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The fact that a work is unpublished shall not itself bar a finding of fair use if such finding is made upon consideration of all the above factors.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.Stimulants History

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!!!Common Side effects
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!!!Common Side Effects
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* weight loss
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* weight loss [^##weight^]
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[^##weight If you're not taking a med to lose weight, even if the drug is approved to treat obesity, then it's a side effect.  Technically ''that'' is the definition of a side effect, as long as you're OK with it.  Anything you ''don't'' want a med to do is an "adverse" effect/event/reaction.  It's like the gardener's definition of a weed: any plant that grows where you don't want it to grow. ^]
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[^#^]

>><<
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%white%[-- (=html=)<span itemprop="discussionURL">(=htmlend=)https://crazymeds.net/CrazyTalk/index.php?/forum/87-stimulants/(=html=)</span>(=htmlend=) --]  [[<<]]
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(:Description Updated {*$LastModified}. About stimulants. Classifications, how they work, what they're used for, taking and discontinuing, side effects, etc.:)
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(:Description Updated {*$LastModified}. About stimulants. Classifications, how they work, what they are used for, taking and discontinuing, side effects, etc.:)
2014-02-23 by JerodPoore -
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* [[Meds.Adderall|Adderall]] (dextroamphetamine saccharate, amphetamine aspartate, dextroamphetamine sulfate, amphetamine sulfate)
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* [[Meds/Adderall|Adderall]] (dextroamphetamine saccharate, amphetamine aspartate, dextroamphetamine sulfate, amphetamine sulfate)
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* [[Adderall]] (dextroamphetamine saccharate, amphetamine aspartate, dextroamphetamine sulfate, amphetamine sulfate)
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* [[Meds.Adderall|Adderall]] (dextroamphetamine saccharate, amphetamine aspartate, dextroamphetamine sulfate, amphetamine sulfate)
2013-06-12 by Jerod Poore -
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* Vyvanse (lisdexamfetamine dimesylate)
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* Vyvanse (lisdexamfetamine dimesylate) - technically Vyvanse is ''not'' an amphetamine; but since your liver turns it into one after you take it, that's close enough for me.
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* Ritalin (methylphenidate HCl) etc.
** including Focalin
(dexmethylphenidate hydrochloride)
to:
* Ritalin (methylphenidate HCl) and its long-lasting flavors:
** Concerta (extended-release methylphenidate HCl)
** Focalin-XR
(dexmethylphenidate hydrochloride)
2013-06-12 by Jerod Poore -
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(:toc-float Table of Contents:)
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* [[Adderall]] (dextroamphetamine and amphetamine)
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* [[Adderall]] (dextroamphetamine saccharate, amphetamine aspartate, dextroamphetamine sulfate, amphetamine sulfate)
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* Desoxyn (methamphetamine)
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* Desoxyn (methamphetamine HCl)[^##trailer^] 
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* Focalin (dexmethylphenidate hydrochloride)
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** Concerta
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** Concerta (extended-release methylphenidate HCl)
** Focalin-XR (dexmethylphenidate hydrochloride)
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[^##trailer Meth - it's not just for white trash in sketchy trailer parks.  Just as cocaine ''hydrochloride'' is still a drug approved for use by the FDA, so is methamphetamine ''hydrochloride''.  ^]
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* horniness
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* horniness[^##horny^]
[^##horny Depending on what your life is like at the time, this particular side effect can be a feature, a bug, or both. ^]

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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]].[[<<]]
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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. [[<<]]
[[Sources/Copyright|Full copyright notice]].  [[Sources/Disclaimer|Our big-ass disclaimer]].
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2012-09-17 by Jerod Poore - Focalin is NOT an amphetamine dipshit.
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* Focalin (dexmethylphenidate hydrochloride)
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** including Focalin (dexmethylphenidate hydrochloride)
2012-09-10 by Jerod Poore -
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* ADD/ADHD
* Sleep disorders
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* [[MedClass/ADD|ADD/ADHD]]
* [[MedClass/Sleep|Sleep disorders]]
2012-09-09 by Jerod Poore -
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(:Title Treatment Options for Insomnia/Hyposomnia and other Sleep Disorders :)
(:Description Updated {*$LastModified}. We help you find the best treatment options for insomnia
, hyposomnia, narcolepsy, sleep eating and other sleep disorders. These include sedatives, hypnotics, antiepileptic drugs (AEDs), antipsychotics, and antidepressants.:)
(:keywords hyposomnia,hypersomnia,topamax for sleep eating,provigil for narcolepsy,nuvigil for narcolepsy,shift work sleep disorder
:)
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(:Title Stimulants for the Treatment of ADD/ADHD in Adults, Sleep Disorders, and More:)
(:Description Updated {*$LastModified}. About stimulants. Classifications, how they work
, what they're used for, taking and discontinuing, side effects, etc.:)
(:keywords stimulants
,amphetamine,modafinil,add/adhd:)
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The sleep disorders covered here, and the methods to treat them, fall into three broad categories. 
!!!Insomnia, Hyposomnia and their Treatments
The most common sleep disorder of the group is insomnia, which is technically not being able to sleep at all, and hyposomnia, which is getting too little sleep.  Most people complaining of insomnia actually have hyposomnia because insomnia means "not enough sleep" to 99% of everyone who isn't a doctor, or they manage to sleep at least a couple hours without being aware of it.  The latter is one of the reasons why I have the 'radio'[^##beeb^] on when I sleep.  As I would wake up every thirty minutes to three hours anyway, the radio lets me know that I was asleep, and for longer than it may have seemed.  The deception that you didn't sleep when you actually have messes with you, and contributes to feeling more tired in the morning than you should.  Hyposomnia and occasional insomnia can be treated with all sorts of things before you need to see a doctor, and there are thousands of websites that deal with non-medicine treatments for them.  As this is Crazy Meds I'm going to assume you've already tried everything else, or at least some of the non-drug therapies which, honestly, you should.  Just don't ask me which is best because leaving the radio on, or the TV if a radio isn't available, so the news[^##talk^] is on all night, is the only non-drug treatment that has ever helped me sleep.  Exercising in the morning vs. exercising later in the day vs. not exercising at all: no difference.  I can get an A+ in [[http://www.sleepfoundation.org/article/ask-the-expert/sleep-hygiene|sleep hygiene]], but without the news on I'll be lucky to get five hours of sleep.
[^##beeb By 'radio' I mean a laptop computer the BBC World Service's news stream playing on it.^]
[^##talk Not talk radio or pundit TV, but actual news.  I have no idea why, but ever since I was nine or ten I've been like this. ^]

So if you do need to use medications, hyposomnia and insomnia are primarily treated with hypnotics, [[benzodiazepines]] and other sedatives, and off-label by a few other drugs. 

%maroon%[+'''Hypnotics, Benzodiazepines and other Sedatives'''+]
How does your doctor determine which group of med to prescribe out of?  That depends on factors such as:
* how old your doctor is
* what their specialty is
* what your HMO's formulary is like
* if you're lucky something actually meaningful:
** is your problem primarily psychological in nature? 
** what other conditions you have and medications you might be taking to treat them 

Younger doctors are far more likely to prescribe hypnotics, while older doctors are apt to prescribe sedatives of one kind or another.  [[Benzodiazepines]] and other sedatives are usually more effective for psychological insomnia psychological (i.e. "in your head"), while hypnotics are usually better for insomnia with an underlying physical problem in your head.  Each class of medication has its pros and cons.  With benzodiazepines you're essentially exploiting a side effect, so taking one on a nightly basis often causes you to rapidly build up a tolerance.  I don't think it's a great idea for the bipolar to take the prescription hypnotics (Ambien, Lunesta, Rozerem, or Sonata).  At least not very often.  Most of [[http://www.ncbi.nlm.nih.gov/pubmed/20701978|what you find in the literature shows it as safe]], and there are few case reports of high weirdness (e.g. [[http://www.ncbi.nlm.nih.gov/pubmed/14519043|Ambien + Depakote + bipolar = sleepwalking]]), but I've collected far too many stories of the bipolar frequently going way overboard with Ambien-induced sleep-what-the-fuckery.  Who else remembers [[http://www.cbsnews.com/2100-250_162-1590041.html|Representative Patrick Kennedy's Ambien Adventure]]?

!!!!Hypnotics
* Ambien (zolpidem tartrate)
* Benadryl (diphenhydramine HCl) - as well as numerous other brand names: Unisom, Compoz, Sominex, Nytol, and every OTC pain reliever with PM after its name.
* Imovane (zopiclone) - not available in the US
* Lunesta (eszopiclone)
* Rozerem (ramelteon)
* Sonata (zaleplon)

!!!!Benzodiazepines with FDA approval to treat insomnia
* estazolam
* quazepam
* flurazepam hydrochloride
* Halcion (triazolam)

!!!!Benzodiazepines used off-label to treat insomnia
* Ativan (lorazepam)
* Klonopin (clonazepam)
* Xanax (alprazolam)

!!!!Other Sedatives with FDA approval to treat insomnia
* Barbiturates
** amobarbital sodium
** butabarbital sodium
** methohexital sodium
** pentobarbital & pentobarbital sodium
** secobarbital sodium
* Good luck getting prescriptions for these:
** chloral hydrate
** hydrochlorides of opium alkaloids (Pantopon)

!!!!Other drugs used off-label to treat insomnia
* Antidepressants:
** doxepin
** [[Elavil]] (amitriptyline HCl)
** [[Remeron]] (mirtazapine)
** [[trazodone]]
* Antipsychotics:
** [[Seroquel]] (quetiapine fumarate)
** [[Zyprexa]] (olanzapine)
* Other medications:
** Xyrem (sodium oxybate) - good luck with this one as well, even for its approved usage

(:if ! equal {$@crazy_meds_device} "mobile":)
----
(:GoogleSleep:)
----
(:ifend:)

!!!Dyssomnia & Hypersomnia - Sleep, Interrupted.
The flip side is sleeping when you need to be awake, from narcolepsy to the newly {-invented-} discovered shift work sleep disorder (SWSD).  Those ailments are usually, but not always, treated with a stimulant of some form.  There may be non-drug therapies to treat narcolepsy, but none that I'm aware of that do any good[^##exist^].  SWSD is a controversial diagnosis, one I'm conflicted about.  As an actual sleep disorder I consider it to be total bullshit.  Either you can work the graveyard shift or you can't; just as some people can get up at five or six in the morning while some people are ready to go to sleep at that time.  On the other hand, the only job available for you might be one where the hours are exactly the same as when your body and brain would rather be asleep no matter how much coffee you drink.  Assuming you can drink coffee in the first place.  So if it takes getting diagnosed with bullshit sleep disorder (BSD)in order to keep the only job available[^##wage^], then you're much better off getting diagnosed with BSD and getting a prescription for modafinil or Nuvigil (armodafinil) - depending on which one is covered by your graveyard-shift health insurance.  I would do the same thing in those circumstances.
!!!!Drugs Approved to Treat Narcolepsy
* [[Adderall]] (dextroamphetamine and amphetamine) - immediate release, not Adderall XR[^##fda^]
to:
!!!FDA-Approved Stimulants
* [[Adderall]] (dextroamphetamine and amphetamine)
* Cylert (pemoline)
* Desoxyn (methamphetamine)
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* Focalin (dexmethylphenidate hydrochloride)
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* Ritalin (methylphenidate HCl)
* Xyrem (sodium oxybate)
[^##exist That doesn't mean reliable non-drug therapies to treat narcolepsy don't exist, I just don't know of any.  If I learn of any I'll list them here.^]
[^##wage Or the only job available with decent health insurance, and that pays enough to keep you and your kids from having to move into a studio apartment and live off of food bank donations.^]
[^##fda For all I know Adderall XR may work for narcolepsy, it just doesn't have FDA approval to treat it the way the older immediate-release form has.^]

!!!!Drugs Approved to Treat Shift Work Sleep Disorder
to:
* Ritalin (methylphenidate HCl) and its variants:
** Concerta
* Vyvanse (lisdexamfetamine dimesylate)

!!!Classifications
Stimulants are currently grouped into two broad categories - amphetamines and everything else.  Amphetamines include:
* [[Adderall]] (dextroamphetamine and amphetamine)
* Desoxyn (methamphetamine)
* Dexedrine (dextroamphetamine sulfate)
* Focalin (dexmethylphenidate hydrochloride)
* Vyvanse (lisdexamfetamine dimesylate)

Everything else includes:
* Cylert (pemoline)
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!!!Parasomnia - Disturbed Sleep
Finally there's doing weird stuff when you're asleep, like sleep binge eating or sleep driving.
  The latter is most often associated with being a side effect of hypnotics like Ambien (zolpidem tartrate), where the treatment is simply to stop taking Ambien.  In other cases the causes range from epilepsy to they don't have a freaking clue, but either way the first treatment tried is usually an [[MedClass/AED|antiepileptic drug]] (AED).  Parasomnia also includes things like restless leg syndrome (RLS) and periodic limb movement disorder (PLMD), probably because RLS & PLMD are both neurological disorders and can also be caused by things like a specific form of iron deficiency (anemia), postpolio syndrome, and the catch-all who the hell knows (idiopathic).  So many things are in this category that non-drug treatments include talk therapy and, except for RLS & PLMD, all the treatments are off-label.
!!!!Drugs Approved to Treat RLS & PLMD
* Mirapex (pramipexole dihydrochloride)
* Requip (ropinirole hydrochloride)

!!!!Drugs Used Off-Label to Treat Assorted other Parasomnias
* [[Topamax]] - Sleep eating, especially sleep binge eating.

If you have any questions about sleep disorders and their treatments that weren't answered here, check out [[https://crazymeds.net/CrazyTalk/index.php?/forum/52-epilepsy-migraines-sleep-disorders-and-other-neurological-conditions/|our forum on epilepsy, migraines, sleep disorders and other neurological conditions
]].
to:
* Ritalin (methylphenidate HCl) etc.

!!!Approved Uses
* ADD/ADHD
* Sleep disorders
* Obesity

!!!Common Off-Label Uses
* Depression

!!!Common Side effects
* headache
* nausea

* dry mouth
* sweating
* insomnia
* constipation
* weight loss
* heart palpitations
* raised blood pressure
* dizziness
* horniness 

(:if ! equal {$@crazy_meds_device} "mobile":)
----
(:GoogleADD:)
----
(:ifend:)


If you have any questions about stimulants that weren't answered here, check out
[[http://www.crazymeds.net/CrazyTalk/index.php?/forum/87-stimulants/|our forum on stimulants]].
Changed lines 72-75 from:
[[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1885116/|Drugs for sleep disorders: mechanisms and therapeutic prospects]]


to:
[[http://astore.amazon.com/crazymedsorg-20/detail/1429233435|''Primer of Drug Action'']] 12th edition by Robert M. Julien Ph.D., Claire D. Advokat, Joseph Comaty © 2011  Published by [[http://www.worthpublishers.com/|Worth Publishers]].



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Author: Jerod Poore.  Date created: 24 May 2012  Last edited by: {$LastModifiedBy} on: {*$LastModified}
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Author: Jerod Poore.  Date created: 09 September 2012  Last edited by: {$LastModifiedBy} on: {*$LastModified}
2012-09-09 by Jerod Poore -
Changed lines 21-30 from:
How does your doctor determine which group of med to prescribe out of?  That depends on factors such as how old your doctor is, what their specialty is, what your HMO's formulary is like, and something actually meaningful like what other conditions you have and medications you might be taking to treat them.  Younger doctors are far more likely to prescribe hypnotics, while older doctors are apt to prescribe sedatives of one kind or another.
to:
How does your doctor determine which group of med to prescribe out of?  That depends on factors such as:
*
how old your doctor is
*
what their specialty is
*
what your HMO's formulary is like
* if you're lucky something actually meaningful:
** is your problem primarily psychological in nature? 
** what other conditions you have and medications you might be taking to treat them 

Younger doctors are far more likely to prescribe hypnotics, while older doctors are apt to prescribe sedatives of one kind or
another.  [[Benzodiazepines]] and other sedatives are usually more effective for psychological insomnia psychological (i.e. "in your head"), while hypnotics are usually better for insomnia with an underlying physical problem in your head.  Each class of medication has its pros and cons.  With benzodiazepines you're essentially exploiting a side effect, so taking one on a nightly basis often causes you to rapidly build up a tolerance.  I don't think it's a great idea for the bipolar to take the prescription hypnotics (Ambien, Lunesta, Rozerem, or Sonata).  At least not very often.  Most of [[http://www.ncbi.nlm.nih.gov/pubmed/20701978|what you find in the literature shows it as safe]], and there are few case reports of high weirdness (e.g. [[http://www.ncbi.nlm.nih.gov/pubmed/14519043|Ambien + Depakote + bipolar = sleepwalking]]), but I've collected far too many stories of the bipolar frequently going way overboard with Ambien-induced sleep-what-the-fuckery.  Who else remembers [[http://www.cbsnews.com/2100-250_162-1590041.html|Representative Patrick Kennedy's Ambien Adventure]]?
Added line 33:
* Benadryl (diphenhydramine HCl) - as well as numerous other brand names: Unisom, Compoz, Sominex, Nytol, and every OTC pain reliever with PM after its name.
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* Benadryl (diphenhydramine HCl) - as well as numerous other brand names: Unisom, Compoz, Sominex, Nytol, and every OTC pain reliever with PM after its name.
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* Adderall (dextroamphetamine and amphetamine) - immediate release, not Adderall XR[^##fda^]
to:
* [[Adderall]] (dextroamphetamine and amphetamine) - immediate release, not Adderall XR[^##fda^]
Added lines 106-113:

!!!Bibliography

[[http://astore.amazon.com/crazymedsorg-20/detail/0521673763|''Stahl's Essential Psychopharmacology: Neuroscientific Basis and Practical Applications (Essential Psychopharmacology Series)'']] Third edition  by Stephen M. Stahl © 2008  Published by [[http://www.cambridge.org|Cambridge University Press]].

[[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1885116/|Drugs for sleep disorders: mechanisms and therapeutic prospects]]

2012-09-08 by Jerod Poore -
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* Adderall (dextroamphetamine and amphetamine)
to:
* Adderall (dextroamphetamine and amphetamine) - immediate release, not Adderall XR[^##fda^]
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[^##fda For all I know Adderall XR may work for narcolepsy, it just doesn't have FDA approval to treat it the way the older immediate-release form has.^]
2012-09-08 by Jerod Poore -
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If you have any questions about sleep disorders and their treatments that weren't answered here, check out [[https://crazymeds.net/CrazyTalk/index.php?/forum/52-epilepsy-migraines-sleep-disorders-and-other-neurological-conditions/|our forum on epilepsy, migraines, sleep disorders and other neurological conditions]].
2012-09-08 by Jerod Poore -
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* Adderall
to:
* Adderall (dextroamphetamine and amphetamine)
2012-09-08 by Jerod Poore -
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How does your doctor determine which group of med to prescribe out of?  That depends on factors such as how old your doctor is, what their specialty is, what your HMO's formulary is like, and something actually meaningful like what other conditions you have and medications you might be taking to treat them.  Younger doctors are far more likely to prescribe hypnotics, while older doctors are apt to prescribe sedatives of one kind or another.[[<<]]
to:
How does your doctor determine which group of med to prescribe out of?  That depends on factors such as how old your doctor is, what their specialty is, what your HMO's formulary is like, and something actually meaningful like what other conditions you have and medications you might be taking to treat them.  Younger doctors are far more likely to prescribe hypnotics, while older doctors are apt to prescribe sedatives of one kind or another.
Changed line 71 from:
The flip side is sleeping when you need to be awake, from narcolepsy to the newly {-invented-} discovered shift work sleep disorder.  Those ailments are usually, but not always, treated with a stimulant of some form.  There may be non-drug therapies, but none that I'm aware of that do any good.
to:
The flip side is sleeping when you need to be awake, from narcolepsy to the newly {-invented-} discovered shift work sleep disorder (SWSD).  Those ailments are usually, but not always, treated with a stimulant of some form.  There may be non-drug therapies to treat narcolepsy, but none that I'm aware of that do any good[^##exist^].  SWSD is a controversial diagnosis, one I'm conflicted about.  As an actual sleep disorder I consider it to be total bullshit.  Either you can work the graveyard shift or you can't; just as some people can get up at five or six in the morning while some people are ready to go to sleep at that time.  On the other hand, the only job available for you might be one where the hours are exactly the same as when your body and brain would rather be asleep no matter how much coffee you drink.  Assuming you can drink coffee in the first place.  So if it takes getting diagnosed with bullshit sleep disorder (BSD)in order to keep the only job available[^##wage^], then you're much better off getting diagnosed with BSD and getting a prescription for modafinil or Nuvigil (armodafinil) - depending on which one is covered by your graveyard-shift health insurance.  I would do the same thing in those circumstances.
Added lines 79-84:
[^##exist That doesn't mean reliable non-drug therapies to treat narcolepsy don't exist, I just don't know of any.  If I learn of any I'll list them here.^]
[^##wage Or the only job available with decent health insurance, and that pays enough to keep you and your kids from having to move into a studio apartment and live off of food bank donations.^]

!!!!Drugs Approved to Treat Shift Work Sleep Disorder
* Nuvigil (armodafinil)
* Provigil (modafinil)
2012-09-08 by Jerod Poore -
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>>font-family:arial font-size:4<<
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>>font-family:verdana font-size:4<<
(:if ! equal {$@crazy_meds_device} "mobile":)
----
(:GoogleSleep:)
----
(:ifend:)
(:toc-float anchors=visible Table of Contents
:)
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!!!Insomnia & Hyposomnia
to:
!!!Insomnia, Hyposomnia and their Treatments
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!!!!Hypnotics, Benzodiazepines and other Sedatives
to:
%maroon%[+'''Hypnotics, Benzodiazepines and other Sedatives'''+]
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'''Hypnotics'''
to:
!!!!Hypnotics
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'''Benzodiazepines with FDA approval to treat insomnia'''
to:
!!!!Benzodiazepines with FDA approval to treat insomnia
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'''Benzodiazepines used off-label to treat insomnia'''
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!!!!Benzodiazepines used off-label to treat insomnia
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'''Other Sedatives with FDA approval to treat insomnia'''
to:
!!!!Other Sedatives with FDA approval to treat insomnia
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* Good luck getting prescriptions for these
to:
* Good luck getting prescriptions for these:
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(:GoogleSleep:)
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* Nuvigil
to:
* Nuvigil (armodafinil)
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(:if ! equal {$@crazy_meds_device} "mobile":)(:AddThis:)(:else:)[[#MobileToc|Return to Site Table of Contents]](:ifend:)
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Author: Jerod Poore.  Date created: 24 May 2012  Last edited by: {$LastModifiedBy}
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Author: Jerod Poore.  Date created: 24 May 2012  Last edited by: {$LastModifiedBy} on: {*$LastModified}
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[[Sources.Copyright|Full copyright notice]].  [[Sources.Disclaimer|Our big-ass disclaimer]].
to:
[[Sources.Copyright|Full copyright notice]].  [[Sources.Disclaimer|Our big-ass disclaimer]].[[<<]]
[[#MobileToc|Return to Site Table of Contents]]
2012-05-24 by JerodPoore -
Changed lines 80-81 from:
Mirapex (pramipexole dihydrochloride)
Requip (ropinirole hydrochloride)
to:
* Mirapex (pramipexole dihydrochloride)
* Requip (ropinirole hydrochloride)
2012-05-24 by JerodPoore -
Changed lines 1-3 from:
(:Title Treatment Options for Insomnia and other Sleep Disorders :)
(:Description Updated {*$LastModified}. We help you find the best treatment options for insomnia, narcolepsy, sleep eating and other sleep disorders. These include sedatives, hypnotics, antiepileptic drugs (AEDs), antipsychotics, and antidepressants.:)
(:keywords topamax for sleep eating,provigil for narcolepsy,nuvigil for narcolepsy,shift work sleep disorder:)
to:
(:Title Treatment Options for Insomnia/Hyposomnia and other Sleep Disorders :)
(:Description Updated {*$LastModified}. We help you find the best treatment options for insomnia, hyposomnia, narcolepsy, sleep eating and other sleep disorders. These include sedatives, hypnotics, antiepileptic drugs (AEDs), antipsychotics, and antidepressants.:)
(:keywords hyposomnia,hypersomnia,topamax for sleep eating,provigil for narcolepsy,nuvigil for narcolepsy,shift work sleep disorder:)
Changed lines 7-9 from:
The sleep disorders covered here, and the drugs used to treat them, fall into three broad categories. 
!!!Insomnia
The most common sleep disorder of the group is insomnia, which is primarily treated by hypnotics, [[benzodiazepines]] and other sedatives, and off-label by a few other drugs.
to:
The sleep disorders covered here, and the methods to treat them, fall into three broad categories. 
!!!Insomnia & Hyposomnia
The most common sleep disorder of the group
is insomnia, which is technically not being able to sleep at all, and hyposomnia, which is getting too little sleep.  Most people complaining of insomnia actually have hyposomnia because insomnia means "not enough sleep" to 99% of everyone who isn't a doctor, or they manage to sleep at least a couple hours without being aware of it.  The latter is one of the reasons why I have the 'radio'[^##beeb^] on when I sleep.  As I would wake up every thirty minutes to three hours anyway, the radio lets me know that I was asleep, and for longer than it may have seemed.  The deception that you didn't sleep when you actually have messes with you, and contributes to feeling more tired in the morning than you should.  Hyposomnia and occasional insomnia can be treated with all sorts of things before you need to see a doctor, and there are thousands of websites that deal with non-medicine treatments for them.  As this is Crazy Meds I'm going to assume you've already tried everything else, or at least some of the non-drug therapies which, honestly, you should.  Just don't ask me which is best because leaving the radio on, or the TV if a radio isn't available, so the news[^##talk^] is on all night, is the only non-drug treatment that has ever helped me sleep.  Exercising in the morning vs. exercising later in the day vs. not exercising at all: no difference.  I can get an A+ in [[http://www.sleepfoundation.org/article/ask-the-expert/sleep-hygiene|sleep hygiene]], but without the news on I'll be lucky to get five hours of sleep.

[^##beeb By 'radio' I mean a laptop computer the BBC World Service's news stream playing on it.^]
[^##talk Not talk radio or pundit TV, but actual news.  I have no idea why, but ever since I was nine or ten I've been like this. ^]

So if you do need to use medications, hyposomnia and insomnia are primarily treated with hypnotics, [[benzodiazepines]] and other sedatives, and off-label by a few other drugs. 

Changed line 17 from:
How does your doctor determine which group of med to prescribe out of?  That depends on factors such as how old your doctor is, what their specialty is, what your HMO's formulary is like, and something actually meaningful like what other conditions you have and medications you might be taking to treat them.  Younger doctors are far more likely to prescribe hypnotics, while older doctors are apt to prescribe sedatives of one kind or another.
to:
How does your doctor determine which group of med to prescribe out of?  That depends on factors such as how old your doctor is, what their specialty is, what your HMO's formulary is like, and something actually meaningful like what other conditions you have and medications you might be taking to treat them.  Younger doctors are far more likely to prescribe hypnotics, while older doctors are apt to prescribe sedatives of one kind or another.[[<<]]
Changed lines 49-63 from:
* [[Remeron]]
* [[Seroquel]]
* [[trazodone]]
* Xyrem (sodium oxybate) - good luck with this one as well, even for its approved usage

 

The flip side is sleeping when you need to be awake, from narcolepsy to the newly {-invented-} discovered shift work sleep disorder.  Those ailments are usually treated with a stimulant of some form.  Finally there's doing weird stuff when you're asleep, like sleep binge eating or sleep driving.  The latter is most often associated with being a side effect of hypnotics like Ambien (zolpidem tartrate), where the treatment is simply to stop taking Ambien.  In other cases the causes range from epilepsy to they don't have a freaking clue, but either way the first treatment tried is usually an [[MedClass/AED|antiepileptic drug]] (AED).






to:
* Antidepressants:
** doxepin
**
[[Elavil]] (amitriptyline HCl)
**
[[Remeron]] (mirtazapine)
** [[trazodone]]
* Antipsychotics:
** [[Seroquel]] (quetiapine fumarate)
** [[Zyprexa]] (olanzapine)
* Other medications:
** Xyrem (sodium oxybate) - good luck with this one as well, even for its approved usage

Changed lines 66-80 from:
!!!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
)
to:

!!!Dyssomnia & Hypersomnia - Sleep, Interrupted.
The flip side is sleeping when you need to be awake, from narcolepsy to the newly {-invented-} discovered shift work sleep disorder.  Those ailments are usually, but not always, treated with a stimulant of some form.  There may be non-drug therapies, but none that I'm aware of that do any good.
!!!!Drugs Approved to Treat Narcolepsy
* Adderall
* Dexedrine (dextroamphetamine sulfate
)
* Nuvigil
* Provigil (modafinil)
* Ritalin (methylphenidate HCl)
* Xyrem (sodium oxybate)

!!!Parasomnia - Disturbed Sleep
Finally there's doing weird stuff when you're asleep, like sleep binge eating or sleep driving.  The latter is most often associated with being a side effect of hypnotics like Ambien (zolpidem tartrate), where the treatment is simply to stop taking Ambien.  In other cases the causes range from epilepsy to they don't have a freaking clue, but either way the first treatment tried is usually an [[MedClass/AED|antiepileptic drug]] (AED).  Parasomnia also includes things like restless leg syndrome (RLS) and periodic limb movement disorder (PLMD), probably because RLS & PLMD are both neurological disorders and can also be caused by things like a specific form of iron deficiency (anemia), postpolio syndrome, and the catch-all who the hell knows (idiopathic).  So many things are in this category that non-drug treatments include talk therapy and, except for RLS & PLMD, all the treatments are off-label.
!!!!Drugs Approved to Treat RLS & PLMD
Mirapex (pramipexole dihydrochloride)
Requip (ropinirole hydrochloride)

!!!!Drugs Used Off-Label to Treat Assorted other Parasomnias
* [[Topamax]] - Sleep eating, especially sleep binge eating.
2012-05-24 by JerodPoore -
Changed lines 1-4 from:
(:Title Treatment Options for Migraines, Other Headaches, Fibromyalgia, and Neuropathic Pain :)
(:Description Updated {*$LastModified}. We help you find the best treatment options for for migraines, other headaches, fibromyalgia and various other flavors of neuropathic pain. That's mostly antiepileptic drugs (AEDs) and some antidepressants.:)
(:keywords migraines,headaches,fibromyalgia,neuropathy,neuropathic pain,migraine medication,headache medication,fibromyalgia medication,neuropathy medication,neuropathic pain medication,migraine relief,headache relief,fibromyalgia relief,neuropathy relief,neuropathic pain relief,migraine remedies,headache remedies,fibromyalgia remedies,neuropathy remedies,neuropathic pain remedies,migraine medicine,headache medicine,fibromyalgia medicine,neuropathy medicine,neuropathic pain medicine,migraine prevention,headache prevention,migraine prophylaxis,headache prophylaxis,migraine treatments,headache treatments,neuropathy treatments,neuropathic pain treatments,fibromyalgia treatments,treatment migraine,treatment headache,treatment neuropathy,treatment neuropathic pain,treatment fibromyalgia,cure migraine,cure headache,cure neuropathy,cure neuropathic pain,cure fibromyalgia,peripheral neuropathy,diabetic neuropathy:)
%comment%(:if expr ( auth admin || {$Author} {$$author} ):) {[foxedit form=Meds.NewArticle]} (:if:)%
to:
(:Title Treatment Options for Insomnia and other Sleep Disorders :)
(:Description Updated {*$LastModified}. We help you find the best treatment options for insomnia, narcolepsy, sleep eating and other sleep disorders. These include sedatives, hypnotics, antiepileptic drugs (AEDs), antipsychotics, and antidepressants.:)
(:keywords topamax for sleep eating,provigil for narcolepsy,nuvigil for narcolepsy,shift work sleep disorder:)
Changed lines 7-24 from:
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
||border = 1
||!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 ||
||Stavzor ||valproic acid delayed release ||Migraine prophylaxis ||
||[[Tegretol]] ||carbamazepine ||Trigeminal Neuralgia, Glossopharyngeal Neuralgia ||
||[[Topamax]]  ||topiramate ||Migraine prophylaxis ||
||[[topiramate]]  ||topiramate ||Migraine prophylaxis ||

to:
The sleep disorders covered here, and the drugs used to treat them, fall into three broad categories. 
!!!Insomnia
The most common sleep disorder of the group is insomnia, which is primarily treated by hypnotics, [[benzodiazepines]] and other sedatives, and off-label by a few other drugs. 
!!!!Hypnotics, Benzodiazepines and other Sedatives
How does your doctor determine which group of med to prescribe out of?  That depends on factors such as how old your doctor is, what their specialty is, what your HMO's formulary is like, and something actually meaningful like what other conditions you have and medications you might be taking to treat them.  Younger doctors are far more likely to prescribe hypnotics, while older doctors are apt to prescribe sedatives of one kind or another.
'''Hypnotics'''
* Ambien (zolpidem tartrate)
* Imovane (zopiclone) - not available in the US
* Lunesta (eszopiclone)
* Rozerem (ramelteon)
* Sonata (zaleplon)

'''Benzodiazepines with FDA approval to treat insomnia'''
* estazolam
* quazepam
* flurazepam hydrochloride
* Halcion (triazolam)

'''Benzodiazepines used off-label to treat insomnia'''
* Ativan (lorazepam)
* Klonopin (clonazepam)
* Xanax (alprazolam)

'''Other Sedatives with FDA approval to treat insomnia'''
* Benadryl (diphenhydramine HCl) - as well as numerous other brand names: Unisom, Compoz, Sominex, Nytol, and every OTC pain reliever with PM after its name.
* Barbiturates
** amobarbital sodium
** butabarbital sodium
** methohexital sodium
** pentobarbital & pentobarbital sodium
** secobarbital sodium
* Good luck getting prescriptions for these
** chloral hydrate
** hydrochlorides of opium alkaloids (Pantopon)

!!!!Other drugs used off-label to treat insomnia
* [[Remeron]]
* [[Seroquel]]
* [[trazodone]]
* Xyrem (sodium oxybate) - good luck with this one as well, even for its approved usage

 

The flip side is sleeping when you need to be awake, from narcolepsy to the newly {-invented-} discovered shift work sleep disorder.  Those ailments are usually treated with a stimulant of some form.  Finally there's doing weird stuff when you're asleep, like sleep binge eating or sleep driving.  The latter is most often associated with being a side effect of hypnotics like Ambien (zolpidem tartrate), where the treatment is simply to stop taking Ambien.  In other cases the causes range from epilepsy to they don't have a freaking clue, but either way the first treatment tried is usually an [[MedClass/AED|antiepileptic drug]] (AED).






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!!!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 ||!Approved Indications ||!Off-Label Uses ||
||[[Elavil]] ||amitriptyline HCl ||Depression ||Migraines ||
||[[Pamelor]] ||nortriptyline HCl  ||Depression ||Migraines ||
||[[Tofranil]] ||imipramine HCl ||Depression ||Migraines ||
.

!!!!Meds we don't have pages on yet
* Inderal (propranolol)
* flunarizine - not available in the US

to:

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''{$Title}'' by Jerod Poore is copyright © 2011  [[<<]]
Author: Jerod Poore.  Date created: 15 May 2011  Last edited by: {$LastModifiedBy}
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''{$Title}'' by Jerod Poore is copyright © 2012  [[<<]]
Author: Jerod Poore.  Date created: 24 May 2012  Last edited by: {$LastModifiedBy}
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 ||
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||border = 1
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(:sortable:)
||class=sortable id=migrainetable border=0 rules=rows align=left width=100%
||!Brand/Trade name ||!generic name ||!Approvals ||
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||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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Page created by: Jerod Poore.  Date created: 15 May 2011  Last edited by: {$Author}
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''{$Title}'' by Jerod Poore is copyright © 2011  [[<<]]
Author: Jerod Poore.  Date created: 15 May 2011  Last edited by:
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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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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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* Inderal (propranolol)
* flunarizine

to:
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||!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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[[<<]]
--------
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:)
----

Added line 33:
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 ||

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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]] [[<<]]

>><<
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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. 
Changed line 28 from:
Page created by: Jerod Poore.  Date created: 22 November 2010  Last edited by: {$Author}
to:
Page created by: Jerod Poore.  Date created: 26 January 2011  Last edited by: {$Author}
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 :)
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 -
Added line 13:
* [[MedClass.AEDBibliography | Bibliography]] Books, journals, websites, etc. used for these pages.
2010-11-23 by Jerod Poore - Creation of AC/AED overview pages
Added lines 1-30:
(: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.

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

>><<
[[<<]]
----
>>font-family:arial font-size:3<<
Page created by: Jerod Poore.  Date created: 22 November 2010  Last edited by: {$Author}
>><<
[[<<]]
--------
(:include Sources.Copyright:)
-------
(:include Sources.Disclaimer:)
>><<
[[<<]]
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:
Changed lines 21-23 from:
* 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.

Added line 104:
'^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
Changed lines 7-8 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, 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
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* 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.

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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.
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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.

 
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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
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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
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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,  
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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.
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?
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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, 
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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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