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DramShopLaw5 karma

Normally have euphoric hypo/mania? Lithium. Have depression being more problematic than hypo/mania? Lamotrigine. Lithium is also less effective against dysphoric hypo/mania, mixed states, and rapid cycling.

Others like valproate can be considered first-line for people who tend to have mixed states or rapid cycling.

DramShopLaw3 karma

If you don’t mind me asking, what kind of change did you make? Does it change if you swap one med for another in the same class, or did you need to switch to a different strategy entirely?

DramShopLaw1 karma

Because many people receive their psych meds through primary care doctors, who are notoriously unaware of proper psychiatric practice. A competent practitioner would never prescribe benzodiazepines as a maintenance drug for anxiety.

What makes this worse is that we have a lot of older PCPs who will throw them at married women because their unspoken assumption is that she only has to be happy enough to do her chores and who cares about her cognitive abilities.

DramShopLaw1 karma

Do you see any hope we’ll get meds that work with novel mechanisms of action any time soon? It seems we’ll probably just have a stream of increasingly-experience AAs for who knows how long.