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The fact that a work is unpublished shall not itself bar a finding of fair use if such finding is made upon consideration of all the above factors.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





Get mugged at Straitjacket T-shirts for Crazymeds mugs to wash down your mood stabilizers. 11oz $13 & 15oz $14
Team Bipolar mugs at Straitjacket T-shirts
Team Bipolar
Mentally Interesting mugs at Straitjacket T-shirts
Mentally Interesting
Captain Manic! mugs at Straitjacket T-shirts
Captain Manic!
I <3 Zyprexa mugs at Straitjacket T-shirts
I <3 Zyprexa


< List of Mood Stabilizers | Mood Stabilizer Overview/Topic Index | Antiepileptic Drugs (AEDs) as Mood Stabilizers

1.  Using Antipsychotic Drugs (APs) as Mood Stabilizers

Most atypical/second-generation antipsychotic medications (AAPs/SGAs)1 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 alone2. Schizophrenia is profitable, but there is far more money to be made in bipolar disorder.

Lithium and some of the older standard / first-generation antipsychotic medications (APs/FGAs) are also approved to treat acute mania. The FGAs other than lithium were the original modern medications to treat bipolar disorder. Carbamazepine and valproic acid weren’t seriously studied for bipolar mania until the 1980s. Lithium wasn’t approved to treat manic-depression (as it was known) until 1970, and while prescribed in the 1960s, it wasn’t all that widely used, so almost all FGAs available were either approved for or prescribed off-label to treat manic-depression. Most of them are no longer available because their adverse effects were just too adverse3.

Although it has fallen out of fashion, lithium is still the best drug available for classic bipolar 1.

2.  Advantages of Using Antipsychotics & Atypical / Second & Third Generation Antipsychotics (AAPs) as Mood Stabilizers

Some of these apply to all APs, some apply to AAPs only. While lithium is classified as an antipsychotic, most of these advantages don’t apply to lithium, other than being a true mood stabilizer4 and the only danger you risk if you suddenly stop taking it is sudden rebound of symptoms. One of the great ironies of crazy meds is that lithium, when it comes to being a mood stabilizer, is practically an antiepileptic drug (AED); except that lithium causes seizures5 instead of preventing them.

  • Most antipsychotics (not lithium and especially not Clozaril (clozapine)) are a lot easier to prescribe and take than AEDs. When all your insurance coverage is going to pay for is four 15-minute medication-checking appointments a year, that can make a big difference.
    • 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, or really severe side effect in general 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.
    • Although the sudden rebound of symptoms, which initially could be a lot worse than any you previously experienced, could land you into all sorts of trouble.
    • 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.
  • AAPs 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.
  • Doctors know and understand why APs work as anti-manics and AAPs work as mood stabilizers. It doesn’t matter if you subscribe to the Communications Interference Hypothesis of psychiatric and neurological conditions or some other reason for the cause of depression and bipolar disorder; APs and antidepressants work in essentially the same way and in ways that are easy to understand.
  • Because they know how they work it’s easier for a doctor to tailor an AAP to your symptoms, and figure out which one would be the best to switch to in case of an allergic reaction or change in your insurance company’s formulary.


Stick to your mood stabilizers with our buttons and magnets. 2.25″ $4 & 3.5″ $4.50
Batshit Crazy magnets at Straitjacket T-shirts
Batshit Crazy
Captain Bipolar buttons at Straitjacket T-shirts
Captain Bipolar
Fuck Bipolar buttons at Straitjacket T-shirts
Fuck Bipolar
Medicated For Your Protection buttons at Straitjacket T-shirts
Medicated For Your Protection



3.  Disadvantages of Using APs/AAPs as Mood Stabilizers

  • The usual 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 - movement disorders - 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 necessarily apply to lithium. While lithium does have a movement disorder associated with it, the data are conflicting as to whether or not getting bad lithium tremors means you’re more likely to get an AP-induced movement disorder, or vice versa. Plus beta blockers like propranolol are really effective in treating lithium’s tremor, while only barely effective in treating AP-induced movement disorders.
    • Two popular movement disorders, extrapyramidal symptoms (EPS) & dyskinesias (especially the tardive form (TD), which happens after you’ve been taking a med that has been working great for over six months) are extremely rare with Zyprexa and clozapine, and rare with Seroquel. If you get EPS and/or TD from any other AP, especially Saphris, Risperdal, and the more potent FGAs, 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. Or anything else.
    • And if you got EPS and/or TD when taking Clozaril (clozapine) your doctor should order a bunch of tests and write you up as a case report.
    • Fortunately there are some ways to deal with these side effects. See the page on AP-induced movement disorders for more information.
  • Another side effect common to most AAPs is metabolism/metabolic syndrome. That’s the one where they give you diabetes and make your cholesterol levels shoot up even if they don’t make you fat as well.
  • Because they are new and shiny - new AEDs are being approved but they aren’t being tested for bipolar disorder that much - doctors are more likely to prescribe the latest AAP, regardless of how appropriate the latest one might be for you.
  • The data are still contradictory whether or not APs can help you stop drinking or deal with other substance abuse problems the way AEDs often do.
  • AAPs are extremely profitable for drug companies. As such the pharm reps push them like you wouldn’t believe.
  • So while a doctor understands the theory behind how AAPs work for bipolar disorder, the latest drug’s mechanism of action isn’t taken into account to see if it fits with your unmedicated symptoms. So it still winds up being a total crap shoot and you may as well open the PDR to a random page and try that med next.


Keep Crazymeds on the air.
Donate some spare electronic currency
you have floating around The Cloud

< List of Mood Stabilizers | Mood Stabilizer Overview/Topic Index | Antiepileptic Drugs (AEDs) as Mood Stabilizers



1 And third-generation antipsychotics (TGAs), there just aren't a hell of a lot of those. [[Abilify]] is currently the only one approved on the US market, although some old FGAs may actually be TGAs, because the definition is based on mechanism/method of action (partial agonism at the D2 dopamine receptor), and not when they were created. Most people who classify APs in this way tend to call all AAPs "second generation."

2 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.

3 Most anti-psychiatry fearmongering is based upon the adverse effects of drugs no longer available and practices no longer, uh, practiced. Although it's a tough call as to which sucks more: the asylum depicted in One Flew over the Cuckoo's Nest, or being seriously batshit crazy with no choice but to live in a cardboard condo and no hope of ever getting near a tablet of trifluoperazine.

4 Although lithium is approved only to treat the manic phase of bipolar disorder.

5 Lithium is given to rats, mice, and other critters to induce seizures when testing AEDs.

6 It is a novel way to ensure med compliance. Not necessarily a good one, but apparently an effective one.



Antipsychotic Drugs as Mood Stabilizers is copyright 2012 Jerod Poore
Page created by: Jerod Poore. Date created: 26 January 2011 Last edited by: JerodPoore on 2014–06–01





Page design and explanatory material by Jerod Poore, copyright © 2003 - 2015. All rights reserved.
Keep up with Crazymeds and and/or my slow descent into irreparable madness boring life. Pick your preferred social media target(s):

Almost all of the material on this site is by Jerod Poore and is copyright © 2003, 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014, and 2015 Jerod Poore. Except, of course, the PI sheets - those are the property of the drug companies who developed the drugs the sheets are about - and any documents that are written by other people which may be posted to this site will remain the property of the original authors. You cannot reproduce this page or any other material on this site outside of the boundaries of fair use copying without the express permission of the copyright holder. That’s usually me, so just ask first. That means if want to print out a few pages to take to your doctor, therapist, counselor, support group, non-understanding family members or something like that - then that’s OK to just do. Go for it! Please. As long as you include this copyright notice and something along the lines of following disclaimer, I’m usually cool with it.



All rights reserved. No warranty is expressed or implied in this information. Consult one or more doctors and/or pharmacists before taking, or changing how you take any neurological and/or psychiatric medication. Your mileage may vary. What happened to us won’t necessarily happen to you. If you still have questions about a medication or condition that were not answered on any of the pages you read, please ask them on Crazy Talk: the Crazymeds Forum.
The information on Crazymeds pertains to and is intended for adults. While some information about children and adolescents is occasionally presented (e.g. US FDA approvals), pediatric-specific data such as dosages, side effects, off-label applications, etc. are rarely included in the articles on drugs or discussed on the forum. If you are looking for information regarding meds for children you’ll have to go somewhere else. Plus we are big pottymouths and talk about S-E-X a lot.
Know your sources!
Nobody on this site is a doctor, a therapist, or a pharmacist. We don’t portray them either here or on TV. Only doctors can diagnose and treat an illness. While it’s not as bad as it used to be, some doctors still get pissed off by patients who know too much about medications, so tread lightly when and where appropriate. Diagnosing yourself from a website is like defending yourself in court, you suddenly have a fool for a doctor. Don’t be a cyberchondriac, thinking you have every disease you see a website about, or that you’ll get every side effect from every medication1. Self-prescribing is as dangerous as buying meds from fraudulent online pharmacies that promise you medications without prescriptions.
All information on this site has been obtained from the medications’ product information / summary of product characteristic (PI/SPC) sheets and/or medication guides - which is all you get from sites like WebMD, RxList, NAMBLA NAMI, etc., the sources that are referenced throughout the site, our personal experience and the experiences family, friends, and what people have reported on various reputable sites all over teh intergoogles. As such the information presented here is not intended as a substitute for real medical advice from your real doctor, just a compliment to it. You should never, ever, replace what a real doctor tells you with something from a website on the Internet. The farthest you should ever take it is getting a second opinion from another real doctor. Educate yourself - always read the PI/SPC sheet or medication guide/patient information leaflet (PIL) that comes with your medications and never ever throw them away. OK, you can throw away duplicate copies, but keep at least one, as that’s your proof of purchase of having taken a med in case a doctor doubts your medical history. Plus they take up less space than a bottle, although keeping one inside of a pill bottle is even better.
Crazymeds is not responsible for the content of sites we provide links to. We like them, or they’re paid advertisements, or they’re something else we think you should read to help you make an informed decision about a particular med. Sometimes they’re more than one of those things. But what’s on those sites is their business, not ours.
Very little information about visitors to this site is collected or saved. From time to time I look at search terms used and which pages they bring up in an effort to make the information I present more relevant. And the country of origin, just because I’m geeky like that. That’s about it. Depending on how you feel about Schrodinger, our privacy policy should either assuage or exacerbate your paranoia.
Crazymeds is optimized for ridiculously large screens and browsers that don’t block ads. I use Firefox and Chrome, running under Windows 72. On a computer that sits on top of my desk. With a 23 inch monitor. Hey, at least you can make the text larger or smaller by clicking on the + or - buttons in the upper right hand corner. If you have Java enabled. Like 99% of the websites on the planet, Crazymeds is hosted on domain running an open source operating system with a variety of open source applications, including the software used to display what you’ve been reading. As such Crazymeds is not responsible for whatever weird shit your browser does or does not do when you read this site3.
No neurologists, psychiatrists, therapists or pharmacists were harmed in the production of this website. Use only as directed. Void where prohibited. Contains nuts. Certain restrictions may apply. All data are subject to availability. Not available on all mobile devices, in the 12 Galaxies Guiltied to a Zegnatronic Rocket Society, or in all dimensions of reality. Hail Xenu!

‘Everything is true, nothing is permitted.’ - Jerod Poore


1 While there are plenty of books to help you with hypochondria, for some reason there’s not much in the way of websites. Then again, staying off of the Internet is a large part of curing/managing the disorder.

2 Remember kids, Microsloth operating systems are like TOS Star Trek movies with in that every other one sucks way, way more. With TOS Star Trek movies you don’t want to bother watching the odd-numbered ones. With Microsloth OS you don’t want to buy and install the even-numbered ones. Anyone who remembers ME and Vista knows what I mean.

3 Have I mentioned how open source operating systems for commercial applications is one of the dumbest ideas in the history of dumb ideas?* I don’t even need my big-ass rant any more. Heartbleed has made my case for me. And that’s just the one that got all the media attention. The very nature of an open source operating system makes security as much of an illusion as anonymity on teh Intergoogles. Before you flip out too much: the domain Crazymeds is hosted on uses a version of SSL that is not affected by the Heartbleed bug. That’s one of the many reasons why I pay a lot of money and keep this site on Lunarpages.

* Yes, I know I’m using open source browsers. I also test the site using the now-defunct IE and Safari browsers. Their popularity - and superiority - killed IE and Safari, so that’s why I rely on the open source browsers. It’s like brand vs. generic meds. Sometimes the generic is better than the brand.


Enable Crazymeds’ Financial Solvency!

Enable Crazymeds to keep spreading our knowledge. Donate some spare e-currency you have floating around The Cloud.

Improve Your Social Media Skills

Net.Presents

Follow our Highly Irregular Updates and Paranoid Rants Other News

Square this Circle

For Site News and NeuroPsych Research

Crazymeds

Show us teh like™

Crazymeds: The Blog

For Site News and Crap that Distracts me from my Fucked-up Life

Crazymeds’ Tumblr

Mentally Interesting Advocacy

OpEd News

Daily Kos

Sites That Probably Suck Less Than Crazymeds

Crazymeds Merchandise

Available at Straitjacket T-Shirts

Vaccines Cause Immunity bumpersticker at Straitjacket T-Shirts

Stuck Up
All stickers $5. Now Available in Packs of 10 & 50


Mentally Interesting button at Straitjacket T-Shirts

Button It!
2.25″ $4 & 3.5″ $4.50. Now Available in Packs of 10 & 100

dimension