17 U.S. Code § 107 - Limitations on exclusive rights: Fair use
Notwithstanding the provisions of sections 106 and 106A, the fair use of a copyrighted work, including such use by reproduction in copies or phonorecords or by any other means specified by that section, for purposes such as criticism, comment, news reporting, teaching (including multiple copies for classroom use), scholarship, or research, is not an infringement of copyright. In determining whether the use made of a work in any particular case is a fair use the factors to be considered shall include—
(1) the purpose and character of the use, including whether such use is of a commercial nature or is for nonprofit educational purposes [all mirrored content falls under this clause, any ads present are mirrored from the original site, mirrored content earns me no revenue whatsoever];
(2) the nature of the copyrighted work [this is a unique resource for the mentally ill, and preservation of it can be argued to be incredibly important];
(3) the amount and substantiality of the portion used in relation to the copyrighted work as a whole; and
(4) the effect of the use upon the potential market for or value of the copyrighted work. [absolutely none whatsoever, as the original work no longer exists anywhere else (outside of whatever bits and pieces archive.org managed to capture) - the original site was intermittantly completely unavailable for a extended period of time before its SSL certificate expired (and was never renewed), and eventually the site went offline for good, then finally the DNS records were removed at some point prior to May 2018, so at this point it is well beyond the 'dead and rotting' stage]
The fact that a work is unpublished shall not itself bar a finding of fair use if such finding is made upon consideration of all the above factors.

This domain is not controlled by Jerod Poore, and I will NOT continue redirecting traffic from this domain to crazymeds.us [as I formerly did] while Jerod continues with his immature temper tantrum over adblock or continues to fail to maintain his site, fucking over his entire community and countless visitors in the process. [belated clarification: with specific regards to the adblock drama I was referring to Poore at one point replacing his entire site with a single page complaining about the amount of revenue lost to users with ad blocking active, which is something that I took extreme exception to because this affected ALL visitors to the site regardless of if or if not they were actually using ad blocking]
This mirror is unfortunately incomplete (and very slightly outdated), as /CrazyTalk/ was not included when I scraped the site (it was far too large to scrape given the site's extremely poor performance, my wish to avoid worsening the poor performance further, and other factors). If you're looking for a replacement forum, I suggest visiting https://www.crazyboards.org/forums/. There are issues with many of the mirrored pages, I am working on identifying and fixing them, but I do not have the time to address every single issue at this moment (although by now the majority of these issues have been resolved). Dynamic content is obviously completely broken (this is beyond my control), and the loss of /CrazyTalk/ is quite bad given how much good user-generated info was on there, but you have Jerod to "thank" for that. Maybe I'll bring it back online at some point, but it wouldn't be the same as before. For now, I suggest visiting CrazyBoards instead.
Note (Oct 9 2018): Infrequent additional updates regarding the status of this site will be posted on https://info.crazymeds.net


MedClass.NP History

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Page design and explanatory material by Jerod Poore, copyright © 2004 - 2014.  All rights reserved.  Don't automatically believe everything you read on teh Intergoogles. [[<<]]
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Page design and explanatory material by Jerod Poore, copyright © 2003 - 2015.  All rights reserved.  Don't automatically believe everything you read on teh Intergoogles. [[<<]]
2014-11-19 by JerodPoore -
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Most drugs used to treat pain[^##morph^] are either [[antiepileptic drugs]] (AEDs) or [[antidepressants]] that have a positive effect on the neurotransmitter norepinephrine, usually SNRIs like [[Cymbalta]] or TCAs like [[amitriptyline]].  AEDs are also used to prevent migraines. [^##morph Other than opioids, of course, or medications that treat the source of non-neuropathic pain, like steroids or other anti-inflammatory drugs.^]

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Most drugs used to treat pain[^##morph^] are either [[antiepileptic drugs]] (AEDs), or [[antidepressants]] that have a positive effect on the neurotransmitter norepinephrine, usually SNRIs like [[Cymbalta]] or TCAs like [[amitriptyline]].  AEDs are also used to prevent migraines. [^##morph Other than opioids, of course, or medications that treat the source of non-neuropathic pain, like steroids or other anti-inflammatory drugs.^]

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||[[Meds/Savella|milnacipran]] ||milnacipran hydrochloride||Fibromyalgia ||
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||[[Meds/Savella|Savella]] ||milnacipran ||Fibromyalgia ||
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* Cannabis - 99% of what medical marijuana advocates claim is utter bullshit[^##forum^].  Chronic pain is one of the very few things cannabis is actually good for.
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* Cannabis - 99% of what medical marijuana advocates claim is utter bullshit[^##forum^].  Chronic pain is one of the very few things the cannabis people smoke to get high is actually good for.  From a medicinal standpoint.
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||'''Linked:'''        ||%font-family:courier%[@<a href="http://scholar.google.com/citations?user=5rkux7sAAAAJ&hl=en&oi=sra">Poore, Jerod</a>. <a href='B4B1B094-37FE-4A56-ACD6-4954F413FBE6.html'>"@]{*$Title}[@"</a>. <a href="@]{*$ScriptUrl}[@/Main/HomePage"> <em>crazymeds.net</em></a>. @](2011). ||
||'''with Microdata:''' ||%font-family:courier%[@<span itemprop='citation'> <a href="http://scholar.google.com/citations?user=5rkux7sAAAAJ&hl=en&oi=sra">Poore, Jerod</a>. <a href='B4B1B094-37FE-4A56-ACD6-4954F413FBE6.html'>"@]{*$Title}[@"</a>. <a href="@]{*$ScriptUrl}[@/Main/HomePage"> <em>crazymeds.net</em></a>. @](2011)[@.</span>@] ||
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||'''Plain text:'''    ||%font-family:courier%Poore, Jerod. "{*$Title}." ''Crazymeds (crazymeds.net)''. (2011). ||
||'''with Microdata:''' ||%font-family:courier%[@ <span itemprop='citation'>Poore, Jerod. "@]{*$Title}[@." <em>Crazymeds (crazymeds.net)</em>.@](2011)[@.</span>@] ||
||'''Linked:'''        ||%font-family:courier%[@<a href="http://scholar.google.com/citations?user=5rkux7sAAAAJ&hl=en&oi=sra">Poore, Jerod</a>. <a href='B4B1B094-37FE-4A56-ACD6-4954F413FBE6.html'>"@]{*$Title}[@"</a>. <a href="@]{*$ScriptUrl}[@/Main/HomePage"> <em>Crazymeds (crazymeds.net)</em></a>. @](2011). ||
||'''with Microdata:''' ||%font-family:courier%[@<span itemprop='citation'> <a href="http://scholar.google.com/citations?user=5rkux7sAAAAJ&hl=en&oi=sra">Poore, Jerod</a>. <a href='B4B1B094-37FE-4A56-ACD6-4954F413FBE6.html'>"@]{*$Title}[@"</a>. <a href="@]{*$ScriptUrl}[@/Main/HomePage"> <em>Crazymeds (crazymeds.net)</em></a>. @](2011)[@.</span>@] ||
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<meta name="DCTERMS.abstract" content="A list of medications and other treatment options for migraines and neuropathic pain. Also an overview of the conflicting data regarding serotonin syndrome when combining triptans with SSRIs or SNRIs." />
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[[http://scholar.google.com/citations?user=5rkux7sAAAAJ|Jerod Poore]] [[<<]]
[[Profiles/JerodPoore|Author Information]] [[#copied|Copyright, Citing and License information]] Published online 15 May 2011
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!!!Meds with FDA Approval to Treat Migraines, Other Headaches, Fibromyalgia and various types of Neuropathic Pain
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||[[duloxetine hydrochloride]] ||duloxetine hydrochloride ||Fibromyalgia, Diabetic Peripheral Neuropathic Pain, Chronic Musculoskeletal Pain ||
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||[[duloxetine]] ||duloxetine hydrochloride ||Fibromyalgia, Diabetic Peripheral Neuropathic Pain, Chronic Musculoskeletal Pain ||
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* Amerge (naratriptan hydrochloride)
* Frova (frovatriptan succinate)
* Axert (almotriptan malate)
* Relpax (eletriptan hydrobromide)
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* Amerge (naratriptan)
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* Axert (almotriptan)
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* Maxalt (rizatriptan benzoate)
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* Maxalt (rizatriptan)

There are conflicting data regarding the safety of mixing triptans with SSRIs or SNRIs.
* I had a blanket warning about combining the two classes all over this site 2004 - 2009 due to the danger of [[http://www.nlm.nih.gov/medlineplus/ency/article/007272.htm|serotonin syndrome]].
* The FDA caught up with me in 2006 when they issued [[http://www.fda.gov/drugs/drugsafety/postmarketdrugsafetyinformationforpatientsandproviders/drugsafetyinformationforheathcareprofessionals/ucm085845.htm|this alert]].
* Since then it's been standard practice to make sure no one takes one from column A and one from column B.
** Except lots of people are probably still taking both.
* Like I did, [[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2100123/#__sec10title|the FDA based its warning on a bunch of case reports]].
** As I have a crappy little website, my warning consisted of "talk to your doctor(s) about mixing these two meds that will result in an interaction with a greater than 0 chance of killing you."
*** Or something like that.
** When the FDA says essentially the same thing, doctors are the ones who stop prescribing one if you're already taking the other.
** Since then I've learned that the chance of serotonin syndrome is extremely low no matter what, and the likelihood of it killing you is lower yet.
** Not only that, we have the best example of contradictory data and dueling studies ever!
*** [[http://www.amcp.org/WorkArea/DownloadAsset.aspx?id=10712|Are triptans even involved in serotonin syndrome?]]
*** They have to be, as [[http://www.nejm.org/doi/full/10.1056/NEJMc0706410|triptans alone can cause serotonin syndrome.]]
*** So?  [[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3550303/pdf/13181_2010_Article_21.pdf|''Anything'' can cause serotonin syndrome!]]
* Like I have, the FDA seems to have changed its mind regarding just how dangerous it is to mix triptans and SSRIs or SNRIs. 
** Have they rescinded their warning?  Of course not!  The FDA is ''never'' wrong.  Even though it was updated in August 2013, look at it.  Notice anything missing?  Where's [[Pristiq]]?
** The real question is: where the hell is [[Viibryd]]?  If ''any'' med on the planet is going to cause serotonin syndrome when mixed with a triptan it would by Viibryd.

As always talk to your doctor(s).  If you have more than one doctor prescribing the medications that could be interacting with each other, try to get them to talk with each other.  Good luck with that.
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** [[http://www.ncbi.nlm.nih.gov/pubmed/21435214|Acupuncture also has side effects]].  Not just ones related to being poked with sharp, and occasionally electrified needles, but things like vertigo, fainting, and abdominal distension.
* [[https://crazymeds.net/crazypress/cefaly-the-anti-migraine-tiara/|The Cefaly, an anti-migraine tiara]].  It may be the greatest thing ever for migraines, but it looks like something out of Logan's Run.
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** [[http://www.ncbi.nlm.nih.gov/pubmed/21435214|Acupuncture also has side effects]].  Not just ones related to being poked with sharp, and occasionally electrified needles, but things like vertigo, fainting, and abdominal distension.[^##botox^]
*
[[https://crazymeds.net/crazypress/cefaly-the-anti-migraine-tiara/|The Cefaly, an anti-migraine tiara]].  It may be the greatest thing ever for migraines, but it looks like something out of ''Logan's Run''.
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[^##botox Drug study I want to see: Botox vs. Acupuncture vs. placebo instead of Botox vs. sham Acupuncture vs. Acupuncture using Botox.  The PI sheet for Botox really stresses the importance of where the injections are placed.  I swear it looks like an acupuncture diagram.  How much of Botox treatment's success is due to the paralytic effect of the toxin and how much, if any, is due to it being a form of acupuncture? Of course the injection sites need to be accurate as hell in order to not fuck up something, so the last part of the study may not be ethical. ^]
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!!!References
# [[PMC:2100123|Evans, Randolph W. "The FDA Alert on Serotonin Syndrome With Combined Use of SSRIs or SNRIs and Triptans: An Analysis of the 29 Case Reports." ''MedGenMed''. 2007; 9(3): 48.]] Published online Sep 5, 2007.
# [[PMID:21870895|Kogut, Stephen J. "Do Triptan Antimigraine Medications Interact with SSRI/SNRI Antidepressants? What Does Your Decision Support System Say?" ''Journal of Managed Care & Specialty Pharmacy.'' 2011 Sep;17(7):547-51.]]
# [[Book:0889373957|Virani, Adil S., K. Bezchlibnyk-Butler, and J. Jeffries ''Clinical Handbook of Psychotropic Drugs'' 18th edition]] Hogrefe & Huber Publishers 2009. ISBN:978-0889373693
# [[Book:0521136725|Silberstein, Stephen D., Michael J. Marmura ''Essential Neuropharmacology: The Prescriber's Guide''  ]] [[http://www.cambridge.org|Cambridge University Press]] 2010. ISBN:978-0521136723

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''{$Title}'' by (=html=)<span itemprop="copyrightHolder">(=htmlend=)[[{Profiles/JerodPoore}|Jerod Poore]](=html=)</span>(=htmlend=) is copyright © (=html=)<span itemprop="copyrightYear">2010</span>(=htmlend=) Jerod Poore[[<<]]
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All drug names are the trademarks of someone else.  Look on the appropriate PI sheets or ask Google who the owners are.
  The way pharmaceutical companies buy each other and swap products like Monopoly™ real estate, the ownership of any trademarks may have changed without my noticing.
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[[http://scholar.google.com/citations?user=5rkux7sAAAAJ|Jerod Poore]] is copyright © (=html=)<span itemprop="copyrightYear">2011</span> <span itemprop="copyrightHolder">(=htmlend=) [[https://independent.academia.edu/JerodPoore|Jerod Poore]] (=html=)</span>(=htmlend=) ||Published online 2011/05/15 ||

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||'''with Microdata:''' ||%font-family:courier%[@<span itemprop='citation'> <a href="http://scholar.google.com/citations?user=5rkux7sAAAAJ&hl=en&oi=sra">Poore, Jerod</a>. <a href='B4B1B094-37FE-4A56-ACD6-4954F413FBE6.html'>"@]{*$Title}[@"</a>. <a href="@]{*$ScriptUrl}[@/Main/HomePage"> <em>crazymeds.net</em></a>. @](2011)[@.</span>@] ||

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All drug names are the trademarks of someone else.  Look on the appropriate PI sheets or ask [[http://www.google.com|Google]] who the owners are.  The way pharmaceutical companies buy each other and swap products like Monopoly™ real estate, the ownership of any trademarks may have changed without my noticing.
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All drug names are the trademarks of someone else.  Look on the appropriate PI sheets or ask Google who the owners are.  The way pharmaceutical companies buy each other and swap products like Monopoly™ real estate, the ownership of any trademarks may have changed without my noticing.
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(:Description {*$LastModified}. We help you find the best treatment options for migraines, other headaches, fibromyalgia and various other flavors of neuropathic pain. That's mostly antiepileptic drugs (AEDs) and some antidepressants.:)
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(:Description {*$LastModified}. We help you find the best treatment options for migraines, other headaches, fibromyalgia and various other flavors of neuropathic pain. I.e. mostly antiepileptic drugs (AEDs) and some antidepressants.:)
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!!!!Meds we don't have pages on yet
* flunarizine - not available in the US

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!!!Meds not Available in the US Approved to Treat Migraines & Neuropathic Pain
* flunarizine - a calcium-channel blocker (like verapamil) and antihistamine approved to treat migraines

!!!Devices and other Non-Medication Treatments Proven to be Effective in Treating Migraines & Neuropathic Pain
* [[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3291669/|Acupuncture]].  That's right, acupuncture really does work for some things. 
** While [[http://www.ncbi.nlm.nih.gov/pubmed/16545747|the data are somewhat mixed]], acupuncture [[http://www.ncbi.nlm.nih.gov/pubmed/21616596|seems to work more often than not in the large, controlled studies]]. 
** [[http://www.ncbi.nlm.nih.gov/pubmed/21435214|Acupuncture also has side effects]].  Not just ones related to being poked with sharp, and occasionally electrified needles, but things like vertigo, fainting, and abdominal distension.
* [[https://crazymeds.net/crazypress/cefaly-the-anti-migraine-tiara/|The Cefaly, an anti-migraine tiara]].  It may be the greatest thing ever for migraines, but it looks like something out of Logan's Run.
* Lifestyle management - still one of the most effective methods to prevent migraines.
* Cannabis - 99% of what medical marijuana advocates claim is utter bullshit[^##forum^].  Chronic pain is one of the very few things cannabis is actually good for.
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[^##forum Which is the main reason we don't discuss medical MJ on the forum.  It turns into a holy war time sink.  A close second is that smoking, or however you like to ingest your pot is one of the worst things anyone with bipolar disorder or schizophrenia can do.  I'm positive all the pot I smoked is one of, if not ''the'' main reason I'm now treatment-resistant.  I'm all for the full relegalization of cannabis and people who aren't as crazy as I am getting as high as they want to as often as they want to.  I just want a warning label on it regarding bipolar and schizophrenia - even if 1% of pot-smoking nutjobs, at best, would pay attention to it - and more of the tax revenue that goes for mental health treatment programs to go to something other than drug rehab programs. ^]

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All drug names are the trademarks of someone else.  Look on the appropriate PI sheets or ask [[http://www.google.com|Google]] who the owners are.  The way pharmaceutical companies buy each other and swap products like Monopoly™ real estate, the ownership of any trademarks may have changed without my noticing.

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(:if expr ( equal {$@crazy_meds_device} "mobile" ) || ( equal {$@crazy_meds_device} "satellite" ) :)
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Page design and explanatory material by Jerod Poore, copyright © 2004 - 2013.  All rights reserved.  Don't automatically believe everything you read on teh Intergoogles. [[<<]]
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Page design and explanatory material by Jerod Poore, copyright © 2004 - 2014.  All rights reserved.  Don't automatically believe everything you read on teh Intergoogles. [[<<]]
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>><<
>>font-family:times font-size:2<<
(
=html=)<div itemscope itemtype="http://schema.org/Article" display=inline>(=htmlend=)
[--Author:
(=html=)<span itemprop="author">(=htmlend=)Jerod Poore(=html=)</span>(=htmlend=)  Date Modified: (=html=)<span itemprop="dateModified">(=htmlend=) {(ftime fmt %F {*$LastModified})} (=html=)</span>(=htmlend=) Date Published: (=html=)<span itemprop="datePublished">(=htmlend=)2011-05-15(=html=)</span>(=htmlend=) (:drugclass: [[MedClass/NP|Headaches & Neuropathic Pain]]:)--] (=html=)</div>(=htmlend=)
>><<
(=html=)<span meta property="og:description" content="{*$Description}"/>(=htmlend=)
(=html=)<span link rel="author"  href="https://crazymeds.net/pmwiki/pmwiki.php/Profiles/JerodPoore" name="Jerod Poore" />
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<meta itemprop="datePublished" content="2011-05-15">
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<meta itemprop
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(=htmlend=)
2014-02-23 by JerodPoore -
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||[[Meds.Cymbalta|Cymbalta]] ||duloxetine hydrochloride ||Fibromyalgia, Diabetic Peripheral Neuropathic Pain, Chronic Musculoskeletal Pain ||
||[[Meds.Depakote|Depakote]]  ||divalproex sodium ||Migraine prophylaxis ||
to:
||[[Meds/Cymbalta|Cymbalta]] ||duloxetine hydrochloride ||Fibromyalgia, Diabetic Peripheral Neuropathic Pain, Chronic Musculoskeletal Pain ||
||[[Meds/Depakote|Depakote]]  ||divalproex sodium ||Migraine prophylaxis ||
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||[[Meds.Neurontin|Neurontin]] ||gabapentin ||Postherpetic Neuralgia ||
to:
||[[Meds/Neurontin|Neurontin]] ||gabapentin ||Postherpetic Neuralgia ||
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||[[Meds.Stavzor|Stavzor]] ||valproic acid delayed release ||Migraine prophylaxis ||
||[[Meds.Tegretol|Tegretol]] ||carbamazepine ||Trigeminal Neuralgia, Glossopharyngeal Neuralgia ||
||[[Meds.Topamax|Topamax]]  ||topiramate ||Migraine prophylaxis ||
to:
||[[Meds/Stavzor|Stavzor]] ||valproic acid delayed release ||Migraine prophylaxis ||
||[[Meds/Tegretol|Tegretol]] ||carbamazepine ||Trigeminal Neuralgia, Glossopharyngeal Neuralgia ||
||[[Meds/Topamax|Topamax]]  ||topiramate ||Migraine prophylaxis ||
Changed lines 72-74 from:
||[[Meds.Elavil|Elavil]] ||amitriptyline ||Depression ||Migraines ||
||[[Meds.Pamelor|Pamelor]] ||nortriptyline  ||Depression ||Migraines ||
||[[Meds.Tofranil|Tofranil]] ||imipramine ||Depression ||Migraines ||
to:
||[[Meds/Elavil|Elavil]] ||amitriptyline ||Depression ||Migraines ||
||[[Meds/Pamelor|Pamelor]] ||nortriptyline  ||Depression ||Migraines ||
||[[Meds/Tofranil|Tofranil]] ||imipramine ||Depression ||Migraines ||
2014-02-22 by JerodPoore -
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||[[Meds/Topamax]]  ||topiramate ||Migraine prophylaxis ||
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||[[Meds.Topamax|Topamax]]  ||topiramate ||Migraine prophylaxis ||
2014-02-22 by JerodPoore -
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||[[Meds/Tofranil]] ||imipramine ||Depression ||Migraines ||
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||[[Meds.Tofranil|Tofranil]] ||imipramine ||Depression ||Migraines ||
2014-02-22 by JerodPoore -
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||[[Meds/Tegretol]] ||carbamazepine ||Trigeminal Neuralgia, Glossopharyngeal Neuralgia ||
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||[[Meds.Tegretol|Tegretol]] ||carbamazepine ||Trigeminal Neuralgia, Glossopharyngeal Neuralgia ||
2014-02-22 by JerodPoore -
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||[[Meds/Stavzor]] ||valproic acid delayed release ||Migraine prophylaxis ||
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||[[Meds.Stavzor|Stavzor]] ||valproic acid delayed release ||Migraine prophylaxis ||
2014-02-22 by JerodPoore -
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||[[Meds/Pamelor]] ||nortriptyline  ||Depression ||Migraines ||
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||[[Meds.Pamelor|Pamelor]] ||nortriptyline  ||Depression ||Migraines ||
2014-02-22 by JerodPoore -
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||[[Meds/Neurontin]] ||gabapentin ||Postherpetic Neuralgia ||
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||[[Meds.Neurontin|Neurontin]] ||gabapentin ||Postherpetic Neuralgia ||
2014-02-22 by JerodPoore -
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||[[Meds/Elavil]] ||amitriptyline ||Depression ||Migraines ||
to:
||[[Meds.Elavil|Elavil]] ||amitriptyline ||Depression ||Migraines ||
2014-02-22 by JerodPoore -
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||[[Meds/Depakote|Depakote]]  ||divalproex sodium ||Migraine prophylaxis ||
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||[[Meds.Depakote|Depakote]]  ||divalproex sodium ||Migraine prophylaxis ||
2014-02-22 by JerodPoore -
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||[[Meds/Depakote]]  ||divalproex sodium ||Migraine prophylaxis ||
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||[[Meds/Depakote|Depakote]]  ||divalproex sodium ||Migraine prophylaxis ||
2014-02-22 by JerodPoore -
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||[[Meds/Cymbalta]] ||duloxetine hydrochloride ||Fibromyalgia, Diabetic Peripheral Neuropathic Pain, Chronic Musculoskeletal Pain ||
to:
||[[Meds.Cymbalta|Cymbalta]] ||duloxetine hydrochloride ||Fibromyalgia, Diabetic Peripheral Neuropathic Pain, Chronic Musculoskeletal Pain ||
2013-08-26 by JerodPoore -
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||[[Cymbalta]] ||duloxetine hydrochloride ||Fibromyalgia, Diabetic Peripheral Neuropathic Pain, Chronic Musculoskeletal Pain ||
||[[Depakote]]  ||divalproex sodium ||Migraine prophylaxis ||
to:
||[[Meds/Cymbalta]] ||duloxetine hydrochloride ||Fibromyalgia, Diabetic Peripheral Neuropathic Pain, Chronic Musculoskeletal Pain ||
||[[Meds/Depakote]]  ||divalproex sodium ||Migraine prophylaxis ||
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||[[Neurontin]] ||gabapentin ||Postherpetic Neuralgia ||
to:
||[[Meds/Neurontin]] ||gabapentin ||Postherpetic Neuralgia ||
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||[[Stavzor]] ||valproic acid delayed release ||Migraine prophylaxis ||
||[[Tegretol]] ||carbamazepine ||Trigeminal Neuralgia, Glossopharyngeal Neuralgia ||
||[[Topamax]]  ||topiramate ||Migraine prophylaxis ||
to:
||[[Meds/Stavzor]] ||valproic acid delayed release ||Migraine prophylaxis ||
||[[Meds/Tegretol]] ||carbamazepine ||Trigeminal Neuralgia, Glossopharyngeal Neuralgia ||
||[[Meds/Topamax]]  ||topiramate ||Migraine prophylaxis ||
Changed lines 72-74 from:
||[[Elavil]] ||amitriptyline ||Depression ||Migraines ||
||[[Pamelor]] ||nortriptyline  ||Depression ||Migraines ||
||[[Tofranil]] ||imipramine ||Depression ||Migraines ||
to:
||[[Meds/Elavil]] ||amitriptyline ||Depression ||Migraines ||
||[[Meds/Pamelor]] ||nortriptyline  ||Depression ||Migraines ||
||[[Meds/Tofranil]] ||imipramine ||Depression ||Migraines ||
2013-08-20 by JerodPoore -
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[--Author: (=html=)<span itemprop="author">(=htmlend=)Jerod Poore(=html=)</span>(=htmlend=)  Date Modified: (=html=)<span itemprop="dateModified">(=htmlend=) {(ftime fmt %F {*$LastModified})} (=html=)</span>(=htmlend=) Date Published: (=html=)<span itemprop="datePublished">(=htmlend=)2011-05-15(=html=)</span>(=htmlend=) (:drugclass: [[MedClass/NP]]:)--] (=html=)</div>(=htmlend=)
to:
[--Author: (=html=)<span itemprop="author">(=htmlend=)Jerod Poore(=html=)</span>(=htmlend=)  Date Modified: (=html=)<span itemprop="dateModified">(=htmlend=) {(ftime fmt %F {*$LastModified})} (=html=)</span>(=htmlend=) Date Published: (=html=)<span itemprop="datePublished">(=htmlend=)2011-05-15(=html=)</span>(=htmlend=) (:drugclass: [[MedClass/NP|Headaches & Neuropathic Pain]]:)--] (=html=)</div>(=htmlend=)
2013-08-20 by JerodPoore -
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[--Author: (=html=)<span itemprop="author">(=htmlend=)Jerod Poore(=html=)</span>(=htmlend=)  Date Modified: (=html=)<span itemprop="dateModified">(=htmlend=) {(ftime fmt %F {*$LastModified})} (=html=)</span>(=htmlend=) Date Published: (=html=)<span itemprop="datePublished">(=htmlend=)2011-05-15(=html=)</span>(=htmlend=) (:drugclass: [[MedClass/Antipsychotics|Antipsychotic Drugs]]:)--] (=html=)</div>(=htmlend=)
to:
[--Author: (=html=)<span itemprop="author">(=htmlend=)Jerod Poore(=html=)</span>(=htmlend=)  Date Modified: (=html=)<span itemprop="dateModified">(=htmlend=) {(ftime fmt %F {*$LastModified})} (=html=)</span>(=htmlend=) Date Published: (=html=)<span itemprop="datePublished">(=htmlend=)2011-05-15(=html=)</span>(=htmlend=) (:drugclass: [[MedClass/NP]]:)--] (=html=)</div>(=htmlend=)
2013-08-20 by JerodPoore -
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(:Description Updated {*$LastModified}. We help you find the best treatment options for migraines, other headaches, fibromyalgia and various other flavors of neuropathic pain. That's mostly antiepileptic drugs (AEDs) and some antidepressants.:)
to:
(:Description {*$LastModified}. We help you find the best treatment options for migraines, other headaches, fibromyalgia and various other flavors of neuropathic pain. That's mostly antiepileptic drugs (AEDs) and some antidepressants.:)
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(=html=)<div itemscope itemtype="http://schema.org/WebPage">(=htmlend=)
%white%[-- (=html=)<span itemprop="discussionURL">(=htmlend=)http://www.crazymeds.net/CrazyTalk/index.php?/forum/53-treatment-options-the-fat-the-stupid-and-the-itchy/(=html=)</span>(=htmlend=) --]  [[<<]]
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>><<
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:2<<
(=html=)<div itemscope itemtype="http://schema.org/Article" display=inline>(=htmlend=)
[
--Author: (=html=)<span itemprop="author">(=htmlend=)Jerod Poore(=html=)</span>(=htmlend=)  Date Modified: (=html=)<span itemprop="dateModified">(=htmlend=) {(ftime fmt %F {*$LastModified})} (=html=)</span>(=htmlend=) Date Published: (=html=)<span itemprop="datePublished">(=htmlend=)2011-05-15(=html=)</span>(=htmlend=) (:drugclass: [[MedClass/Antipsychotics|Antipsychotic Drugs]]:)--] (=html=)</div>(=htmlend=)
>><<
(=html=)<span meta property="og:description" content="{*$Description}"/>(=htmlend=)
(=html=)<span link rel="author"  href="https://crazymeds.net/pmwiki/pmwiki.php/Profiles/JerodPoore" name="Jerod Poore" />(=htmlend=)
2013-06-12 by Jerod Poore -
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%white%[-- (=html=)<span itemprop="discussionURL">(=htmlend=)https://crazymeds.net/CrazyTalk/index.php?/forum/30-treatment-options-for-bipolar-disorder-the-spirit-levels-of-your-mind/(=html=)</span>(=htmlend=) --]  [[<<]]
%white%[-- (=html=)<span itemprop="breadcrumb">(=htmlend=){$DefaultName} -> {$Group} -> {$Title} -> Drugs Used to Treat Bipolar Disorder (=html=)</span></div>(=htmlend=) --]
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%white%[-- (=html=)<span itemprop="discussionURL">(=htmlend=)https://crazymeds.net/CrazyTalk/index.php?/forum/53-treatment-options-the-fat-the-stupid-and-the-itchy/(=html=)</span>(=htmlend=) --]  [[<<]]
%white%[-- (=html=)<span itemprop="breadcrumb">(=htmlend=){$DefaultName} -> {$Group} -> {$Title}(=html=)</span></div>(=htmlend=) --]
2013-06-12 by Jerod Poore -
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[[Sources/Copyright|Full copyright notice]].  [[Sources.Disclaimer|Our big-ass disclaimer]].
to:
[[Sources/Copyright|Full copyright notice]].  [[Sources/Disclaimer|Our big-ass disclaimer]].
2013-06-12 by Jerod Poore -
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(:toc-float anchors=visible Table of Contents:)

Most drugs used to treat pain[^##morph^] are either [[antiepileptic drugs]] (AEDs) or [[antidepressants]] that have a positive effect on the neurotransmitter norepinephrine, usually SNRIs like [[Cymbalta]] or TCAs like [[amitriptyline]].  AEDs are also used to prevent migraines.

[^##morph Other than opioids, of course, or medications that treat the source of non-neuropathic pain, like steroids or other anti-inflammatory drugs.^]
to:
 
(:toc-float Table of Contents:)
Added lines 15-16:
Most drugs used to treat pain[^##morph^] are either [[antiepileptic drugs]] (AEDs) or [[antidepressants]] that have a positive effect on the neurotransmitter norepinephrine, usually SNRIs like [[Cymbalta]] or TCAs like [[amitriptyline]].  AEDs are also used to prevent migraines. [^##morph Other than opioids, of course, or medications that treat the source of non-neuropathic pain, like steroids or other anti-inflammatory drugs.^]
Added line 31:
||Savella ||milnacipran ||Fibromyalgia ||
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(:if ! equal {$@crazy_meds_device} "mobile":)(:AddThis:)(:ifend:)
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(:AddThis:)
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(:ifend:)
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(:ifend:)

(=html=)<div itemscope itemtype="http://schema.org/WebPage">(=htmlend=)
%white%[-- (=html=)<span itemprop="discussionURL">(=htmlend=)https://crazymeds.net/CrazyTalk/index.php?/forum/30-treatment-options-for-bipolar-disorder-the-spirit-levels-of-your-mind/(=html=)</span>(=htmlend=) --]  [[<<]]
%white%[-- (=html=)<span itemprop="breadcrumb">(=htmlend=){$DefaultName} -> {$Group} -> {$Title} -> Drugs Used to Treat Bipolar Disorder (=html=)</span></div>(=htmlend=) --]
2013-06-08 by Jerod Poore -
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(:keywords migraines,headaches,fibromyalgia,neuropathy,neuropathic pain,migraine medication,headache medication,fibromyalgia medication,neuropathy medication,neuropathic pain medication,migraine relief,headache relief,fibromyalgia relief,neuropathy relief,neuropathic pain relief,migraine remedies,headache remedies,fibromyalgia remedies,neuropathy remedies,neuropathic pain remedies,migraine medicine,headache medicine,fibromyalgia medicine,neuropathy medicine,neuropathic pain medicine,migraine prevention,headache prevention,migraine prophylaxis,headache prophylaxis,migraine treatments,headache treatments,neuropathy treatments,neuropathic pain treatments,fibromyalgia treatments,treatment migraine,treatment headache,treatment neuropathy,treatment neuropathic pain,treatment fibromyalgia,cure migraine,cure headache,cure neuropathy,cure neuropathic pain,cure fibromyalgia,peripheral neuropathy,diabetic neuropathy:)
%comment%(:if expr ( auth admin || {$Author} {$$author} ):) {[foxedit form=Meds.NewArticle]} (:if:)%
to:
(:keywords migraines,headaches,fibromyalgia,neuropathy,neuropathic pain,peripheral diabetic neuropathy:)
Changed line 85 from:
Author: Jerod Poore.  Date created: 15 May 2011  Last edited: {$LastModified} Last edited by: {$LastModifiedBy}
to:
Author: Jerod Poore.  Date created: 15 May 2011  Last edited: {$LastModified} Last edited by: {$LastModifiedBy} on {$LastModified}
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[[Sources.Copyright|Full copyright notice]].  [[Sources.Disclaimer|Our big-ass disclaimer]].
to:
[[Sources/Copyright|Full copyright notice]].  [[Sources.Disclaimer|Our big-ass disclaimer]].
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(:include Sources.Copyright:)
to:
(:include Sources/Copyright:)
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(:include Sources.Disclaimer:)
>><<
[[<<]]
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(:include Sources/Disclaimer:)
2013-01-07 by Jerod Poore -
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||Inderal ||propranolol ||Migraine prophylaxis ||
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||pregablin ||pregabalin ||Postherpetic Neuralgia, Diabetic Peripheral Neuropathy, Fibromyalgia ||
to:
||pregabalin ||pregabalin ||Postherpetic Neuralgia, Diabetic Peripheral Neuropathy, Fibromyalgia ||
Changed lines 71-73 from:
||[[Elavil]] ||amitriptyline HCl ||Depression ||Migraines ||
||[[Pamelor]] ||nortriptyline HCl  ||Depression ||Migraines ||
||[[Tofranil]] ||imipramine HCl ||Depression ||Migraines ||
to:
||[[Elavil]] ||amitriptyline ||Depression ||Migraines ||
||[[Pamelor]] ||nortriptyline ||Depression ||Migraines ||
||[[Tofranil]] ||imipramine ||Depression ||Migraines ||
Deleted line 76:
* Inderal (propranolol)
2013-01-06 by Jerod Poore -
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to:
[[<<]] [[<<]]   
     
.
---- 
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||class=sortable id=paintable border=0 rules=rows align=left width=100%
to:
||class=sortable id=Headache border=0 rules=rows align=left width=100%
2013-01-06 by Jerod Poore -
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.
2013-01-02 by Jerod Poore -
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(:if ! equal {$@crazy_meds_device} "mobile":)
----
(:GoogleAEDs:)
----
(:ifend:)
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----
(:GoogleAEDs:)
----
to:
%frame%(:CenterLinks:)
2013-01-02 by Jerod Poore -
2013-01-02 by Jerod Poore -
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||border = 1
to:
(:sortable:)
||class=sortable id=Pain border=1 rules=rows align=left width=100%
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||Lyrica ||pregabalin ||Postherpetic Neuralgia, Diabetic Peripheral Neuropathy, Fibromyalgia ||
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||pregablin ||pregabalin ||Postherpetic Neuralgia, Diabetic Peripheral Neuropathy, Fibromyalgia ||
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Author: Jerod Poore.  Date created: 15 May 2011  Last edited by: {$LastModifiedBy}
to:
Author: Jerod Poore.  Date created: 15 May 2011  Last edited: {$LastModified} Last edited by: {$LastModifiedBy}
Changed line 83 from:
Page design and explanatory material by Jerod Poore, copyright © 2004 - 2012.  All rights reserved.  Don't automatically believe everything you read on teh Intergoogles. [[<<]]
to:
Page design and explanatory material by Jerod Poore, copyright © 2004 - 2013.  All rights reserved.  Don't automatically believe everything you read on teh Intergoogles. [[<<]]
2012-08-02 by Jerod Poore -
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>>font-family:arial font-size:4<<
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>>font-family:verdana font-size:4<<
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Most drugs used to treat pain[^##morph^] are either antiepileptic drugs (AEDs) or antidepressants that have a positive effect on the neurotransmitter norepinephrine, usually SNRIs like [[Cymbalta]] or TCAs like [[amitriptyline]].  AEDs are also used to prevent migraines.
to:
Most drugs used to treat pain[^##morph^] are either [[antiepileptic drugs]] (AEDs) or [[antidepressants]] that have a positive effect on the neurotransmitter norepinephrine, usually SNRIs like [[Cymbalta]] or TCAs like [[amitriptyline]].  AEDs are also used to prevent migraines.
2012-07-24 by JerodPoore -
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(:toc-float:)
to:
(:toc-float anchors=visible Table of Contents:)
2012-07-04 by JerodPoore -
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||[[valproic acid]] delayed release ||valproic acid delayed release ||Migraine prophylaxis ||
2012-07-04 by JerodPoore -
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||Stavzor ||valproic acid delayed release ||Migraine prophylaxis ||
to:
||[[Stavzor]] ||valproic acid delayed release ||Migraine prophylaxis ||
2012-05-24 by JerodPoore -
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(:Description Updated {*$LastModified}. We help you find the best treatment options for for migraines, other headaches, fibromyalgia and various other flavors of neuropathic pain. That's mostly antiepileptic drugs (AEDs) and some antidepressants.:)
to:
(:Description Updated {*$LastModified}. We help you find the best treatment options for migraines, other headaches, fibromyalgia and various other flavors of neuropathic pain. That's mostly antiepileptic drugs (AEDs) and some antidepressants.:)
2012-05-24 by JerodPoore -
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||Stavzor ||(valproic acid delayed release) ||Migraine prophylaxis ||
to:
||Stavzor ||valproic acid delayed release ||Migraine prophylaxis ||
2012-05-24 by JerodPoore -
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(:keywords migraines,headaches,fibromyalgia,neuropathy,neuropathic pain,migraine treatments,headache treatments,neuropathy treatments,neuropathic pain treatments,fibromyalgia treatments,treatment migraine,treatment headache,treatment neuropathy,treatment neuropathic pain,treatment fibromyalgia,cure migraine,cure headache,cure neuropathy,cure neuropathic pain,cure fibromyalgia,peripheral neuropathy,diabetic neuropathy:)
to:
(:keywords migraines,headaches,fibromyalgia,neuropathy,neuropathic pain,migraine medication,headache medication,fibromyalgia medication,neuropathy medication,neuropathic pain medication,migraine relief,headache relief,fibromyalgia relief,neuropathy relief,neuropathic pain relief,migraine remedies,headache remedies,fibromyalgia remedies,neuropathy remedies,neuropathic pain remedies,migraine medicine,headache medicine,fibromyalgia medicine,neuropathy medicine,neuropathic pain medicine,migraine prevention,headache prevention,migraine prophylaxis,headache prophylaxis,migraine treatments,headache treatments,neuropathy treatments,neuropathic pain treatments,fibromyalgia treatments,treatment migraine,treatment headache,treatment neuropathy,treatment neuropathic pain,treatment fibromyalgia,cure migraine,cure headache,cure neuropathy,cure neuropathic pain,cure fibromyalgia,peripheral neuropathy,diabetic neuropathy:)
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||Brand/Trade name ||generic name ||Approvals ||
to:
||border = 1
||!Brand/Trade name ||!generic name ||!Approvals ||
2012-05-23 by JerodPoore -
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(:sortable:)
||class=sortable id=migrainetable border=0 rules=rows align=left width=100%
||!Brand/Trade name ||!generic name ||!Approvals ||
to:
||Brand/Trade name ||generic name ||Approvals ||
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.
2012-05-23 by JerodPoore -
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(:Title Crazy Meds' Overview of Drugs to Treat Migraines, Other Headaches, and Neuropathic Pain :)
(:Description Updated {*$LastModified}. An overview drugs for various types pain discussed on Crazy Meds :)
to:
(:Title Treatment Options for Migraines, Other Headaches, Fibromyalgia, and Neuropathic Pain :)
(:Description Updated {*$LastModified}. We help you find the best treatment options for for migraines, other headaches, fibromyalgia and various other flavors of neuropathic pain. That's mostly antiepileptic drugs (AEDs) and some antidepressants.:)
(:keywords migraines,headaches,fibromyalgia,neuropathy,neuropathic pain,migraine treatments,headache treatments,neuropathy treatments,neuropathic pain treatments,fibromyalgia treatments,treatment migraine,treatment headache,treatment neuropathy,treatment neuropathic pain,treatment fibromyalgia,cure migraine,cure headache,cure neuropathy,cure neuropathic pain,cure fibromyalgia,peripheral neuropathy,diabetic neuropathy
:)
Changed lines 8-11 from:
Until I write something useful I can at least provide links to the meds that deal with neuropathic pain that we have something written about.

!!!Meds with FDA Approval to Treat Migraines, Other Headaches, and Neuropathic Pain

to:
Most drugs used to treat pain[^##morph^] are either antiepileptic drugs (AEDs) or antidepressants that have a positive effect on the neurotransmitter norepinephrine, usually SNRIs like [[Cymbalta]] or TCAs like [[amitriptyline]].  AEDs are also used to prevent migraines.

[^##morph Other than opioids, of course, or medications that treat the source of non-neuropathic pain, like steroids or other anti-inflammatory drugs.^]
!!!Meds with FDA Approval to Treat Migraines, Other Headaches, Fibromyalgia and various types of Neuropathic Pain
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[[<<]]
----
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Page created by: Jerod Poore.  Date created: 15 May 2011  Last edited by: {$Author}
to:
''{$Title}'' by Jerod Poore is copyright © 2011  [[<<]]
Author: Jerod Poore.  Date created: 15 May 2011  Last edited by:
{$LastModifiedBy}
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Page design and explanatory material by Jerod Poore, copyright © 2004 - 2012.  All rights reserved.  Don't automatically believe everything you read on teh Intergoogles. [[<<]]
[[Sources.Copyright|Full copyright notice]].  [[Sources.Disclaimer|Our big-ass disclaimer]].
(:else:)
[[<<]]
--------
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(:ifend:)
(:if !equal {$@crazy_meds_device} "desk":)
[[<<]]
--------
Page design and explanatory material copyright © 2004 - 2012 Jerod Poore. All rights reserved.  Don't automatically believe everything you read on teh Intergoogles. [[<<]]
[[Sources.Copyright|Full copyright notice]].  [[Sources.Disclaimer|Our big-ass disclaimer]].
2012-05-11 by JerodPoore -
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(:ifend:)
to:
(:else:)
(:if2 !{$@crazy_meds_device}:)
----
(:GoogleAEDs:)
----
(:if2end:)
(:ifend:)
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(:ifend:)
to:
(:else:)
(:if2 !{$@crazy_meds_device}:)
----
(:GoogleAEDs:)
----
(:if2end:)
(:ifend:)
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(:if equal {$@crazy_meds_device} "desk":)(:AddThis:)(:ifend:)
to:
(:if equal {$@crazy_meds_device} "desk":)(:AddThis:)(:else:)(:if2  !{$@crazy_meds_device}:)(:AddThis:)(:if2end:)(:ifend:)
2012-04-10 by JerodPoore -
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* Inderal (propranolol)
* flunarizine

to:
Changed lines 61-64 from:
||!Brand/Trade name ||!generic name ||!Off-Label Uses ||
||[[Elavil]] ||amitriptyline HCl ||Migraines ||
||[[Pamelor]] ||nortriptyline HCl  ||Migraines ||
||[[Tofranil]] ||imipramine HCl ||Migraines ||
to:
||!Brand/Trade name ||!generic name ||!Approved Indications ||!Off-Label Uses ||
||[[Elavil]] ||amitriptyline HCl ||Depression ||Migraines ||
||[[Pamelor]] ||nortriptyline HCl  ||Depression ||Migraines ||
||[[Tofranil]] ||imipramine HCl ||Depression ||Migraines ||
Added lines 66-69:

!!!!Meds we don't have pages on yet
* Inderal (propranolol)
* flunarizine - not available in the US
2012-04-09 by JerodPoore -
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Bayer Extra Strength Asprin
Cambia (diclofenac potassium)
to:
* Bayer Extra Strength Asprin
* Cambia (diclofenac potassium)
Changed lines 49-53 from:
Botox (onabotulinumtoxinA)
Migranal (dihydroergotamine mesylate)
Inderal (propranolol)

to:
* Botox (onabotulinumtoxinA)
* Migranal (dihydroergotamine mesylate)
* Inderal (propranolol)
* flunarizine
2012-04-09 by JerodPoore -
Added lines 65-67:
||[[Elavil]] ||amitriptyline HCl ||Migraines ||
||[[Pamelor]] ||nortriptyline HCl  ||Migraines ||
||[[Tofranil]] ||imipramine HCl ||Migraines ||
2012-04-09 by JerodPoore -
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Inderal (propranolol)
2012-04-08 by JerodPoore -
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to:
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(:ifend:)
(:if !equal {$@crazy_meds_device} "desk":)
[[<<]]
--------
Page design and explanatory material copyright © 2004 - 2012 Jerod Poore. All rights reserved.  Don't automatically believe everything you read on teh Intergoogles. [[<<]]
[[Sources.Copyright|Full copyright notice]].  [[Sources.Disclaimer|Our big-ass disclaimer]].
(:ifend:)
2012-04-08 by JerodPoore -
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||Stavzor ||(valproic acid delayed release) ||Migraine prophylaxis ||
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Stavzor (valproic acid delayed release)
to:


----
(:GoogleAEDs:)
----

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2012-04-08 by JerodPoore -
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Stavzor (valproic acid delayed release)

!!!Other Meds with FDA Approval to Treat Migraines, Other Headaches, and Neuropathic Pain
!!!!Serotonin Receptor Agonists (Triptans)
* Zomig (zolmitriptan)
* Amerge (naratriptan hydrochloride)
* Frova (frovatriptan succinate)
* Axert (almotriptan malate)
* Relpax (eletriptan hydrobromide)
* Imitrex (sumatriptan)
* Maxalt (rizatriptan benzoate)

!!!!NSAIDs
Bayer Extra Strength Asprin
Cambia (diclofenac potassium)

!!!!Other
Botox (onabotulinumtoxinA)
Migranal (dihydroergotamine mesylate)


2012-03-22 by JerodPoore -
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(:Description An overview drugs for various types pain discussed on Crazy Meds :)
to:
(:Description Updated {*$LastModified}. An overview drugs for various types pain discussed on Crazy Meds :)
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.
2011-07-24 by JerodPoore -
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.
2011-05-15 by JerodPoore -
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(:Title Crazy Meds' Overview of Mood Stabilizers :)
(:Description An overview mood stabilizers
discussed on Crazy Meds :)
to:
(:Title Crazy Meds' Overview of Drugs to Treat Migraines, Other Headaches, and Neuropathic Pain :)
(:Description An overview drugs for various types pain
discussed on Crazy Meds :)
Changed lines 6-10 from:
!!!What is a Mood Stabilizer?
In [[http://astore.amazon.com/crazymedsorg-20/detail/0521673763|''Essential Psychopharmacology: Neuroscientific Basis and Practical Applications'']]  Stahl writes
that the FDA states there is no such thing as a mood stabilizer.  That's not quite true.  Granted, there is no "mood stabilizer" product subcategory (under psychotherapeutic agents) in the PDR, but the old "antimanic" has been replaced with "bipolar agents." [[Lamictal]] is approved to "delay the time to occurrence of mood episodes in patients treated for acute mood episodes with standard therapy." Which is about as close to "mood stabilizer" as you can get.  [[Seroquel]] is approved to treat bipolar mania, mixed states, and bipolar depression.  That covers everything I'm aware of.

Every medication has its advantages and disadvantages when it comes to treating any condition.  Each class of medication has general pros and cons when it comes to treating bipolar disorder.

to:

Until I write something useful I can at least provide links to the meds that deal with neuropathic pain that we have something written about.

!!!Meds with FDA Approval to Treat Migraines
, Other Headaches, and Neuropathic Pain
(:sortable:)
||class=sortable id=migrainetable border=0 rules=rows align=left width=100%
||!Brand/Trade name ||!generic name ||!Approvals ||
||[[carbamazepine]] ||carbamazepine ||Trigeminal Neuralgia, Glossopharyngeal Neuralgia ||
||[[Cymbalta]] ||duloxetine hydrochloride ||Fibromyalgia, Diabetic Peripheral Neuropathic Pain, Chronic Musculoskeletal Pain ||
||[[Depakote]]  ||divalproex sodium ||Migraine prophylaxis ||
||[[divalproex sodium]]  ||divalproex sodium ||Migraine prophylaxis  ||
||[[duloxetine hydrochloride]] ||duloxetine hydrochloride ||Fibromyalgia, Diabetic Peripheral Neuropathic Pain, Chronic Musculoskeletal Pain ||
||[[gabapentin]] ||gabapentin ||Postherpetic Neuralgia ||
||[[Neurontin]] ||gabapentin ||Postherpetic Neuralgia ||
||[[Tegretol]] ||carbamazepine ||Trigeminal Neuralgia, Glossopharyngeal Neuralgia ||
||[[Topamax]]  ||topiramate ||Migraine prophylaxis ||
||[[topiramate]]  ||topiramate ||Migraine prophylaxis ||

Changed lines 28-71 from:
!!!Antipsychotics
Most [[MedClass.AP#AAPs|atypical / second-generation antipsychotics (AAPs/SGAs]] are approved to treat acute (short-term) bipolar mania, and a few, like [[Seroquel]], have ''de facto'' approval or are used off-label as actual mood stabilizers.  These days it's unusual for an SGA or third-generation antipsychotic (TGA) to be approved in the US for schizophrenia alone[^##fan^].  Schizophrenia is profitable, but the real money is in bipolar disorder.[[<<]]
Many of the older [[MedClass.AP#FGAs|standard / first-generation antipsychotics (APs/FGAs)]] - including lithium - are also approved to treat acute mania.  Although it has fallen out of fashion, lithium is still the best drug available for classic bipolar 1.
!!!!Advantages of Using Antipsychotics as Mood Stabilizers
* Antipsychotics are a lot easier to prescribe and take than AEDs
** APs have simple titration schedules.
** APs require fewer dosage adjustments than AEDs.
** APs have ''consistent'' side effects.  They may suck, but at least you know what you're in for.
** APs are far less likely than AEDs to cause a severe allergic or similar reaction that will require you to stop taking the med immediately.
** Missing doses, even suddenly stopping the med isn't dangerous.  It's not a good idea, but there is little chance that sudden discontinuation will be directly responsible for physical harm.
** Regardless of how or why you stop taking it, an AP usually works just as well the next time you take it.
* APs work quickly.
* APs are more likely to be actual mood stabilizers, in that they treat both mania and depression, so you need to take only one med.  The fewer meds the better.

!!!!Disadvantages of Using Antipsychotics as Mood Stabilizers
* The usual, especially long-term side effects of APs, especially AAPs, are a lot more problematic than those of most AEDs - [[Depakote]] being the one exception.
* One collection of side effects common to all APs - EPS, TD & NMS - is almost like an allergy in that if you get any (or all) of those from one AP you may have to stop taking all APs.  There are a couple exceptions:
** This doesn't apply to lithium.
** EPS & TD are extremely rare with Zyprexa and clozapine, and rare with Seroquel.  If you get EPS and/or TD from any other AP you can still try Zyprexa, clozapine, or Seroquel (if you haven't already).  Of course, if you got EPS and/or TD while taking Zyprexa, clozapine, or Seroquel - and no other AP - you may as well give up on the idea of using an AP to treat bipolar disorder.

!!!Antiepileptic Drugs  / Anticonvulsants
Almost all [[MedClass.AED|Antiepileptic Drugs (AEDs) / Anticonvulsants (ACs)]] can be used to treat bipolar disorder, although only [[Lamictal]], [[Depakote]] (but '''''not''''' valproic acid), [[Tegretol]] and [[Equetro]] (they're both carbamazepine, but each has an approval different from the other for bipolar) have FDA approval to treat bipolar disorder.  Plus [[Lamictal]] is the only AC that is a true mood stabilizer and the only one approved for maintenance use (i.e. 18 months instead of 3 to 6 weeks).
!!!!Advantages of Using Antiepileptic Drugs/Anticonvulsants as Mood Stabilizers
* AEDs are proven to be neuroprotective.  I.e. they prevent, and even repair the damage caused by bipolar kindling.  Lithium is the only AP proven to be neuroprotective for bipolar disorder.

!!!!Disadvantages of Using Antiepileptic Drugs/Anticonvulsants as Mood Stabilizers
* Frequent dosage changes
* Side effects vary widely from person to person
* Some side effects are dosage-dependent, some aren't.  Sometimes they'll go away and and return.  Frequently.

!!!Drugs discussed on this site classified as mood stabilizers/bipolar agents:
*[[MedClass.AED|Antiepileptic Drugs (AEDs) / Anticonvulsants (ACs)]]
**[[Depakote]]
**[[Lamictal]]
*[[MedClass.AP|Antipsychotics]]
**[[lithium]]
**[[Seroquel]]

[^##fan E.g. Fanapt (iloperidone).  Developed in 1993 by Hoechst Marion Roussel, phase III clinical trials for schizophrenia began in 1998 (Novartis had the license).  Iloperidone kept getting shopped around and tested.  Eventually Vanda Pharmaceuticals bought it and decided to go old school by getting it approved for schizophrenia first, and then if it made any money go through the process for bipolar.^]

----
(:GoogleAEDs:)
----

to:
!!!Meds Commonly Used Off-Label to Treat Migraines, Other Headaches, and Neuropathic Pain
(:sortable:)
||class=sortable id=paintable border=0 rules=rows align=left width=100%
||!Brand/Trade name ||!generic name ||!Off-Label Uses ||

Added line 35:
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>>font-family:times font-size:3<<
See also:[[<<]]
[[http://www.ncbi.nlm.nih.gov/pubmed/16127622|Iloperidone Hoechst Marion Roussel]] [[<<]]
[[http://www.ncbi.nlm.nih.gov/pubmed/12861482|Iloperidone Novartis]] [[<<]]
[[http://ipoboutique.com/0605Advisories/VNDA_P.htm|Vanda Pharmaceuticals' IPO brochure]] [[<<]]

>><<
Changed line 40 from:
Page created by: Jerod Poore.  Date created: 26 January 2011  Last edited by: {$Author}
to:
Page created by: Jerod Poore.  Date created: 15 May 2011  Last edited by: {$Author}
2011-04-16 by JerodPoore -
Changed lines 1-2 from:
(:Title Crazy Meds' Pages about Mood Stabilizers :)
(:Description An index of topics about mood stabilizers discussed on Crazy Meds :)
to:
(:Title Crazy Meds' Overview of Mood Stabilizers :)
(:Description An overview mood stabilizers discussed on Crazy Meds :)
Changed lines 27-28 from:
* APs are more likely to be actual mood stabilizers, so you need to take only one med.  The fewer meds the better.
to:
* APs are more likely to be actual mood stabilizers, in that they treat both mania and depression, so you need to take only one med.  The fewer meds the better.
Changed lines 30-32 from:
* The usual, especially long-term side effects of APs are a lot more problematic than those of most AEDs - [[Depakote]] being the one exception.
*
to:
* The usual, especially long-term side effects of APs, especially AAPs, are a lot more problematic than those of most AEDs - [[Depakote]] being the one exception.
* One collection of side effects common to all APs - EPS, TD & NMS - is almost like an allergy in that if you get any (or all) of those from one AP you may have to stop taking all APs.  There are a couple exceptions:
** This doesn't apply to lithium.
** EPS & TD are extremely rare with Zyprexa and clozapine, and rare with Seroquel.  If you get EPS and/or TD from any other AP you can still try Zyprexa, clozapine, or Seroquel (if you haven't already).  Of course, if you got EPS and/or TD while taking Zyprexa, clozapine, or Seroquel - and no other AP - you may as well give up on the idea of using an AP to treat bipolar disorder.

Changed lines 37-38 from:

to:
!!!!Advantages of Using Antiepileptic Drugs/Anticonvulsants as Mood Stabilizers
* AEDs are proven to be neuroprotective.  I.e. they prevent, and even repair the damage caused by bipolar kindling.  Lithium is the only AP proven to be neuroprotective for bipolar disorder.

!!!!Disadvantages of Using Antiepileptic Drugs/Anticonvulsants as Mood Stabilizers
* Frequent dosage changes
* Side effects vary widely from person to person
* Some side effects are dosage-dependent, some aren't.  Sometimes they'll go away and and return.  Frequently.
2011-04-16 by JerodPoore -
Changed lines 5-7 from:

In ''Essential Psychopharmacology,'' Stahl writes that the FDA states there is no such thing as a mood stabilizer.  That's not quite true.  Granted, there is no "mood stabilizer" product subcategory (under psychotherapeutic agents) in the PDR, but the old "antimanic" has been replaced with "bipolar agents." [[Meds.LamictalBasicOverview|Lamictal]] is approved to "delay the time to occurrence of mood episodes in patients treated for acute mood episodes with standard therapy." Which is about as close to "mood stabilizer" as you can get.   [[Meds.SeroquelXRBasicOverview|Seroquel]] is approved to treat bipolar mania, mixed states, and bipolar depression.  That covers everything I'm aware of.
to:
(:toc-float:)
!!!What is a Mood Stabilizer?
In [[http://astore.amazon.com/crazymedsorg-20/detail/0521673763|''Essential Psychopharmacology: Neuroscientific Basis and Practical Applications'']]  Stahl writes that the FDA states there is no such thing as a mood stabilizer.
  That's not quite true.  Granted, there is no "mood stabilizer" product subcategory (under psychotherapeutic agents) in the PDR, but the old "antimanic" has been replaced with "bipolar agents." [[Lamictal]] is approved to "delay the time to occurrence of mood episodes in patients treated for acute mood episodes with standard therapy." Which is about as close to "mood stabilizer" as you can get.  [[Seroquel]] is approved to treat bipolar mania, mixed states, and bipolar depression.  That covers everything I'm aware of.

Every medication has its advantages and disadvantages when it comes to treating any condition.  Each class of medication has general pros and cons when it comes to treating bipolar disorder
.
Changed lines 15-16 from:
Most [[MedClass.APClasses#AAPs|atypical / second-generation antipsychotics (AAPs/SGAs]] are approved to treat acute (short-term) bipolar mania, and a few, like [[Meds.SeroquelXRBasicOverview|Seroquel]], have ''de facto'' approval or are used off-label as actual mood stabilizers.  These days it's unusual for an SGA or third-generation antipsychotic (TGA) to be approved in the US for schizophrenia alone[^##fan^].  Schizophrenia is profitable, but the real money is in bipolar disorder.[[<<]]
Many of the older [[MedClass.APClasses#FGAs|standard / first-generation antipsychotics (APs/FGAs)]] - including lithium - are also approved to treat acute mania.  Although it has fallen out of fashion, lithium is still the best drug available for classic bipolar 1.
to:
!!!Antipsychotics
Most [[MedClass.AP#AAPs|atypical / second-generation antipsychotics (AAPs/SGAs]] are approved to treat acute (short-term) bipolar mania, and a few, like [[Seroquel]], have ''de facto'' approval or are used off-label as actual mood stabilizers.  These days it's unusual for an SGA or third-generation antipsychotic (TGA) to be approved in the US for schizophrenia alone[^##fan^].  Schizophrenia is profitable, but the real money is in bipolar disorder.[[<<]]
Many of the older [[MedClass.AP#FGAs|standard / first-generation antipsychotics (APs/FGAs)]] - including lithium - are also approved to treat acute mania.  Although it has fallen out of fashion, lithium is still the best drug available for classic bipolar 1.
!!!!Advantages of Using Antipsychotics as Mood Stabilizers
* Antipsychotics are a lot easier to prescribe and take than AEDs
** APs have simple titration schedules.
** APs require fewer dosage adjustments than AEDs.
** APs have ''consistent'' side effects.  They may suck, but at least you know what you're in for.
** APs are far less likely than AEDs to cause a severe allergic or similar reaction that will require you to stop taking the med immediately.
** Missing doses, even suddenly stopping the med isn't dangerous.  It's not a good idea, but there is little chance that sudden discontinuation will be directly responsible for physical harm.
** Regardless of how or why you stop taking it, an AP usually works just as well the next time you take it.
* APs work quickly.
* APs are more likely to be actual mood stabilizers, so you need to take only one med.  The fewer meds the better.

!!!!Disadvantages of Using Antipsychotics as Mood Stabilizers
* The usual, especially long-term side effects of APs are a lot more problematic than those of most AEDs - [[Depakote]] being the one exception.
*

!!!Antiepileptic Drugs  / Anticonvulsants
Almost all [[MedClass.AED|Antiepileptic Drugs (AEDs) / Anticonvulsants (ACs)]] can be used to treat bipolar disorder, although only [[Lamictal]], [[Depakote]] (but '''''not''''' valproic acid), [[Tegretol]] and [[Equetro]] (they're both carbamazepine, but each has an approval different from the other for bipolar) have FDA approval to treat bipolar disorder.  Plus [[Lamictal]] is the only AC that is a true mood stabilizer and the only one approved for maintenance use (i.e. 18 months instead of 3 to 6 weeks).



!!!Drugs discussed on this site classified as mood stabilizers/bipolar agents:
*[[MedClass.AED|Antiepileptic Drugs (AEDs) / Anticonvulsants (ACs)]]
**[[Depakote]]
**[[Lamictal]]
*[[MedClass.AP|Antipsychotics]]
**[[lithium]]
**[[Seroquel]]

Changed lines 47-53 from:
Almost all [[MedClass.AED|Antiepileptic Drugs (AEDs) / Anticonvulsants (ACs)]] can be used to treat bipolar disorder, although only [[Meds.LamictalBasicOverview|Lamictal]], Depakote (but '''''not''''' valproic acid), Tegretol and Equetro (they're both carbamazepine, but each has an approval different from the other for bipolar) have FDA approval to treat bipolar disorder.  Plus [[Meds.LamictalBasicOverview|Lamictal]] is the only AC that is a true mood stabilizer and the only one approved for maintenance use (i.e. 18 months instead of 3 to 6 weeks).

Drugs on this site classified as mood stabilizers:

[[Meds.Lamictal|Lamictal]]
[[Meds.Seroquel|Seroquel]]

to:
Changed lines 52-53 from:
[#]
to:
[^#^]

>><<
>>font-family:times font-size:3<<
2011-03-08 by JerodPoore -
Added lines 16-20:

Drugs on this site classified as mood stabilizers:

[[Meds.Lamictal|Lamictal]]
[[Meds.Seroquel|Seroquel]]
2011-01-26 by Jerod Poore -
Changed lines 1-2 from:
(:Title Crazy Meds' Pages about Antiepileptic Drugs (AEDs) / Anticonvulsants (ACs) :)
(:Description An index of topics about AEDs / anticonvulsants
discussed on Crazy Meds :)
to:
(:Title Crazy Meds' Pages about Mood Stabilizers :)
(:Description An index of topics about mood stabilizers discussed on Crazy Meds :)
Changed lines 6-14 from:
Pages about Antiepileptic Drugs (AEDs) / Anticonvulsants (ACs):
* [[MedClass.AEDClasses | Classifications of AEDs]] How AEDs are classified and categorized
.
* [[MedClass.AEDUses | Common uses of AEDs/ACs]] What AEDs/ACs are used for.
* [[MedClass.AEDTips | Tips on Taking or Discontinuing AEDs/ACs]] Tips on
, and things to know about before taking or stopping AEDs/ACs.
* [[MedClass.AEDSideEffects | Common Side Effects of AEDs/ACs]] No matter which one you take, this will probably happen.
* [[MedClass.AEDStatus | SUDEP and ''status epilepticus'']] Or: Why epilepsy sucks more than the worst AED on the planet
.
* [[MedClass.AEDList | List of AEDs]] Alphabetical list of all AEDs we know about.
* [[MedClass.AEDBibliography | Bibliography]] Books, journals, websites, etc. used for these pages.
to:
In ''Essential Psychopharmacology,'' Stahl writes that the FDA states there is no such thing as a mood stabilizerThat's not quite true.  Granted, there is no "mood stabilizer" product subcategory (under psychotherapeutic agents) in the PDR, but the old "antimanic" has been replaced with "bipolar agents." [[Meds.LamictalBasicOverview|Lamictal]] is approved to "delay the time to occurrence of mood episodes in patients treated for acute mood episodes with standard therapy." Which is about as close to "mood stabilizer" as you can get.   [[Meds.SeroquelXRBasicOverview|Seroquel]] is approved to treat bipolar mania, mixed states, and bipolar depressionThat covers everything I'm aware of.
Changed lines 12-13 from:
>><<
[[<<]]
to:
Most [[MedClass.APClasses#AAPs|atypical / second-generation antipsychotics (AAPs/SGAs]] are approved to treat acute (short-term) bipolar mania, and a few, like [[Meds.SeroquelXRBasicOverview|Seroquel]], have ''de facto'' approval or are used off-label as actual mood stabilizers.  These days it's unusual for an SGA or third-generation antipsychotic (TGA) to be approved in the US for schizophrenia alone[^##fan^].  Schizophrenia is profitable, but the real money is in bipolar disorder.[[<<]]
Many of the older [[MedClass.APClasses#FGAs|standard / first-generation antipsychotics (APs/FGAs)]] - including lithium - are also approved to treat acute mania.  Although it has fallen out of fashion, lithium is still the best drug available for classic bipolar 1.
[^##fan E.g. Fanapt (iloperidone).  Developed in 1993 by Hoechst Marion Roussel, phase III clinical trials for schizophrenia began in 1998 (Novartis had the license).  Iloperidone kept getting shopped around and tested.  Eventually Vanda Pharmaceuticals bought it and decided to go old school by getting it approved for schizophrenia first, and then if it made any money go through the process for bipolar.^]
Almost all [[MedClass.AED|Antiepileptic Drugs (AEDs) / Anticonvulsants (ACs)]] can be used to treat bipolar disorder, although only [[Meds.LamictalBasicOverview|Lamictal]], Depakote (but '''''not''''' valproic acid), Tegretol and Equetro (they're both carbamazepine, but each has an approval different from the other for bipolar) have FDA approval to treat bipolar disorder.  Plus [[Meds.LamictalBasicOverview|Lamictal]] is the only AC that is a true mood stabilizer and the only one approved for maintenance use (i.e. 18 months instead of 3 to 6 weeks).

Changed lines 18-19 from:
>>font-family:arial font-size:3<<
Page created by
: Jerod Poore.  Date created: 22 November 2010  Last edited by: {$Author}
to:
(:GoogleAEDs:)
----

[#]

See also
:[[<<]]
[[http://www
.ncbi.nlm.nih.gov/pubmed/16127622|Iloperidone Hoechst Marion Roussel]] [[<<]]
[[http://www.ncbi.nlm.nih.gov/pubmed/12861482|Iloperidone Novartis]] [[<<]]
[[http://ipoboutique.com/0605Advisories/VNDA_P.htm|Vanda Pharmaceuticals' IPO brochure]] [[<<]]

>><<
[[<<]]
----
>>font-family:arial font-size:3<<
Page created by: Jerod Poore.  Date created: 26 January 2011
  Last edited by: {$Author}
2011-01-26 by Jerod Poore -
Changed lines 6-8 from:
In ''Essential Psychopharmacology,'' Stahl writes that the FDA states there is no such thing as a mood stabilizer.  That's not quite true.  Granted, there is no "mood stabilizer" product subcategory (under psychotherapeutic agents) in the PDR, but the old "antimanic" has been replaced with "bipolar agents." [[Meds.Lamictal|Lamictal]] is approved to "delay the time to occurrence of mood episodes in patients treated for acute mood episodes with standard therapy." Which is about as close to "mood stabilizer" as you can get.  [[Meds.Seroquel|Seroquel]] is approved to treat bipolar mania, mixed states, and bipolar depression.  That covers everything I'm aware of. 

Pages about Antiepileptic Drugs
(AEDs) / Anticonvulsants (ACs):
to:
In ''Essential Psychopharmacology,'' Stahl writes that the FDA states there is no such thing as a mood stabilizer.  That's not quite true.  Granted, there is no "mood stabilizer" product subcategory (under psychotherapeutic agents) in the PDR, but the old "antimanic" has been replaced with "bipolar agents." [[Meds.Lamictal|Lamictal]] is approved to "delay the time to occurrence of mood episodes in patients treated for acute mood episodes with standard therapy." Which is about as close to "mood stabilizer" as you can get.  [[Meds.Seroquel|Seroquel]] is approved to treat bipolar mania, mixed states, and bipolar depression.  That covers everything I'm aware of.

Most [[MedClass.APClasses#AAPs|atypical / second-generation antipsychotics
(AAPs/SGAs]] are approved to treat acute (short-term) bipolar mania, and a few, like [[Meds.Seroquel|Seroquel]], have ''de facto'' approval or are used off-label as actual mood stabilizers.  These days it's unusual for an SGA or third-generation antipsychotic (TGA) to be approved in the US for schizophrenia alone.  Schizophrenia is profitable, but the real money is in bipolar disorder.[[<<]]
Many of the older [[MedClass.APClasses#FGAs|standard / first-generation antipsychotics (APs/FGAs)]] - including lithium - are also approved to treat acute mania.  Although it has fallen out of fashion, lithium is still the best drug available for classic bipolar 1.

Almost all [[MedClass.AED|Antiepileptic Drugs (AEDs) / Anticonvulsants (ACs)]] can be used to treat bipolar disorder, although only [[Meds.Lamictal|Lamictal]] is a true mood stabilizer. 
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Page created by: Jerod Poore.  Date created: 22 November 2010  Last edited by: {$Author}
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Page created by: Jerod Poore.  Date created: 26 January 2011  Last edited by: {$Author}
2011-01-26 by Jerod Poore -
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(:Title Crazy Meds' Pages about Antiepileptic Drugs (AEDs) / Anticonvulsants (ACs) :)
(:Description An index of topics about AEDs / anticonvulsants
discussed on Crazy Meds :)
to:
(:Title Crazy Meds' Pages about Mood Stabilizers :)
(:Description An index of topics about mood stabilizers discussed on Crazy Meds :)
Added lines 5-6:

In ''Essential Psychopharmacology,'' Stahl writes that the FDA states there is no such thing as a mood stabilizer.  That's not quite true.  Granted, there is no "mood stabilizer" product subcategory (under psychotherapeutic agents) in the PDR, but the old "antimanic" has been replaced with "bipolar agents." [[Meds.Lamictal|Lamictal]] is approved to "delay the time to occurrence of mood episodes in patients treated for acute mood episodes with standard therapy." Which is about as close to "mood stabilizer" as you can get.  [[Meds.Seroquel|Seroquel]] is approved to treat bipolar mania, mixed states, and bipolar depression.  That covers everything I'm aware of. 
2010-11-23 by Jerod Poore -
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* [[MedClass.AEDBibliography | Bibliography]] Books, journals, websites, etc. used for these pages.
2010-11-23 by Jerod Poore - Creation of AC/AED overview pages
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(:Title Crazy Meds' Pages about Antiepileptic Drugs (AEDs) / Anticonvulsants (ACs) :)
(:Description An index of topics about AEDs / anticonvulsants discussed on Crazy Meds :)
%comment%(:if expr ( auth admin || {$Author} {$$author} ):) {[foxedit form=Meds.NewArticle]} (:if:)%
>>font-family:arial font-size:4<<

Pages about Antiepileptic Drugs (AEDs) / Anticonvulsants (ACs):
* [[MedClass.AEDClasses | Classifications of AEDs]] How AEDs are classified and categorized.
* [[MedClass.AEDUses | Common uses of AEDs/ACs]] What AEDs/ACs are used for.
* [[MedClass.AEDTips | Tips on Taking or Discontinuing AEDs/ACs]] Tips on, and things to know about before taking or stopping AEDs/ACs.
* [[MedClass.AEDSideEffects | Common Side Effects of AEDs/ACs]] No matter which one you take, this will probably happen.
* [[MedClass.AEDStatus | SUDEP and ''status epilepticus'']] Or: Why epilepsy sucks more than the worst AED on the planet.
* [[MedClass.AEDList | List of AEDs]] Alphabetical list of all AEDs we know about.

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(:GoogleAEDs:)
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Page created by: Jerod Poore.  Date created: 22 November 2010  Last edited by: {$Author}
>><<
[[<<]]
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(:include Sources.Copyright:)
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(:include Sources.Disclaimer:)
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[[<<]]
2010-11-22 by Jerod Poore - Creation of pages on AC/AED classes
Changed line 40 from:
* Felbatol felbamate
to:
* Felbatol (felbamate)
Changed line 110 from:
Carbonic Anhydrase Inhibitors (and nothing else)
to:
Carbonic Anhydrase Inhibitors (CAIs) (and nothing else)
Changed line 114 from:
  
to:
That's right, they are all CAIs, although Topamax and Zonegran do a lot more.  Topamax and Zonegran have similar mechanisms of action, and are two of extremely few AEDs that work in similar ways where one isn't derived from the other.
2010-11-22 by Jerod Poore - Creation of pages on AC/AED classes
Changed lines 27-28 from:
Lots of other medications, both crazy and non-crazy meds, induce CYP450 and UGT enzymes.  AEDs are singled out because epileptics have been given more than one med to control their seizures for over 100 years'^1^' and neurologists as a group are more aware of drug-drug interactions and how the slightest change in dosage can affect their patients' symptoms than most other doctors.
to:
Lots of other medications, both crazy and non-crazy meds, induce CYP450 and UGT enzymes.  AEDs are singled out because epileptics have been given more than one med to control their seizures for over 150 years;'^1^' so neurologists as a group are more aware of drug-drug interactions and how the slightest change in dosage can affect their patients' symptoms than most other doctors.
Changed lines 115-119 from:
   progesterone-based birth control.  Sorry, guys, this is just for the girls.  This is both for Catamenial epilepsy (shaking it up that time of the month) and all other forms.  I've found a couple of studies in humans (and plenty in critters) that show progesterone to have mild anticonvulsant properties in of itself or as an add-on to other meds.  One from Finland and one from the good old USA.  This doesn't even count its use in treating catamenial epilepsy, which is documented all over the place.


 

to:
Changed lines 124-125 from:
'^1^' Most modern AEDs are approved by the FDA to be used only with other AEDs.  Topamax was the first AED in a long time to receive FDA approval to be used all by itself (monotherapy) to treat both partial and generalized epilepsy.
to:
'^1^' Most modern AEDs are approved by the FDA to be used only with other AEDs.  Topamax was the first AED in a long time to receive FDA approval to be used all by itself (monotherapy) to treat both partial and generalized seizures.[[<<]]
Potassium bromide is still in use after 150 years, although it is the final straw you'd ever want to grasp at.  Phenobarbital is over 100 years old and may be in front of some newer meds to try if you're running out of options.
2010-11-22 by Jerod Poore - Creation of pages on AC/AED classes
Changed lines 44-45 from:
Finally we come to groups of drugs that are chemically related and/or work in similar ways.  There may be only one drug per class because it is unique, or it is the only still on the market, or that ever made it to the market in the first place.
to:
Finally we come to classifications of drugs that are chemically related and/or work in similar ways.  There may be only one drug per class because it is unique, or it is the only still on the market, or that ever made it to the market in the first place.
Changed lines 52-53 from:
* Potassium bromide
to:
* potassium bromide
Added lines 57-62:
Dibenzapine derivities
* Tegretol (carbamazapine)
* Trileptal (oxacarbazepine)
* Banzel (rufinamide)
* eslicarbazepine

Changed line 64 from:
* valproates
to:
* valproates:
Added lines 72-79:
GABA analogues
* Gabrene (progabide)
* Sabril (vigabatrin)
* Neurontin (gabapentin) and Lyrica (pregablain) were once considered GABA analogues.

GABA reuptake inhibitors (and nothing else)
* Gabatril (tiagabine)

Added lines 91-94:
Pyrrolidines
* Keppra (levetiracetam)
* Keppra derivatives (e.g. brivaracetam) that UCB is working on.

Changed lines 100-118 from:

GABA analogues
* Gabrene (progabide)
* Sabril (vigabatrin)
* Neurontin (gabapentin) and Lyrica
(pregablain) were once considered GABA analogues.

GABA reuptake inhibitors (and nothing else).
* Gabatril (tiagabine)

Dibenzapine derivities
* Tegretol (carbamazapine)
* Trileptal (oxacarbazepine)
* Banzel (rufinamide)
* eslicarbazepine

Pyrrolidines
* Keppra (levetiracetam)
* Keppra derivatives (e.g. brivaracetam) that UCB is working on.

to:
Can you guess how these last groups are related:

Sulfamate-substituted monosaccharides
* Topamax
(topiramate)
Changed line 107 from:
* Sultiame
to:
* sultiame
Deleted lines 109-111:
Sulfamate-substituted monosaccharides
* Topamax (topiramate)

Changed lines 112-127 from:
* Sultiame

Miscellaneous

    * Acetazolamide (Diamox)
    * Carbamazepine (Carbatrol, Tegretol)
    * Felbamate (Felbatol)
    * Levetiracetam (Keppra)
    * Oxcarbazepine (Trileptal)
    * Primidone (Mysoline)
    * Topiramate (Topamax)
    * Valproic acid (Depakene, Depakote)
    * Zonisamide (Zonegran)


57 CENTRAL NERVOUS SYSTEM AGENTS 64 ANTICONVULSANTS 351 CARBONIC ANHYDRASE INHIBITOR ANTICONVULSANTS
to:
* sultiame
Changed lines 115-166 from:
Only the last two work in similar ways in your brain and are chemically related.  See the pages for more detail, but you can pretty much switch between Tegretol and Trileptal without too much trouble.  Dilantin is also classed as a Hydantoin, along with Cerebyx (something you'd only get in a hospital).  As of this writing there are new medications, some under development, some waiting for FDA approval to be released, that are variations of Tregretol and Dilantin.  I don't know if they'll induce enzymes or not.

 


Then there are the GABA analogues.  These meds are basically fake GABA, a neurotransmitter critical to treating epilepsy, bipolar disorder, anxiety disorder and a variety of other issues.  Real GABA can't cross the blood-brain barrier, so don't waste your money on buying GABA at the health food store.  Gabitril isn't really a GABA analogue, but it gets classified as such because all it does is potent GABA reuptake inhibition and absolutely nothing else.  No voltage channel modification,  no messing with glutamate or kainate.  Nothing.  So it may as well be fake GABA because you get slammed with enough of it when you take some.  Trust me on that point.

    * Neurontin (gabapentin)
    * Gabitril (tiagabine)

 


A couple meds we may or may not cover are the Succinimides - Celontin and Zarontin.  These are kind of last resort meds for absence and partial seizures.  I've not been able to find out too much about them.  One of these days I'd like to cover them.

 

That leaves all the other anticonvulsants:

    * Felbatol (felbamate)
    * Lyrica (pregablin)
    * Keppra (levetiracetam)
    * Lamictal (lamotrigine)
    * Mysoline (primodone) (withdrawn from most markets, good luck finding it)
    * Topamax (topiramate)
    * Zonegran (zonisamide)

Again, to get technical, Lamictal is in a class of its own.  Which shouldn't surprise anyone.  It's a Phenyltriazine.

 

At some point I hope to cover some of the meds only available or primarily used outside of the US.  Such as:

    * Diamox (acetazolamide)
    * piracetam
    * Sabril  (vigabatrin)

 

 

Then we have the stuff has anticonvulsant properties, but the use of which is way off-label.  For example:

    * Meclofenamic acid, a non-steroid anti-inflammatory that is regularly used to treat canine epilepsy.  It is approved as a human painkiller, so this isn't a vet drug.
    * Progesterone-based birth control pills.  Sorry, guys, this is just for the girls.  This is both for Catamenial epilepsy (shaking it up that time of the month) and all other forms.  I've found a couple of studies in humans (and plenty in critters) that show progesterone to have mild anticonvulsant properties in of itself or as an add-on to other meds.  One from Finland and one from the good old USA.  This doesn't even count its use in treating catamenial epilepsy, which is documented all over the place.

 

 


People are constantly asking me what the equivalents are for different anticonvulsants.  Except for Tegretol / Carbatrol (carbamazepine) and Trileptal (oxcarbazepine) or all of the valproates (Depakote (divalproex sodium),Depakene (valproic acid) and  Depacon (valproate sodium)) it literally is an apples and oranges comparison.  But since apples and oranges are both types of fruits, there are commonalities.  Brent Jensen of Queen's University School of Medicine, Kingston Ontario has put together a handy Mood Stabilizer Comparison Chart.  Of course it applies only for meds available in Canada, eh.  And it deals with these medications only as they apply to treat bipolar disorder, and not epilepsy, migraines or any off-label applications.  But it's better than nothing.  Especially until I get around to doing the drug-to-drug comparisons for anticonvulsants like I have for some of the atypical antipsychotics like Seroquel (quetiapine).
to:
   progesterone-based birth control.  Sorry, guys, this is just for the girls.  This is both for Catamenial epilepsy (shaking it up that time of the month) and all other forms.  I've found a couple of studies in humans (and plenty in critters) that show progesterone to have mild anticonvulsant properties in of itself or as an add-on to other meds.  One from Finland and one from the good old USA.  This doesn't even count its use in treating catamenial epilepsy, which is documented all over the place.

2010-11-22 by Jerod Poore - Creation of pages on AC/AED classes
Added lines 51-65:
Bromides
* Potassium bromide

Carbamates
* Felbatol (felbamate)

Fatty acid derivities
* valproates
** [[Meds.Depakote | Depakote (divalproex sodium)]]
** [[Meds.Depakene | Depakene (valproic acid)]]
** [[Meds.Depacon  | Depacon (valproate sodium or sodium valproate)]]
* Gabatril (tiagabine)
* Gabrene (progabide)
* Sabril (vigabatrin)

Changed line 74 from:
Phenyltriazines
to:
Phenyltriazines / Triazines
Deleted lines 81-87:
Fatty acid derivities
* [[Meds.Depakote | Depakote (divalproex sodium)]]
* [[Meds.Depakene | Depakene (valproic acid)]]
* [[Meds.Depacon  | Depacon (valproate sodium or sodium valproate)]]
* Gabatril (tiagabine)
* Gabrene (progabide)
* Sabril (vigabatrin)
2010-11-22 by Jerod Poore - Creation of pages on AC/AED classes
Changed lines 78-79 from:
* Neurontin (gabapentin) and Lyrica (pregablin) were once considered GABA analogues.
to:
* Neurontin (gabapentin) and Lyrica (pregablain) were once considered GABA analogues.

GABA reuptake inhibitors (and nothing else).
* Gabatril (tiagabine)

Changed lines 89-98 from:
Sulfamate-substituted monosaccharides / Fructose derivatives
to:
Pyrrolidines
* Keppra (levetiracetam)
* Keppra derivatives (e.g. brivaracetam) that UCB is working on.

Sulfonamides
* Diamox (acetazolamide)
* Sultiame
* Zonegran (zonisamide)

Sulfamate-substituted monosaccharides
Changed lines 101-104 from:
to:
Carbonic Anhydrase Inhibitors (and nothing else)
* Diamox (acetazolamide)
* Sultiame

Deleted lines 117-119:
57 CENTRAL NERVOUS SYSTEM AGENTS 64 ANTICONVULSANTS 346 GAMMA-AMINOBUTYRIC ACID REUPTAKE INHIBITORS
57 CENTRAL NERVOUS SYSTEM AGENTS 64 ANTICONVULSANTS 347 GAMMA-AMINOBUTYRIC ACID ANALOGS
57 CENTRAL NERVOUS SYSTEM AGENTS 64 ANTICONVULSANTS 350 PYRROLIDINE ANTICONVULSANTS
2010-11-22 by Jerod Poore - Creation of pages on AC/AED classes
Added line 71:
* Gabatril (tiagabine)
Added lines 75-89:
GABA analogues
* Gabrene (progabide)
* Sabril (vigabatrin)
* Neurontin (gabapentin) and Lyrica (pregablin) were once considered GABA analogues.

Dibenzapine derivities
* Tegretol (carbamazapine)
* Trileptal (oxacarbazepine)
* Banzel (rufinamide)
* eslicarbazepine

Sulfamate-substituted monosaccharides / Fructose derivatives
* Topamax (topiramate)

Deleted lines 102-103:
57 CENTRAL NERVOUS SYSTEM AGENTS 64 ANTICONVULSANTS 311 DIBENZAZEPINE ANTICONVULSANTS
57 CENTRAL NERVOUS SYSTEM AGENTS 64 ANTICONVULSANTS 345 FATTY ACID DERIVATIVE ANTICONVULSANTS
Deleted line 104:
57 CENTRAL NERVOUS SYSTEM AGENTS 64 ANTICONVULSANTS 348 TRIAZINE ANTICONVULSANTS
2010-11-22 by Jerod Poore - Creation of pages on AC/AED classes
Changed lines 44-45 from:
Finally we come to groups of drugs that are chemically related and/or work in similar ways.
to:
Finally we come to groups of drugs that are chemically related and/or work in similar ways.  There may be only one drug per class because it is unique, or it is the only still on the market, or that ever made it to the market in the first place.
Deleted line 46:
Deleted line 51:
Changed lines 57-59 from:

   * Trimethadione (Tridione)
to:
* trimethadione
Changed lines 60-62 from:

   * Lamotrigine (Lamictal)
to:
* Lamictal (lamotrigine)
Changed lines 63-67 from:

   * Ethosuximide (Zarontin)
    * Methsuximide (Celontin)
    * Phensuximide (Milontin)
to:
* ethosuximide
* methsuximide
* phensuximide

Fatty acid derivities
* [[Meds.Depakote | Depakote (divalproex sodium)]]
* [[Meds.Depakene | Depakene (valproic acid)]]
* [[Meds.Depacon
  | Depacon (valproate sodium or sodium valproate)]]
* Gabrene (progabide)
* Sabril (vigabatrin
)
Changed lines 87-93 from:
to:
57 CENTRAL NERVOUS SYSTEM AGENTS 64 ANTICONVULSANTS 311 DIBENZAZEPINE ANTICONVULSANTS
57 CENTRAL NERVOUS SYSTEM AGENTS 64 ANTICONVULSANTS 345 FATTY ACID DERIVATIVE ANTICONVULSANTS
57 CENTRAL NERVOUS SYSTEM AGENTS 64 ANTICONVULSANTS 346 GAMMA-AMINOBUTYRIC ACID REUPTAKE INHIBITORS
57 CENTRAL NERVOUS SYSTEM AGENTS 64 ANTICONVULSANTS 347 GAMMA-AMINOBUTYRIC ACID ANALOGS
57 CENTRAL NERVOUS SYSTEM AGENTS 64 ANTICONVULSANTS 348 TRIAZINE ANTICONVULSANTS
57 CENTRAL NERVOUS SYSTEM AGENTS 64 ANTICONVULSANTS 350 PYRROLIDINE ANTICONVULSANTS
57 CENTRAL NERVOUS SYSTEM AGENTS 64 ANTICONVULSANTS 351 CARBONIC ANHYDRASE INHIBITOR ANTICONVULSANTS
2010-11-22 by Jerod Poore - Creation of pages on AC/AED classes
Changed line 11 from:
The next classification is if the drug [[MedInfo.PK | induces CYP450 and/or UGT enzymes]].  Enzyme-inducing AEDs (EIAEDs) can have numerous drug-drug interactions, as well as deplete your body of vitamin D'_3_'.  EIAEDs include:   
to:
The next classifications are based on [[MedInfo.PK | pharmacokinetics,]] specifically those AEDs that induce CYP450 and/or UGT enzymes.  Enzyme-inducing AEDs (EIAEDs) can have numerous drug-drug interactions, as well as deplete your body of vitamin D'_3_'.  EIAEDs include:   
Changed lines 29-30 from:
The flipside of enzyme induction is [[MedInfo.PK | enzyme inhibition or suppression]].  Currently there is only one group of AEDs that inhibits UGT (or any) enzymes involved in the metabolism of crazy meds, and that's the [[Meds.valproates | valproates]]:
to:
Some doctors, researchers, et al. lump the rest into the category of non-EIAED, but the true flipside of enzyme induction is [[MedInfo.PK | enzyme inhibition or suppression]].  Currently there is only one group of AEDs that inhibits UGT (or any) enzymes involved in the metabolism of any medications, and that's [[Meds.valproates | the valproates]]:
Changed line 35 from:
The next group is the aromatic anticonvulsants.  These meds don't help you smell purty.  Aromatic refers to aromatic hydroxylation, which is part of the process when these drugs are metabolized by CYP450 enzymes.  With a very small percentage of people (somewhere between 1 in 1,500 or 1 in 10,000) the metabolism isn't done correctly and a toxic substance is left over instead of cleaned up.  That triggers [[http://www.medscape.com/viewarticle/564608 | anticonvulsant hypersensitivity syndrome]], and that sucks donkey dong.  Anticonvulsants with a particular chemical structure (similar to [[MedClass.TCA | TCAs]], and [[http://www.ncbi.nlm.nih.gov/pubmed/17165282 | TCAs may trigger a similar reaction]]) are going to be converted into the problem toxin, but there's no way (yet) of telling if someone won't be able to properly metabolize the toxin once it is created.  While the odds are a bad reaction of one of these drugs means a bad reaction to one or more, if not all of the others, someone may have a problem with just one of them.  Or there may be one of them they can take.
to:
The next group is the aromatic anticonvulsants.  These meds don't help you smell purty.  Aromatic refers to aromatic hydroxylation, which is part of [[MedInfo.PK | the process when these drugs are metabolized by CYP450 enzymes.]]  With a very small percentage of people (somewhere between 1 in 1,500 or 1 in 10,000) the metabolism isn't done correctly and a toxic substance is left over instead of cleaned up.  That triggers [[http://www.medscape.com/viewarticle/564608 | anticonvulsant hypersensitivity syndrome]], and that sucks donkey dong.  Anticonvulsants with a particular chemical structure (similar to [[MedClass.TCA | TCAs]], and [[http://www.ncbi.nlm.nih.gov/pubmed/17165282 | TCAs may trigger a similar reaction]]) are going to be converted into the problem toxin, but there's no way (yet) of telling if someone won't be able to properly metabolize the toxin once it is created.  While the odds are a bad reaction of one of these drugs means a bad reaction to one or more, if not all of the others, someone may have a problem with just one of them.  Or there may be one of them they can take.
Added lines 43-82:

Finally we come to groups of drugs that are chemically related and/or work in similar ways.

Barbiturates

* mephobarbital
* pentobarbital
* phenobarbital

Hydantoins

* Peganone (ethotoin)
* Mesantoin (fosphentyoin)
* Dilantin (phenytoin)

Oxazolidinediones

    * Trimethadione (Tridione)

Phenyltriazines

    * Lamotrigine (Lamictal)

Succinimides

    * Ethosuximide (Zarontin)
    * Methsuximide (Celontin)
    * Phensuximide (Milontin)

Miscellaneous

    * Acetazolamide (Diamox)
    * Carbamazepine (Carbatrol, Tegretol)
    * Felbamate (Felbatol)
    * Levetiracetam (Keppra)
    * Oxcarbazepine (Trileptal)
    * Primidone (Mysoline)
    * Topiramate (Topamax)
    * Valproic acid (Depakene, Depakote)
    * Zonisamide (Zonegran)
2010-11-22 by Jerod Poore - Creation of pages on AC/AED classes
Changed line 35 from:
The next group is the aromatic anticonvulsants.  These meds don't help you smell purty.  Aromatic refers to aromatic hydroxylation, which is part of the process when these drugs are metabolized by CYP450 enzymes.  With a very small percentage of people (somewhere between 1 in 1,500 or 1 in 10,000) the metabolism isn't done correctly and a toxic substance is left over instead of cleaned up.  That triggers [[http://www.medscape.com/viewarticle/564608 | anticonvulsant hypersensitivity syndrome]], and that sucks donkey dong.  Anticonvulsants with a particular chemical structure are going to be converted into the problem toxin, but there's no way (yet) of telling if someone won't be able to properly metabolize the toxin once it is created.  While the odds are a bad reaction of one of these drugs means a bad reaction to one or more, if not all of the others, someone may have a problem with just one of them.  Or there may be one of them they can take.
to:
The next group is the aromatic anticonvulsants.  These meds don't help you smell purty.  Aromatic refers to aromatic hydroxylation, which is part of the process when these drugs are metabolized by CYP450 enzymes.  With a very small percentage of people (somewhere between 1 in 1,500 or 1 in 10,000) the metabolism isn't done correctly and a toxic substance is left over instead of cleaned up.  That triggers [[http://www.medscape.com/viewarticle/564608 | anticonvulsant hypersensitivity syndrome]], and that sucks donkey dong.  Anticonvulsants with a particular chemical structure (similar to [[MedClass.TCA | TCAs]], and [[http://www.ncbi.nlm.nih.gov/pubmed/17165282 | TCAs may trigger a similar reaction]]) are going to be converted into the problem toxin, but there's no way (yet) of telling if someone won't be able to properly metabolize the toxin once it is created.  While the odds are a bad reaction of one of these drugs means a bad reaction to one or more, if not all of the others, someone may have a problem with just one of them.  Or there may be one of them they can take.
Changed line 38 from:
* phenobarbital
to:
* phenobarbital (the data are mixed regarding primidone)
2010-11-22 by Jerod Poore - Creation of pages on AC/AED classes
Changed lines 29-37 from:
The flipside of enzyme induction is [[MedInfo.PK | enzyme inhibition or suppression]].  Currently there is only one group of AEDs that inhibits UGT (or any) enzymes involved in the metabolism of crazy meds, and that's the valproates:

    * [[Meds.Depakote | Depakote (divalproex sodium)]]
   * [[Meds.Depakene | Depakene (valproic acid)]]
    * and the rarely used (but much more popular overseas) Depacon (valproate sodium or sodium valproate depending on the literature you read).

Look closely, note that valproic acid is not the generic for Depakote.  I'll be hammering this point until people get it.
  These three meds are very closely related chemically, and are often lumped together as the same med.  But they aren't really.  Once they hit your brain it's close enough for government work, but in your digestive system and liver they can be very different.  If circumstances force you to switch from one to another your brain won't care too much, but your digestive system might care, and let you know in no uncertain terms.

to:
The flipside of enzyme induction is [[MedInfo.PK | enzyme inhibition or suppression]].  Currently there is only one group of AEDs that inhibits UGT (or any) enzymes involved in the metabolism of crazy meds, and that's the [[Meds.valproates | valproates]]:

*
[[Meds.Depakote | Depakote (divalproex sodium)]]
* [[Meds.Depakene | Depakene (valproic acid)]]
*
[[Meds.Depacon  | Depacon (valproate sodium or sodium valproate)]]

The next group is the aromatic anticonvulsants.  These meds don't help you smell purty.  Aromatic refers to aromatic hydroxylation, which is part of the process when these drugs are metabolized by CYP450 enzymes.  With a very small percentage of people (somewhere between 1 in 1,500 or 1 in 10
,000) the metabolism isn't done correctly and a toxic substance is left over instead of cleaned up.  That triggers [[http://www.medscape.com/viewarticle/564608 | anticonvulsant hypersensitivity syndrome]], and that sucks donkey dong.  Anticonvulsants with a particular chemical structure are going to be converted into the problem toxin, but there's no way (yet) of telling if someone won't be able to properly metabolize the toxin once it is created.  While the odds are a bad reaction of one of these drugs means a bad reaction to one or more, if not all of the others, someone may have a problem with just one of them.  Or there may be one of them they can take.
* Dilantin (phenytoin)
* Tegretol (carbamazepine)
* phenobarbital
* Lamictal (lamotrigine)
* Felbatol felbamate
* Trileptal (oxcarbazepine)
* Zonegran (zonisamide)

2010-11-22 by Jerod Poore - Creation of pages on AC/AED classes
Deleted line 11:
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* primidone is converted to phenobarbital
* Trileptal's induction of UGT enzymes is only moderate and it doesn't do much in the way of CYP3A4/5 induction like Tegretol does, Topamax induces some enzymes, but only at higher dosages, Lamictal also induces UGT enzymes, but is usually not a factor,
to:
* primidone is converted to phenobarbital.
* Trileptal's induction of UGT enzymes is only moderate and it doesn't do much in the way of CYP3A4/5 induction like Tegretol does.
*
Topamax induces some enzymes, but only at higher dosages.
*
Lamictal barely induces UGT enzymes, so it rarely makes a difference.
* Why Sabril speeds up the clearance of some meds hasn't been identified.  Enzyme induction is assumed.

Lots of other medications, both crazy and non-crazy meds, induce CYP450 and UGT enzymes.  AEDs are singled out because epileptics have been given more than one med to control their seizures for over 100 years'^1^' and neurologists as a group are more aware of drug-drug interactions and how the slightest change in dosage can affect their patients' symptoms than most other doctors.

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'^1^' Most modern AEDs are approved by the FDA to be used only with other AEDs.  Topamax was the first AED in a long time to receive FDA approval to be used all by itself (monotherapy) to treat both partial and generalized epilepsy.
2010-11-22 by Jerod Poore - Creation of pages on AC/AED classes
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Like [[MedClass.AD | antidepressants]] anticonvulsants are broken up into different classes based upon things like chemical structure, how they work in your brain or how your liver deals with them.  Unlike antidepressants there is overlapping membership, classes that consist of a single drug or a drug and drugs derived from it, and existing anticonvulsants will be added or removed from categories as the understanding of their pharmacodynamics and/or pharmacokinetics improved.  Thus the taxonomy of AEDs is as complex and fungible as that of mushrooms.
to:
Like [[MedClass.AD | antidepressants]] anticonvulsants are broken up into different classes based upon things like chemical structure, how they work in your brain or how your liver deals with them.  Unlike antidepressants there is overlapping membership, classes that consist of a single drug or a drug and drugs derived from it, and existing anticonvulsants will be added or removed from categories as the understanding of their pharmacodynamics and/or pharmacokinetics improved.  Thus the taxonomy of antiepileptic drugs (AEDs) is as complex and fungible as that of mushrooms.
Changed lines 11-14 from:
The next classification is if the drug [[MedInfo.PK | induces CYP450 or UGT enzymes]].  Enzyme-inducing AEDs (EIAEDs) can have numerous drug-drug interactions, as well as deplete your body of vitamin D'_3_'.  Most of the time when referring to EIAEDs, the drugs in question are:

* Tegretol
* Dilantin
to:
The next classification is if the drug [[MedInfo.PK | induces CYP450 and/or UGT enzymes]].  Enzyme-inducing AEDs (EIAEDs) can have numerous drug-drug interactions, as well as deplete your body of vitamin D'_3_'.  EIAEDs include:   

* Tegretol (carbamazapine)
* Dilantin (phenytoin)
Changed lines 16-19 from:
* sometimes Trileptal
* perhaps Sabril (vigabatrin)

Trileptal's induction of UGT enzymes is only moderate and it doesn't do much in the way of CYP3A4/5 like Tegretol does.  Topamax induces some enzymes, but only at higher dosages.  Lamictal also induces UGT enzymes, but is usually not a factor.
to:
* primidone
*
Trileptal (oxacarbazepine)
* Topamax (topiramate)
* Sabril (vigabatrin)

Most of the time EIAEDs refers only to Tegretol, Dilantin, and phenobarbital, because:
* primidone is converted to phenobarbital
* Trileptal's induction of UGT enzymes is only moderate and it doesn't do much in the way of CYP3A4/5 induction like Tegretol does, Topamax induces some enzymes, but only at higher dosages, Lamictal also induces UGT enzymes, but is usually not a
factor,
2010-11-21 by Jerod Poore - AED classes
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* and sometimes Trileptal
to:
* sometimes Trileptal
* perhaps Sabril (vigabatrin)
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The flipside of enzyme induction is [[MedInfo.PK | enzyme inhibition or suppression]].  Currently there is only one group of AEDs that inhibits UGT (or any) enzymes involved in the metabolism of crazy meds, and that's the valproates:

    * [[Meds.Depakote | Depakote (divalproex sodium)]]
    * [[Meds.Depakene | Depakene (valproic acid)]]
    * and the rarely used (but much more popular overseas) Depacon (valproate sodium or sodium valproate depending on the literature you read).

Look closely, note that valproic acid is not the generic for Depakote.  I'll be hammering this point until people get it.  These three meds are very closely related chemically, and are often lumped together as the same med.  But they aren't really.  Once they hit your brain it's close enough for government work, but in your digestive system and liver they can be very different.  If circumstances force you to switch from one to another your brain won't care too much, but your digestive system might care, and let you know in no uncertain terms.

Changed lines 30-37 from:
So in the US market we have the valproates:

    * Depakote (divalproex sodium)
    * Depakene (valproic acid),
    * and the rarely used (but much more popular overseas) Depacon (valproate sodium or sodium valproate depending on the literature you read).

Look closely
, note that valproic acid is not the generic for DepakoteI'll be hammering this point until people get it.  These three meds are very closely related chemically, and are often lumped together as the same medBut they aren't really.  Once they hit your brain it's close enough for government work, but in your digestive system and liver they can be very different.  If circumstances force you to switch from one to another your brain won't care too much, but your digestive system might care, and let you know in no uncertain terms.
to:


   
Only the last two work in similar ways in your brain and are chemically related.
  See the pages for more detail, but you can pretty much switch between Tegretol and Trileptal without too much trouble.  Dilantin is also classed as a Hydantoin, along with Cerebyx (something you'd only get in a hospital)As of this writing there are new medications, some under development, some waiting for FDA approval to be released, that are variations of Tregretol and DilantinI don't know if they'll induce enzymes or not.
Deleted lines 35-45:

Next up are the Enzyme Inducing Anti-Epileptic Drugs, or EIAEDs.  A barely-related family of meds that produce similar effects on your liver, and wildly different results in your brain.  They are grouped together though because of important drug-drug interactions with other meds, including other anticonvulsants, antidepressants, antipsychotics, as well as other, non-crazy medications.  It does make sense to group these together because AEDs have what is known as a "narrow therapeutic range."  I.e. a slight change in how much how much you have in your system can cause you to lose seizure control.  It's also why neurologists were the first doctors to recognize the difference in brand vs. generic medications.  The drugs in this family include:

    * Dilantin (phenytoin)
    * phenobarbital
    * Tegretol / Carbatrol (carbamazepine)
    * Trileptal (oxcarbazepine)

Only the last two work in similar ways in your brain and are chemically related.  See the pages for more detail, but you can pretty much switch between Tegretol and Trileptal without too much trouble.  Dilantin is also classed as a Hydantoin, along with Cerebyx (something you'd only get in a hospital).  As of this writing there are new medications, some under development, some waiting for FDA approval to be released, that are variations of Tregretol and Dilantin.  I don't know if they'll induce enzymes or not.

 
Deleted line 44:
Technically the benzodiazepines are also anticonvulsants, and while they have their place in treating both epilepsy and bipolar disorder, they have a section of their own.
2010-11-21 by Jerod Poore - AED classes
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The next classification is if the drug [[MedInfo.PK | induces CYP450 or UGT enzymes]].  Enzyme-inducing AEDs (EIAEDs) can have numerous drug-drug interactions, as well as deplete your body of vitamin D'_3_'.  Most of the time when referring to EIAEDs, the drugs in question are:

* Tegretol
* Dilantin
* phenobarbital
* and sometimes Trileptal

Trileptal's induction of UGT enzymes is only moderate and it doesn't do much in the way of CYP3A4/5 like Tegretol does.  Topamax induces some enzymes, but only at higher dosages.  Lamictal also induces UGT enzymes, but is usually not a factor.
2010-11-21 by Jerod Poore - AED classes
Changed lines 6-7 from:

to:
Changed lines 9-13 from:
to:
The primary classification of anticonvulsants is [[MedClass.Benzo | benzodiazepine]] and non-benzodiazepine.  While still used as AEDs, benzos are more often prescribed for anxiety and other conditions these days, so they get their own pages.  These pages, and the terms "antiepileptic drug" and "anticonvulsant" are for non-benzodiazepine AEDs / anticonvulsants.



 
2010-11-21 by Jerod Poore - AED classes
Changed lines 8-9 from:
Like [[MedClass.AD | antidepressants]] anticonvulsants are broken up into different classes based upon things like chemical structure, how they work in your brain or how your liver deals with them.  Unlike antidepressants there is overlapping membership, classes that consist of a single drug or a drug and drugs derived from it,  
to:
Like [[MedClass.AD | antidepressants]] anticonvulsants are broken up into different classes based upon things like chemical structure, how they work in your brain or how your liver deals with them.  Unlike antidepressants there is overlapping membership, classes that consist of a single drug or a drug and drugs derived from it, and existing anticonvulsants will be added or removed from categories as the understanding of their pharmacodynamics and/or pharmacokinetics improved.  Thus the taxonomy of AEDs is as complex and fungible as that of mushrooms.
2010-11-21 by Jerod Poore - AED classes
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Anticonvulsants are broken up into different classes based upon chemical structure, how they work in your brain or how your liver deals with them.  Brain, liver, they're all squishy bits, right?
to:
Like [[MedClass.AD | antidepressants]] anticonvulsants are broken up into different classes based upon things like chemical structure, how they work in your brain or how your liver deals with them.  Unlike antidepressants there is overlapping membership, classes that consist of a single drug or a drug and drugs derived from it, 
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2010-11-21 by Jerod Poore - AED classes
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Anticonvulsants are broken up into different classes based upon chemical structure, how they work in your brain or how your liver deals with them.  Brain, liver, they're all squishy bits, right?

So in the US market we have the valproates:

    * Depakote (divalproex sodium)
    * Depakene (valproic acid),
    * and the rarely used (but much more popular overseas) Depacon (valproate sodium or sodium valproate depending on the literature you read).

Look closely, note that valproic acid is not the generic for Depakote.  I'll be hammering this point until people get it.  These three meds are very closely related chemically, and are often lumped together as the same med.  But they aren't really.  Once they hit your brain it's close enough for government work, but in your digestive system and liver they can be very different.  If circumstances force you to switch from one to another your brain won't care too much, but your digestive system might care, and let you know in no uncertain terms.

 

Next up are the Enzyme Inducing Anti-Epileptic Drugs, or EIAEDs.  A barely-related family of meds that produce similar effects on your liver, and wildly different results in your brain.  They are grouped together though because of important drug-drug interactions with other meds, including other anticonvulsants, antidepressants, antipsychotics, as well as other, non-crazy medications.  It does make sense to group these together because AEDs have what is known as a "narrow therapeutic range."  I.e. a slight change in how much how much you have in your system can cause you to lose seizure control.  It's also why neurologists were the first doctors to recognize the difference in brand vs. generic medications.  The drugs in this family include:

    * Dilantin (phenytoin)
    * phenobarbital
    * Tegretol / Carbatrol (carbamazepine)
    * Trileptal (oxcarbazepine)

Only the last two work in similar ways in your brain and are chemically related.  See the pages for more detail, but you can pretty much switch between Tegretol and Trileptal without too much trouble.  Dilantin is also classed as a Hydantoin, along with Cerebyx (something you'd only get in a hospital).  As of this writing there are new medications, some under development, some waiting for FDA approval to be released, that are variations of Tregretol and Dilantin.  I don't know if they'll induce enzymes or not.

 


Then there are the GABA analogues.  These meds are basically fake GABA, a neurotransmitter critical to treating epilepsy, bipolar disorder, anxiety disorder and a variety of other issues.  Real GABA can't cross the blood-brain barrier, so don't waste your money on buying GABA at the health food store.  Gabitril isn't really a GABA analogue, but it gets classified as such because all it does is potent GABA reuptake inhibition and absolutely nothing else.  No voltage channel modification,  no messing with glutamate or kainate.  Nothing.  So it may as well be fake GABA because you get slammed with enough of it when you take some.  Trust me on that point.

    * Neurontin (gabapentin)
    * Gabitril (tiagabine)

 

Technically the benzodiazepines are also anticonvulsants, and while they have their place in treating both epilepsy and bipolar disorder, they have a section of their own.

A couple meds we may or may not cover are the Succinimides - Celontin and Zarontin.  These are kind of last resort meds for absence and partial seizures.  I've not been able to find out too much about them.  One of these days I'd like to cover them.

 

That leaves all the other anticonvulsants:

    * Felbatol (felbamate)
    * Lyrica (pregablin)
    * Keppra (levetiracetam)
    * Lamictal (lamotrigine)
    * Mysoline (primodone) (withdrawn from most markets, good luck finding it)
    * Topamax (topiramate)
    * Zonegran (zonisamide)

Again, to get technical, Lamictal is in a class of its own.  Which shouldn't surprise anyone.  It's a Phenyltriazine.

 

At some point I hope to cover some of the meds only available or primarily used outside of the US.  Such as:

    * Diamox (acetazolamide)
    * piracetam
    * Sabril  (vigabatrin)

 

 

Then we have the stuff has anticonvulsant properties, but the use of which is way off-label.  For example:

    * Meclofenamic acid, a non-steroid anti-inflammatory that is regularly used to treat canine epilepsy.  It is approved as a human painkiller, so this isn't a vet drug.
    * Progesterone-based birth control pills.  Sorry, guys, this is just for the girls.  This is both for Catamenial epilepsy (shaking it up that time of the month) and all other forms.  I've found a couple of studies in humans (and plenty in critters) that show progesterone to have mild anticonvulsant properties in of itself or as an add-on to other meds.  One from Finland and one from the good old USA.  This doesn't even count its use in treating catamenial epilepsy, which is documented all over the place.

 

 


People are constantly asking me what the equivalents are for different anticonvulsants.  Except for Tegretol / Carbatrol (carbamazepine) and Trileptal (oxcarbazepine) or all of the valproates (Depakote (divalproex sodium),Depakene (valproic acid) and  Depacon (valproate sodium)) it literally is an apples and oranges comparison.  But since apples and oranges are both types of fruits, there are commonalities.  Brent Jensen of Queen's University School of Medicine, Kingston Ontario has put together a handy Mood Stabilizer Comparison Chart.  Of course it applies only for meds available in Canada, eh.  And it deals with these medications only as they apply to treat bipolar disorder, and not epilepsy, migraines or any off-label applications.  But it's better than nothing.  Especially until I get around to doing the drug-to-drug comparisons for anticonvulsants like I have for some of the atypical antipsychotics like Seroquel (quetiapine).

 

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