Posted by maz81 on June 2, 2008, at 13:32:14
In reply to Re: Do mood stabilisers block antidepressants?, posted by Horned One on June 2, 2008, at 12:48:38
> Some mood stabilizers (lithium, lamotrigine) are used to augment antidepressants, so not all mood stabilizers block the efects of antidepressants. They may prevent hypomania to a certain extent though, and some bipolars may be used to having a somewhat hypomanic response to antidepressants. I sometimes want to come off my mood stabilizer so that I can feel hypomanic, or even manic again.
>
> -HornyHi Horny
I know that some mood stabilizers are used to augment AD's. What was being suggested is that in some cases they don't augment the AD's but actually block the AD effect. I have copied and pasted the extract below;
To the Editor: The trial by Sachs and colleagues
is the latest in a string of studies showing that
the addition of antidepressants to mood stabilizers
in depressed bipolar patients is of minimal
benefit.1,2 However, antidepressants given in the
absence of a mood stabilizer either alone (in
type II illness)3,4 or added to a second-generation
antipsychotic drug5 are effective in treating
bipolar depression. The major difference in the
design of these studies is the absence or presence
of mood stabilizers. When mood stabilizers (lithium
or valproate, carbamazepine, or lamotrigine)
are used, antidepressants are of minimal benefit.
This finding has traditionally been interpreted as
showing that mood stabilizers have an intrinsic
antidepressant effect, which cannot be augmented
by the antidepressant agent. An alternative
interpretation that would reconcile the discrepant
data is that mood stabilizers may actually
interfere with or block the effect of antidepressant
drugs. This distinction is important, since it
would alter the approach to treating depression
in patients with bipolar disorder. Studies that specifically
examine this question need to be performed.
Rif S. El-Mallakh, M.D.
University of Louisville School of Medicine
Louisville, KY 40202
rselma01@louisville.edu
poster:maz81
thread:832472
URL: http://www.dr-bob.org/babble/20080528/msgs/832523.html