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medication / mood stabilizers / anticonvulsants

Mood stabilizers: anticonvulsants

Prescription

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  • Perform blood tests (for liver and blood evaluation, among others) monthly for the first 6 months, then regularly thereafter.

  • Examination of thyroid function every year

  • Measurement of valproate blood concentration at the start of treatment to find the target dose. Then, check periodically, as for lithium

Directions​

Physical health issues

  • Epilepsy

 

​ Mental health problems

  • Bipolar disorder, manic or depressive phase

  • Prevention of relapses of bipolar disease

  • Aggressive or explosive behavior

Contraindications ​

 

Physical health issues

  • Avoid if suffering from blood, kidney or liver disease

  • May, in rare cases, increase bleeding

  • Allergies to active substances or one of their components

  • Fructose intolerance

  • Different types of headache (migraines and others)

  • Acute myopia and secondary angle-closure glaucoma

  • Rashes

  • Diuretics

 

Mental health problems

Suicidal thoughts

 

For seniors

Lower doses than those used for adults

 

During pregnancy and lactation

  • Refrain

  • Should not be used during pregnancy or in  women who plan to become pregnant, nor during lactation. Neonates exposed to topiramate (Topamax) in utero are at increased risk of cleft lip and/or cleft palate (absence of oral vault substance resulting in communication between the nose and

  • the mouth)

 

For kids

May be dangerous (hepatitis), but indicated for epilepsy

 

Others

  • Avoid taking it with soft drinks

  • Do not drink alcohol

Drugs interactions ​

 

Psychiatric drugs (add to side effects ) ​

  • Central nervous system depressants (alcohol, narcotics, benzodiazepines, barbiturates, antipsychotics)

  • Certain anticonvulsants  (Mysoline, Apo-Primidone)

 

Other drugs

  • Oral anticoagulants  and some blood thinners:  warfarin (Coumadin)

  • Acetylsalicylic acid  (Aspirin) in high doses

  • oral contraceptives

  • Anesthetics

  • Valproate doubles the amount of lamotrigine (Lamictal) in the blood

Side effects​

They depend on the dosage and duration of treatment, the metabolism of the individual and the context in which he lives.

 

Head

  • Dizziness

  • Dizziness

  • Sedation

  • Memory problems

  • Confusion

  • Headache

  • Vision problems

  • Speech disorders

  • Headaches

 

Abdomen

  • Nausea, vomiting

  • Indigestion (the first few weeks)

  • Risks of developing kidney stones (drink plenty of water)

  • Respiratory tract infections (colds, bronchitis)

  • Diarrhea, constipation

 

Sexuality

  • Change in menstruation cycle

  • Decreased sexual appetite

  • Increase in hair growth in women

 

Sleep

Drowsiness (the first few weeks)

 

Members

  • Tingling

  • Tremors

  • Muscle coordination disorders

  • Weakness

 

Weight

Loss of appetite

 

Blood

Increased acid level in the blood

 

Psychological

  • Mental confusion

  • Hustle

  • Difficulty in  focus

  • Nervousness

 

Others

  • Fatigue

  • Decreased sweating and increased body temperature (fever)

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Less common side effects

 

Head

  • Headache

  • Confusion

  • Difficulty speaking

  • Hair loss

  • Allergic reactions (swelling of lips, throat, eyelids, face)

  • Slowing of the thyroid gland

 

Members

  • Tremors

  • Gait instability

  • Involuntary movements

  • Muscle aches

 

Abdomen

  • Diarrhea

  • Indigestion

  • Abdominal cramps

  • Rare liver problems that manifest as:

> Weakness

> Deep and continuous sleep

> Loss of appetite

> Vomiting

> Swelling of the figure

 

Skin

Rashes

 

Weight

Loss of appetite

 

Blood

Decreased white blood cell count

 

Psychological

Suicidal thoughts and behaviors

 

Others

  • Bleeding, bruising

  • Polycystic ovaries

  • signs of hepatitis

  • Mood swings

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Monitoring and medical surveillance​

Actions one can take to avoid iatrogenic effects (which are caused by medicine)

 

  • Blood test

  • Liver examination

  • Weight monitoring

General​

Prescribed primarily to fight against epilepsy, anticonvulsants occupy more and more a place of choice in the treatment of mood disorders, because an improvement in the stability of mood was observed in people who took it to fight epilepsy. They also have a calming effect. They begin to take effect after about two weeks. Regular blood tests are necessary, especially because of certain possible side effects on the liver, kidneys and blood platelets (small cells without a nucleus circulating in the blood with red blood cells and white blood cells. They have an essential role in the coagulation).

Withdrawal symptoms

Psychotropic drugs act in the brain just as they do in the rest of the body; and as we have seen, each person reacts differently. It's the same with weaning; the person's metabolism, the type of drug, the dose as well as the duration of the intake and its half-life, explain that the withdrawal effects are varied. We have listed the potential and main withdrawal symptoms of each class of psychotropic drugs. This list is incomplete, as not all withdrawal effects are listed; moreover, knowledge is rapidly evolving in this field. A person may have no withdrawal symptoms or experience one, a few, or even many. The medication reduction journey is specific to each person, just as each process is unique. For example, a person can take the same medicine twice at the same dose and the effects will be different. Gradual reduction, like removing 10  % of dose per week/month, reduces the frequency or intensity of withdrawal symptoms and the incidence of rapid relapses. It is very important to undertake this process with the collaboration of your doctor. The pharmacist also plays a key role and can provide guidance to monitor withdrawal effects for each drug. Most people who will have withdrawal symptoms will tolerate them without problems for the short duration of these symptoms.

 

Common and frequent withdrawal symptoms for all classes: anxiety, nervousness, restlessness, sleep problems, greater need to rest, sleep, irritability, fatigue.

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Withdrawal symptoms for anticonvulsants:

Tegretol, Epival, Depakene, Topamax, Lamictal and Neurontin

 

Main psychological withdrawal symptoms:

  • Return of episodes of mania or depression

  • Mood swings

  • Irritability

  • suicidal tendencies

 

Main physical withdrawal symptoms:

  • Headaches (headaches)

  • Dizziness

  • Discomfort

  • Return of seizures if taken as part of epilepsy

  • Tremors

Rarely:

  • Involuntary muscle movements

  • Lack of coordination

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