These drugs are prescribed to reduce the severity and frequency of the moodswings. They are used alone or in combination. Slow introduction of the drug and slow phasing out is usual for these drugs.

CLASS & DRUGS	TRADE NAME	POSSIBLE EFFECTS	CAUTIONS
Lithium Carbonate	LITHICARB           PRIADEL	Nausea, loose stools, fine hand tremor, thirst, increased urination, weight gain, oedema (fluid buildup), thyroid function affected, aggravation of psoriasis, mild intoxication - lethargy, muscle weakness, slight twitching and loss of balance.	Take with water. Dehydration, vomiting or diarrhoea can cause toxicity Requires blood level test. Caution card available from GP or pharmacist.
Anticonvulsant
Carbamazepine	TEGRETOL         TERIL	Drowsiness, anorexia, dry mouth, diarrhoea or constipation, headache, dizziness, skin rashes, blurred vision, confusion, agitation (in the elderly). Rarely: vomiting, mental confusion, allergic skin reactions, blood problems, hepatitis.	Take with food. Restrict alcohol intake. May affect the action of other drugs and other drugs, may affect blood levels of carbamazepine. Requires blood level test.
Sodium Valproate	EPILIM	Gastric irritation, weight gain, hair loss, effects on blood, skin rashes, psoriasis. Severe effects are pancreatitis, liver damage. However liver damage is rare.	Take with food. Restrict alcohol intake. If vomiting, imbalance, clouding of consciousness, stop therapy and consult your doctor. Requires blood level test.

Newer anticonvulsant drugs, such as lamotrigine and gabapentin, have both undergone clinical testing for use as treatment agents in bipolar disorder (manic depression). Both are already being widely used in the USA. While New Zealand has participated in the international trials of these drugs they are yet to become available here. Another second generation anticonvulsant currently being systematically investigated is topiramate. One of the side effects of this drug appears to be loss of appetite and loss of weight. More definitive data is needed on appropriate dose and titration of this agent before it is approved for widespread use. Early indications are that it may prove to be of particular use in individuals who are already overweight or who experience weight gain while using other mood stabilising agents.


PLEASE NOTE:
THE DRUG INFORMATION ON THIS AND THE FOLLOWING PAGES IS A GUIDE ONLY. IT IS NOT INTENDED TO PROVIDE DETAILED INFORMATION ON ALL DRUGS. IT IS NOT INTENDED TO BE A SUBSTITUTE FOR MEDICAL ADVICE.