

Id love to have access to ketamine that would help both of my problems all at once. I bet ketamine would be the bomb for nerve pain but ive never had it. Id like to get a IM injection of it sometime for neuropathic pain just to see how well it stacks up against a shot of morphine. I doubt very much i will ever get a ketamine shot at a ER here in canada for nerve pain though.
 
Jamshyd said:
^ To my knowlege, Levitracetam is just another one of the 'racetam family of Nootropics that somehow got turned into an anticonvulsant/anti-seizure medication. (So it shouldn't posess sedative qualities).

I wouldn't touch this one with a 10-foot pole though... all the 'racetams I've tried have done the opposite of ketamine for me, ie. plunge me into the deepest (suicidal) states of depression I've ever encountered.

Is your rationalle about the sedation due to structural similarity to GABA? I believe Piracetam itself is technically a GABA analogue, and so are its derivatives. It seems like this particular arrangement loses its affinity for GABA agonism.
Click to expand...

Aside from some distant structural similarities, AFAIK, they have virtually nothing in common. Levetiracetam is a highly selective SVA2 ligand ... it's one of a kind, although I believe two more are on their way through clinical trials.

It's likely not a great addition for mania though ... :\

"This randomized open-label study was performed to further
define the clinical profile of LEV. We compared adjunctive
LEV to a standard treatment with VPA. Our results suggest
that LEV does not lead to a better or faster improvement of
manic symptoms when added to VPA. A total of 61% in
both treatment groups responded, and 52% of the patients
achieved remission. While this did not reach statistical
significance, it suggested a trend toward better antimanic
efficacy of the combination treatment."

Levetiracetam as monotherapy or add-on to valproate in the treatment of acute mania-a randomized open-label study. Psychopharmacology (Berl). 2008 Mar 28 [Epub ahead of print]
 
I'm Bipolar 1 and am currently on carbamazepine in conjunction with both Zyprexa and Risperdal. While I personally find Zyprexa to be quite effective at curtailing mania, it's by no means a perfect solution (read: weight gain). I'm currently in the process of tapering down the Zyprexa and replacing it with Risperdal, which I personally find to be rife with side-effects and a low degree of efficacy.

Anyways, although it's not available here (Canada), I did get the opportunity to try Abilify. I personally found it to be quite an effective med, with minimal side effects. It was a highly functional med, IMO, in that it didn't hamper cognitive functioning, motivation or any other discernible traits. It was substantially more effective than Risperdal in combating mania and was comparable with Zyprexa in that regard. Overall, I suggest considering Abilify as an anti-manic component to a medication regimen.
 
every neuroleptic I've ever tried- and I've had every single one in the atypical branch now- turned me into a fucking zombie.

Geodon (reminds me of a superman villain), Abilify, Zyprexa, Risperdal, and on and on.
 
You know what, forget about neuroleptics. Things are kinda kicking off with a wacky, very unconventional combo I've somehow "got into". Lamotrigine + Cannabis. Lamotrigine just seems to be the right mood stabilizer for me and weed is always there to fix my face when I'm pissed. I'm so bipolar it's funny.
 
My Mania Stack...

Gaba and SALVIA (just a little not enough to launch or anything)


Sally is really good for just halting what ever bp storm coming your way.


just a little smoke eating.... no need to over do :0


GABA is a natural suppliment that mimics Valaprioc acid class.

with some gaba, ginko, ginseng, green tee, Momma green (cannabis), vegtables, fish oil and exercise.

I have Bipolar tendencies... (and don't feel all numb and shit..and that shit makes you feel NUMB) and I like to feel I have harnessd my G-d given super powers.

Going thru a tremendously stressful time right now.

Dealing with It.

Knew I had to come up with my own treatments cause the job i had insurance with was soul stealing an i knew i had to leave, eventually.

Economy is tanking.

Dealing with it... shit making lemonade out of lemons...

Dealing and Dancing and Loving.

(does a small curtesy and leaves the room)

:P
 
All of that aside, if you ain't feeling just a tad maniK, with all the shit going on...

Your dead from the neck up.
 
Gabapentin was prescribed alongside Klonopin for Bipolar II and social anxiety/panic attacks. I started with just Kpins and it worked like a charm, I never really even cared to try medication for the Bipolar because it really wasn't my big problem, unlike crippling anxiety that haunted me for years. The doctor wanted to add the Gaba-p. as a mild anxiety med and to hopefully take care of the Bipolar tendencies (I really was indifferent about it). All it did was rob me of my sex drive...when I COULD even get it up, I could go forever but never cum...

I stayed on it for about a month before just going back to Klonopin only. I really hear so many horror stories about BPD meds and their side effects that I would rather just deal with that problem and simply treat the anxiety/panic disorder.
 
Can you use antiepiletptic drugs to treat bipolar just when you are symtomatic? Should I really be scared about the long term side effects? I have just started Epilum and am feeling pretty well on it. Is this any worse than the speculated long term effects of any of these drugs? Shorely they would have to be preferable to neuroleptics.?
 
Reviving this thread,part. because of the Levetiracetam.While this acts quite specifically as per Dondantes post,the structural similarity to the other racetams makes me think that it still contains some of its properties.Aniracetam and Nefiracetam for example both show also certain anti-epileptic(~=anti-bipolar) activity:

http://www.sciencedirect.com/scienc...serid=10&md5=8c69a2024ba5927ec20f4fd07e1a1f98

http://www.ncbi.nlm.nih.gov/pubmed/16190926


So there must be some overlap,maybe the Levetiracetam (Keppra) is okay as Nootropic in the lower doses.Point is,I'm trying to find alternatives to the usual Bipolar dirty and dumb-drug medication,and as f&b said forget as well the Neuroleptics as long term solution.Whats left are the so far mostly (by mainstream) unrecognised racetams,but some here on BL noticed it,as I did-well I have only mild symptoms (hence the desire to get SE freer stuff),but my familiar loading is high,so its advisable to address it:

http://www.bluelight.ru/vb/showthread.php?t=362210&highlight=levetiracetam

Anyone taken Levetiracetam alone,and/or in lower doses?Experience with phase prophylaxis?

Jamshyd,we know you don't like racetams,so you shut up partner ;)
 
Piracetam does nothing for me or my manic/depressive/anxiety states, however it does change the way my memory works in a bizarre and somewhat positive fashion. I don't know if anyone else has this experience, but it can potentiate l-theanine and gabapentin a lot for me as well. DXM (and to a lesser extent ketamine) is the only thing I've found that seems to effectively relax me and get me back to earth when I start getting paranoid and rambly. I was on olanzapine shortly but it actually made me hallucinate a lot aside from turning me into a cinderblock.

But I don't know, drugs tend to have bizarre effects on me, most mu-opioid agonists cause me to become depressed.
 
Jamshyd said:
Low-dose Ketamine has helped me with bipolar, but my problem was with depression, not mania.

I believe last-resort drugs for mania are anti-psychotics, and these aren't exactly nice. If you must, I personally think seroquel is the least vicious one.

Although I am anti-lithium, have you given it a try?

I have never heard of people having trouble with controlling mania before, to be honest. It is usually the depression that is the problem.

Are you properly diagnosed with bipolar? There is no such thing is unipolar mania, to my knowledge.

ps. Psychomantis rocks! :)
Click to expand...

As you may know, the hypomanic episodes of Bipolar 2 tend not to cause severe disruptions and can be kinda fun. The manic episodes of bipolar one can entail severe irritability, destructive impulsiveness, racing thoughts, delusions, etc. And mixed states really suck. Also, for many people, preventing a manic episode will also prevent the depressive episode that follows it.

Unipolar mania exists, but it is very rare. Also, those with milder forms of it (rightfully) usually don't consider it a "disorder" to be treated. Hell, I wish I were hypomanic right now. ;)
...
Oddly enough, some studies have found that a significant number of biopolar patients benefit from marijuana (alleviates depression, controls mania, but not by much), while depressed patients typically find weed dysphoric.

ebola
 
Opioids are antimanic, and if I were on the frontlines of experimentation I would be very interested in trialing memantine + buprenorphine in a BPI individual.

edit: Walkaway from various other boards uses cannabis regularly, a California prescription, to calm the edges of his hypomania (he cycles between this and depression) with very good effect.
 
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