Any PRN mood stabilizers?

[ahalo]

Are there any mood stabilizers that can just be taken as needed, like over a 2 week period of time rather than throughout a month? 

[critical_reflection]

I don't think any of the traditional mood stabilisers would work like that.

An antipsychotic that can act as a mood stabiliser can be given prm.  I have zyprexa perscribed this way.  But as I understand it, this is as an adjunct to a mood stabiliser.  Because a mood stabiliser will hopefully stop you from having a mood episode, whereas Zyprexa will only help to treat it once its starts.

[NARS]

I think it seems that PRN mood stabilizers are usually add-ons to cover breakthrough mania.  And zyprexa has serious metabolic consequences for a lot of people, so unless you need the anti-psychotic and an AC doesn't work, you may want to try a regular stabilizer.

Most stabilizers besides zyprexa and maybe seroquel sound like they need to even out in your body over several weeks, so if you're not taking one of those two it won't help to just take it for a few weeks.  I think this goes when you're using them for epilepsy too.  Anyone know on that question?

But if you're getting mania associated with your menstrual cycle, I'd think you need a general stabilizer to keep you stable all month.  Have you had a diagnosis from a pdoc?

[AirMarshall]

None of the first line mood stabilizers work that way or that fast, i.e. Lithium, Lamictal, Depakote.  Although Lithium can be given at high dosage for a short time to get quick saturation, but you are still looking at a week to 2 weeks before it starts to take hold.  And it isn't something that you then drop cold again.

For fast action probably about the best you would get is something like Risperdal, or Seroquel, or possibly some other AP's I'm not familiar with.

You joined the club, you're in for the long haul. 

A.M.

[ahalo]

I have PMDD, and I've been able to get pretty specific on how the symptoms effect me.  There are about 7 days where I experience a sudden onset of anxiety that continue throughout that week.  Then, for about 9 days I'm pretty much "unstable".  During this time (sometimes for as many as 12 days) I am terribly anxious, reactive, have mood swings that range from regular hyperactivity to really mean, and just do not deal with anything in my life very well.  I don't get particularly "depressed",  though I am more emotional.  I've made some really stupid decisions during these times of the month that could have had lasting implications in my life and in some ways have.

The reason I was hoping to find a PRN mood stabilizer is that I have no medical insurance and it looks like all the mood stabilizers are extremely expensive.  My pdoc has given me samples of different ADs and Abilify, and I could ask about samples for mood stabilizers, but at some point samples run out.  And I anticipate this is something I will be dealing with for at least, oh, 20 more years. 

I've also recently developed panic attacks and I'm not sure what is behind them.  It seems like dealing with the implications of my PMDD actions come back to haunt me later and that could explain the panic attacks.  So I would just like to get some help with the moods. 

Right now I'm on a starting dose of Effexor, but like clockwork the anxiety started a couple days ago that is associated with the PMDD.  I decided to add on 2.5 mg Abilify because a couple months ago it seemed to help some with my PMDD symptoms, and so far it is really helping me sleep which has eased the anxiety quite a bit.  By mid-next week the severe PMDD will probably hit so I'm bracing for that. 

If I am overlooking any "cheaper" mood stabilizer, please feel free to enlighten me :-)

[sun_zoom_spark]

I've also recently developed panic attacks and I'm not sure what is behind them.

[peeej]

i duno if 'cheap' varies depending on your geography. i have def. pattern around menstrual cycle. my gdoc did not want to put me on birth control as while the hormones would get stabilized they'd be raised throughout the month which he thought would make symptoms worse rather than better. so he opted for lithium.

for me, the carbolith i am on is 14.82CDN for 60 doses 150mg (1month). that's with no ins. reductions whatsoever as i have none atm. I duno. maybe that's not cheap.

pj

[NARS]

Tegretol's generic (carbamazepine) is dirt cheap.  Lithium is cheap.  I'm not sure if brand-name Depakote is cheap, but there a few similar generics that must be. 

One thing with generics is that if you don't stick with the same manufacturer or, in the case of the depakote generics, the same exact compound, you can get variations in blood levels and effects.  So if you go that way try to go with a pharmacy that tends to stick with the same suppliers, or ask before submitting the Rx so you can find another pharmacy with the right supplier.

Another option you should check is https://www.pparx.org/Intro.php.  Manufacturers will often supply meds to patients who can't afford them.  Your prescriber has to participate to get you signed up.  It'll give you a wider variety of meds to try.

And 12 days a month of loopiness would sure convince me to get on a mood stabilizer.

[WholeNewHomeBody]

I've also recently developed panic attacks and I'm not sure what is behind them.  It seems like dealing with the implications of my PMDD actions come back to haunt me later and that could explain the panic attacks.  So I would just like to get some help with the moods. 

If I am overlooking any "cheaper" mood stabilizer, please feel free to enlighten me :-)

<{POST_SNAPBACK}>

Benzos knock out panic attacks and they are dirt cheap compared to other meds.

<{POST_SNAPBACK}>

Just what I was thinking. Even for PRN dosage 2 weeks/ month. You just have to be careful. And have decent MD (manipulation of doctors) qualifications.

[Velvet Elvis]

The problem with the generic mood stabilizers is that they all require regular blood tests which aren't cheap. With teg. you can get by with doing them every three months but you have to be a lot more careful with dep. and lith. 

All drugs in this catagory are taken as a preventitive measure so PRN dosing isn't really an option.

[AirMarshall]

Every post I write today has lithium in it.    As mentioned above, it is avaible in generic and probably one of the cheapest MI drugs.  Blood tests cost about $250 each at full price.

ONe consideration that might affect your decision:  getting on a mood stabilzer continuously may improve your overal condition enough to eliminate or greatly decrease your anxiety attacks. None of this MI stuff happens in a vacuum.  They are interelated.

A.M.

[NARS]

One thing about blood testing with depakote & its cousins is that once you're stable and your liver function tests have been fine for a year or so, you can go to blood testing every 6 months to a year.  YMMV, as with everything.  Still more expensive than no tests, but apparently less than lithium.

And I agree with AirMarshall about the anxiety attacks.  I used to have them all the time and used benzos PRN.  Problem was that sometimes I was just one big hairy anxiety attack, for days on end.  They didn't go away until I was on Depakote.  The anxiety I had on that med was many orders of magnitute less than I'd had before.