1 reply to this topic

[dymphna]

I have what my pdoc calls bipolar 3. I dont have the depressive part just the rapid cycle anger and hyperactivity part.
I am on epival 1200 and it has always made me moody since the day I took it. So I was interested in taking tegrital till I found out that it makes it so the other meds I have wont work as well.
So Im interested in taking Depakote as I saw that it works on the personality disorder complex part of my bipolar. Im also hoping for the mood stabilizer as well of course.

Thank you for your help!

From the user agreement:

5) We don't deal with what are primarily psychological issues that are mostly treated with talk therapy. It's one thing if you happen to have a primarily psychological diagnosis (e.g. PTSD) in addition to brain cooties. List it with your other diagnoses if you want. Many of such things are treated with the meds we discuss here. We just aren't going to get into extended discussions about the origins, nature of or treatments for conditions such as borderline personality disorder. We're all about Axis I in the DSM, and not Axis II.

You may discuss Depakote and BPAD (bipolar) to your heart's content.

Per the latest Psychiatric Times CME:

Pharmacological treatment

While randomized clinical trials of patients with BPD have been performed using mood stabili­zers, antidepressants, and typical and atypical antipsychotics, their effect sizes have not been particularly robust. This, coupled with small sample sizes, prompted the recent Cochrane review to state that there are “insufficient data” to sup­port any recommendations for pharmacological treatment in BPD. The report concluded that medication effects in BPD are “unimpressive.”

³⁷

[...]

In BPD, randomized controlled trials of valproate and carbamazepine have targeted impulsivity and anger rather than affective instability, while a randomized controlled trial of lithium showed no benefit at all.

39-42

Refs from the CME:

37. Binks CA, Fenton M, McCarthy L, et al. Pharmacological interventions for people with borderline personality disorder. Cochrane Database Syst Rev. 2006;(1):CD005653.
38. Zanarini MC, Frankenburg FR, Khera GS, Bleichmar J. Treatment histories of borderline inpatients. Compr Psychiatry. 2001;42:144-150.
39. Hollander E, Swann AC, Coccaro EF, et al. Impact of trait impulsivity and state aggression on divalproex versus placebo response in borderline personality disorder. Am J Psychiatry. 2005;162:621-624.
40. Kavoussi RJ, Coccaro EF. Divalproex sodium for impulsive aggressive behavior in patients with personality disorder. J Clin Psychiatry. 1998;59:676-680.
41. Cowdry RW, Gardner DL. Pharmacotherapy of borderline personality disorder. Alprazolam, carbamazepine, trifluoperazine, and tranylcypromine. Arch Gen Psychiatry. 1988;45:111-119.
42. Links PS, Steiner M, Boiago I, Irwin D. Lithium therapy for borderline patients: preliminary findings. J Pers Disord. 1990;4:173-181.

Dymphna