The Carlat Psychiatry Podcast Psychopharm Secrets: What Patients Won’t Tell You
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Nov 4, 2024 Discover the long-term benefits of lithium as a mood stabilizer, emphasizing the importance of tracking mood changes over time. Dive into the complexities of managing bipolar disorder with Lamotrigine and the misconceptions surrounding sleep medications. Learn about the difference between affective instability and rapid cycling, and why patients often misunderstand their mood patterns. Finally, explore effective methods for assessing medication responses, highlighting the value of input from patients and their families.
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Lithium's Subtle Long-Term Benefits
- Lithium's major benefits appear over long-term use, improving mood stability and reducing hospitalizations and suicide rates.
- Patients often don't perceive these benefits, so mood charts are essential to track lithium's preventive effects.
Lamotrigine's Hidden Mood Stabilizing
- Lamotrigine reduces bipolar depressive episodes by half but patients may still experience occasional depression.
- They often misinterpret these episodes as medication failure and may want to discontinue prematurely.
Sleep Meds Mainly Aid Sleep Onset
- Sleep medications mainly help initiate sleep but add only about 10 minutes beyond placebo effect.
- They fail to improve sleep quality or next-day functioning meaningfully.