Posted by SLS on March 8, 2006, at 7:28:55
In reply to Re: Keppra for generalized or social anxiety? » SLS, posted by CareBear04 on March 7, 2006, at 15:12:09
Hi CB.
How does your bipolar disorder affect you?
There are so many different opinions regarding the utitility of Keppra for bipolar disorder. One doctor I spoke to said that it was better for the depressive phase than for the manic phase. Another told me just the opposite. Another told me that it didn't have much of a mood-stabilizing effect, another published a paper saying that it does. Yet another said that it had the effect to destabilize mood and precipitate depression and mood lability.
I think all of these things are true. I think it depends on the person and the dosage used. For me, higher dosages were depressogenic and produced mood lability. For me, 1000mg is OK, but 2000mg is not. It does help me with depression, but not much. However, I keep it because it works with the other drugs I take to allow me to function.
Keppra is unique. Unlike the other mood stabilizers, it neither blocks sodium or calcium channels nor potentiates GABA neurotransmission. It seems to bind selectively to a receptor on the synaptic vessicle - the storage and release structure of the presynaptic neuronal terminal. My guess is that it has a reserpine-type effect for some people. It might produce a short periods of both improvement and worsening of depression by producing increases and decreases in neurotransmitter release respectively.
The one side effect that I am finding problematic is that it is producing a very dry skin condition on the palms of my hands. It took a month or so to develop. Using a moisturizer has helped, but I find that I must apply it continuously throughout the day.
Check this out:
I saw this doctor for a consultation. He genuinely believes that Keppra helped his patient recover from a treatment-resistant rapid-cycling bipolar disorder that presented as a mixed state. I don't know how he came to choose 2000mg as a maintenance dosage, but he apparantly tailored it for this patient through trial and error.
Here, the authors describes some patients as experiencing periodic worsenings of their condition during treatment:
My guess is that the dosages used were too high for these people. Ultimately, it will probably be discovered that Keppra displays a therapeutic window for bipolar disorder.
I think I would first target 1000mg for a month or so. If there is no improvement, then continue to 2000-3000mg.
I hope Keppra works out for you.
- Scott
> Hi Scott,
> I just started taking Keppra for bipolar, too. I don't know anyone else who has taken it, so I'm curious to know more about your experience. Have you taken other mood stabilizers? How do you find Keppra compares to them? I'm on such a huge cocktail of meds that I can't tell what the Keppra is doing. You're right, though, that it's a "clean" drug without many side effects. I'd love to hear any thoughts you have about the drug.
> Thanks!
> CB
poster:SLS
thread:616686
URL: http://www.dr-bob.org/babble/20060304/msgs/617392.html