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Bipolar Disorder Treatment - Lamotrigine, Gabapentin, Topiramate and Calcium Channel Blockers

Rashmi Nemade, Ph.D. & Mark Dombeck, Ph.D.

Bipolar Disorder Treatment - Lamotrigine (Lamictal)

Yet another drug originally designed to treat epilepsy, lamotrigine behaves similar to sodium valproate and carbamazepine when used as a bipolar disorder treatment. Unlike either valproate or carbamazepine, lamotrigine has an anti-depressant effect as well as an anti-manic effect. Its efficacy as a long-term prophylactic bipolar disorder treatment is unknown at this time.

open medication bottleSide effects of lamotrigine include nausea, headache, insomnia, dizziness, sleepiness, and lack of coordination. Quite serious skin rashes are a rare but possible side effect as well.

Bipolar Disorder Treatment - Gabapentin (Neurontin)

Gabapentin is a recently developed drug now approved for epilepsy and currently under investigation as a bipolar disorder treatment because of its calming effect on epileptic patients. Its efficacy in bipolar disorders is thus far controversial. Some patients with anxiety, aggression, or rapid cycling issues may benefit from treatment with gabapentin, administered alongside other mood-stabilizing agents.

Side effects of gabapentin are mild and include blurred vision, dizziness, clumsiness, and sedation. These symptoms are transient and can often be relieved by a reduction in dosage.

Bipolar Disorder Treatment - Topiramate (Topamax)

The evidence that anticonvulsant agents are useful for bipolar disorder treatment has prompted preliminary study of topiramate, yet another new drug used in the treatment of epilepsy. Initial studies suggest that some 30-60% of tested patients show mood improvements with topiramate.

Side effects of topiramate include nausea, decreased appetite, weight loss, dizziness, sleepiness, fatigue, decreased concentration, kidney stones, worsening of psychotic symptoms, numbness and tingling in the hands and feet, or ringing in the ears.

Bipolar Disorder Treatment - Calcium Channel Blockers

Calcium channel blockers are a class of medications that are approved to treat high blood pressure, heart failure, cardiac arrhythmias, and similar conditions. There are multiple types of calcium channel blockers. However, Verapamil and Nimodipine have received the most attention with regard to bipolar disorder treatment. Though calcium channel blocker mood regulation effects are smaller in magnitude than those produced by lithium or the anticonvulsant mood stabilizers, they are nevertheless useful for some patients, and thus are deserving of mention.