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Do antipsychotics make effective anti manic medications?

Amazingly

Amazingly

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In your opinion do antipsychotics help your manic episodes?
My doctor raised my Risperdal dose a bit from 4mg to 5mg to help quell down my manic episodes.
I’ve been on all the mood stabilizers and I didn’t want to remain on the Depakote because of excessive weight gain so my doctor raised my AP dose instead of being on a typical mood stabilizer.
The Lamictal was making me manic.
So basically I’m on 2 different meds for my bipolar disorder.
An antipsychotic and a very low dose
25mg of Lamictal, which at this dose doesn’t treat mania.
I also take Klonopin on a as needed basis.
 
Amazingly

Amazingly

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But I wonder if APs make effective long term mood stabilizers, taking the place of more traditional mood stabilizers?
 
K

keith74

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In your opinion do antipsychotics help your manic episodes?
My doctor raised my Risperdal dose a bit from 4mg to 5mg to help quell down my manic episodes.
I’ve been on all the mood stabilizers and I didn’t want to remain on the Depakote because of excessive weight gain so my doctor raised my AP dose instead of being on a typical mood stabilizer.
The Lamictal was making me manic.
So basically I’m on 2 different meds for my bipolar disorder.
An antipsychotic and a very low dose
25mg of Lamictal, which at this dose doesn’t treat mania.
I also take Klonopin on a as needed basis.
Antipsychotics are typically the first choice line of medication for treating someone in an acute manic episode. My wife has typically been given an antipsychotic during every hospitalization due to acute mania. It typically pulls her out of her manic episode in a few weeks. For her last manic episode, she was given olanzapine.

Antipsychotics typically cause more issues with weight gain than depakote. My wife has no issues with weight gain on depakote (she has been on it for decades) but antipsychotics definitely cause her to crave sugar and carbs more and she has to work harder to keep her weight steady when on an antipsychotic. But of course everyone is different.

Lamictal doesn't really help with mania at any dose. Its effectiveness is mainly for depression. Depakote has the best track record of the mood stabilizers for helping with mania.
 
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keith74

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But I wonder if APs make effective long term mood stabilizers, taking the place of more traditional mood stabilizers?
Sometimes they are used as a maintenance drug in place of a typical mood stabilizer. Quetiapine is one such antipsychotic often used like that because it can treat both mania and depression. But people usually have stronger negative side effects from antipsychotics than mood stabilizers so mood stabilizers are typically more preferred. Also, I think mood stabilizers are more helpful for rapid cycling and mixed mania.
 
Amazingly

Amazingly

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Antipsychotics are typically the first choice line of medication for treating someone in an acute manic episode. My wife has typically been given an antipsychotic during every hospitalization due to acute mania. It typically pulls her out of her manic episode in a few weeks. For her last manic episode, she was given olanzapine.

Antipsychotics typically cause more issues with weight gain than depakote. My wife has no issues with weight gain on depakote (she has been on it for decades) but antipsychotics definitely cause her to crave sugar and carbs more and she has to work harder to keep her weight steady when on an antipsychotic. But of course everyone is different.

Lamictal doesn't really help with mania at any dose. Its effectiveness is mainly for depression. Depakote has the best track record of the mood stabilizers for helping with mania.
Thanks @keith74
Depakote works miracles for me but it keeps me constantly craving for carbs and junk food.
I gained 40 pounds in 4 months!
 
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keith74

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Thanks @keith74
Depakote works miracles for me but it keeps me constantly craving for carbs and junk food.
I gained 40 pounds in 4 months!
More than the risperdal? My wife gained a lot of weight the first (and only) time she was on risperdal many years ago. But she was on a fairly high dose (can't remember what exactly but it was considered high) because she was hospitalized for an acute manic episode. Again, she never had an issue with the depakote. But every antipsychotic she's been on has given her the carb/sugar cravings. Goes to show that everyone is indeed different and experiences different side effects.
 
Wishbone

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I've been on mood stabilisers-plus since I was first diagnosed so I can't speak first-hand for whether APs are good or not on their own as anti-manics but from all I've read there are a number of them that are deemed to be. Following on from what Keith said, what I've read is that when used in acute cases, which they largely do, it seems that often they'll keep some of these meds going after the acute episode has passed as maintenance medications as they know these work for the patient and they know that others, such as Lithium, Depakote or Lamotrigine haven't.
You also have to factor in things like compliance as some people may take their meds sporadically if they begin to see things like weight gain as serious problems and don't feel quite so happy about taking the meds every day and may start to mess around with them a little, leading to illness reappearing. Given that weight gain is one of the biggest reasons for non-compliance and most APs cause this, this could be one of the reasons for APs not being successful for some people.

But I was taking Risperidone as PRN before and got on well with it, that definitely felt like it took me back down when I felt myself getting too irritable, especially, but this was in combination with Lithium in the first instance and then Depakote. I too haven't had any problems with weight gain since I've been on it by the way, my weight hit a certain point a few years back and has remained the same since. Are you sure that Depakote has been the culprit and not Risperidone?
 
Amazingly

Amazingly

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I gain some weight on Risperdal but with Depakote I can’t stop eating.
But also I am noticing that my appetite has increased some on an increased dose of Risperdal, so it could be dose dependent.
 
Wishbone

Wishbone

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Yeah could be. Best load up on those rice cracker things that taste of cardboard!
 
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