Dr. Henry Paul, MD

Psychiatrist, Author and Educator

WHAT ARE THE DRUGS USED TO TREAT TDD & BDD?

April 25th, 2014

Below is a list of the major mood stabilizers. Of all of these, Lithium, Depakote, and Tegretol are the three most commonly used.

  • Lithium – Approved for children 12 years and older.
  • Depakote -Approved for children 2 years and older for seizures.
  • Tegretol – Approved for all ages for seizures.
  • Gabapentin – Approved for young people 18 and older. Approved only for epilepsy.
  • Lamictal – Approved for young people 18 and older. Approved for seizures in children.
  • Topamax – Approved for young people 18 and older and approved for seizures.
  • Trilpetal – Approved for children 4 and older and approved for seizures.

LITHIUM

The most well-known, well-studied, and longest used drug for BD is Lithium. Despite favorable publicity, the misconception still exists that Lithium is dangerous. The fear springs from the well-publicized stories of the rare Lithium toxicity reaction. I have prescribed Lithium to many hundreds of patients, young and old, and have only witnessed this reaction once. People can and do take Lithium for years with only positive results.

Lithium can be harmful to the thyroid and to the kidneys over the long term. It is essential that kidney and thyroid function tests be done regularly when taking this drug. Before starting Lithium, your child should have a complete blood count, an ECG, and thyroid and kidney tests.

TEGRETOL

Tegretol (Carbamazine) is an antiepileptic drug used commonly for BD in adults and young people. It is not approved for use in BD and is given off-label. It is approved for use in epilepsy for children as well as adults. Despite this off label use, it has been reported as quite successful in some of the few trials reported. The dosage recommended for young people is up to 300 mgs a day.

Before prescribing Tegretol a complete history and physical examination is necessary. There should be a complete examination of the skin as well as a complete blood count and other blood tests to be sure of the level of liver function.

DEPAKOTE

Depakote, as it is most well-known, is another anti-epileptic medication used as a mood stabilizer. Like with other antiepileptic medication this is used off-label in young people. But it is widely used and considered almost as good as Lithium for BD. It is specifically used quite a bit in teenagers with BD with good results. It is sometimes used as a first line monotherapy like Lithium or in combination with other drugs.

Before starting this drug a complete medical history and physical exam is necessary. There should also be a complete blood count, clotting tests, tests of kidney function, urine analysis, and a pregnancy test for girls. Caution should be taken and full disclosure about PCOS (polycystic ovaries) and pregnancy issues should be made.

DISCLAIMER

Information contained in this blog is intended for educational purposes only. It is not intended as medical or psychiatric advice for individual conditions or treatment and does not substitute for a medical or psychiatric examination. A psychiatrist must make a determination about any treatment or prescription. Dr. Paul does not assume any responsibility or risk for the use of any information contained within this blog.