What are some of the newest bipolar medications?

I saw my psychiatrist today. He raised my Seroquel XR because of some mood issues I've been having. He said that he went to some major psychopharmaceutical seminar recently and received detailed information on many new medications that can be used for bipolar disorder. He said that perhaps in a couple of appointments he might talk about some with me. My current cocktail is so-so, but I still have breakthrough symptoms and occasionally major episodes. Maybe something new would be good, but it's scary to try new stuff.

I know of some "newer" medications, but perhaps not the newest ones out there. Does anyone have any experience with very new medications for bipolar disorder? If so, what are they and what is/was your experience?

Note: Antidepressants and stimulants are not options for me. I'm more interested in new antipsychotics, moodstabilizers, or anything in some new class.

For reference, I have experience taking all of the following medications, so feedback on any NOT on the following lists would be great. I will not include antidepressants or stimulants since they'll likely be off the table.

Moodstabilizers:

Lithium ER
Depakote ER (divalproex sodium)
Lamictal (lamotrigine)
Tegretol XR (carbamazepine)
Trileptal (oxcarbazepine spelling?)
Neurontin (gabapentin)
I never took Topamax (topiramate), but I doubt that's being considered

Antipsychotics:

Zyprexa (olanzapine)
Seroquel and Seroquel XR (quetiapine)
Abilify (aripiprazole)
Risperdal (risperidone)
Invega (paliperidone)
Geodon (ziprasidone)
Navane (thiothixene) - 1st gen (not interested in other 1st gens)
Trilafon (perphanazine) - ditto as above

Other Miscellaneous:

Synthroid (Levothyroxine) - I take it for hypothyroidism
Inderal (propranolol) - I take for tachycardia/anxiety
Vistaril (hydroxyzine) - I took for anxiety
Buspar (buspirone) - I took for anxiety

I have bipolar disorder type 1. I am vulnerable to all types of episodes, especially mixed type episodes. I have had a history of psychosis during severe manias and manias with mixed features.

hi. all i can think of (and, honestly, this is based more on what piques my own interest, in terms of my treatment...) are the new D2 partial agonists, Vraylar (probably not spelled correctly) and Rexulti.

what went wrong with trileptal? im not a mega-fan myself, but i did OK with it...it has fewer drug-drug interactions than tegretol, that's why im asking. and the blood work is fairly minimal, too. I took trileptal and lamictal together for a time, and it was OK until the Trileptal pushed me down into bad depression. now, its lamictal @ a higher dose, plus moderate dose abilfy.

there's...saphris and fanapt, both of which were briefly brough up by my new prescriber person. they're 'aytpicals,' a newer round. i think one is a dissolving tablet?

latuda. everybody and their mama is on latuda or was on latuda...i just stuck with abilify, personally. but, its supposed to help bad depression and also...clear out cognitive probs, if that happens to you during your episodes.

oh, this is kinda old, but...2 prescriber people have brought up amoxapine to me. it -is- techically an antidepresant, a tricyclic at that. but..there's very limited data showing that high(ish) doses can act a lot like 'atypicals,' but with more pronounced effects on mood and anxiety. probably not something you're interested in, but i thought id throw it out there, just in case.

lyrica? i think its extra-strength gabapentin. more popular in the EU. long term use requires careful tapering, just like a benzodiazepine. i dont know if the discontinuation situation is any better than the benzodiazepines, but...some mood disordered people take it and rather like it, it seems.

sorry you're dealing with all this. hope this helps a bit. :-)

Vraylar came out 2 years ago, I've been taking it for a month and it has been great. It's an antipsychotic, it's not generic yet though

Thanks, Still_Crazy and Blue_Bird! Vraylar is likely going to be one that my psychiatrist puts out there. I have a strong feeling about that. I have heard good things about it. I've seen it advertised on TV, too. I did hear it's expensive. That's a bummer since right now all of my meds are generics. I guess if I'm going to try something new I have to expect brand co-pays.

Rexulti, Saphris, and Fanapt? I'm not excited about the Saphris because it's not a pill. I heard it tastes horrible. I know almost nothing about Rexulti and Fanapt, but have heard the names. I'll wait to see what my psychiatrist says. He has in the past mentioned Latuda, but is it also good for preventing/easing mania? It has always sounded more like bipolar depression medication.

Trileptal was not effective at the time I took it. Tegretol XR seems to work better for me. I take it despite interactions. That just means my doses have to be higher/lower with them. I do have to use different birth control because of it.

That's an interesting aspect about the amoxapine. I am just very scared of anything hinting at antidepressant. Antidepressants have always meant psychiatric hospital for me. I haven't really been seriously depressed for a long time. I do have mixed periods, though. I'd think that if I tried amoxapine that I'd have to be on a hefty dose of an actual antipsychotic with it. My psychiatrist wants to try something different than Seroquel XR (or lower my Seroquel XR a lot) to help improve my blood work and weight gain.

I'm afraid of trying anything new for fear of major destabilization. I haven't been in the hospital for over 8 years, though I have had some serious episodes since then. And boy, I do not want hyperprolactinemia again, or akathisia, or more weight gain, or dystonia, etc. However, I'm still not fully functional on what I'm taking. I guess I must take some risks to try to move forward further.

hi. i had an acquaintance who was the same way...trileptal was a no go, tegretol was her main mood drug. honestly, trileptal was never approved for mood disorders, and most of the data comes from force feeding it to hospitalized people in other countries, so...yeah. for me, it was basically a glorified sedative, and then the dose was too high and I got seriously slowed down, lethargic, etc. but...some people swear by it.

i think latuda is like a lot of neuroleptics...higher doses=antimanic. oddly enough, abilify has relatively solid data for antimanic effects (Full dose), schizophrenia+schizoaffective (full dose, usually higher than bipolar I), but...even when used w/ an antidepressant, the data for depression is surprisingly...disappointing. and yet, its a best seller. go figure, right?

i just mentioned the amoxapine because its generic, fairly inexpensive, and some people apparently do well on it...but i think the studies w/ higher doses vs risperidone were done in less affluent nations, on people with Schizophrenia...the idea was to save $$$ by -not- using an atypical.

i knew of a dude on keppra. i dont know much about it, but i did read its got a rep for -causing- some mood instability...but I think he was also on lithium.

gabapentin, -with- standard drugs, is supposedly somewhat helpful in 'hard to stabilize forms of bipolar I,' according to my current prescriber. i think she just wants me on a sedative, but...whatever...

sorry you're going thru it. good luck!

Thanks for this thread BD. I have been looking for something that would allow me to cut out Wellbutrin, which sends me up too high so I really want this thread on my subscribed list that I look at every day. I was afraid to trust my current doc for a meds change and now its out of the question because she inadvertantly prescribed twice my correct dosage of Xanax. I hit a sign and had to pay $250 for a new side mirror for my car. A new low in my lack of trust issues with pdocs, LOL
Sorry you have hit some speed bumps in your treatment as well. Hugs!

still_crazy, I had also heard of keppra, but think it's not that frequently used. I really think my pdoc is thinking of antipsychotics and not anticonvulsants. My history seems to be that antipsychotics are what keep my mania in check. Neurontin/Gabapentin would be an unlikely choice for me. I don't think it's efficacy for bipolar is that well established. Plus, I took it for a week years ago that led to a psychotic mania.

luvyrself, that's horrible about the Xanex. I had a similar thing happen after an acupuncture treatment. My pdoc then ordered me to stop the acupuncture. I did, but that ended up possibly being the beginning of the end of a friendship. My friend's husband had been giving them to me for free. When I stopped them, he got pissed off.

Hi There,

I have a different diagnosis, but I do have the Bipolar Type of Schizoaffective Disorder. In case you don't know Schizoaffective Disorder is when a person has symptoms of a mood disorder either major depression or bipolar as well as prominent elements of schizophrenia. It's different than bipolar disorder with psychotic features and major depressive disorder with psychotic features although there are similarities, there's Schizoaffective Disorder Depressive Type and Schizoaffective Disorder Bipolar Type. I also have Post Traumatic Stress Disorder with Dissociative Features added. So I've taken different antipsychotics.

I currently take the Abilify shot once per month which helps more than the pills were and Rexulti in pills daily which has really helped. Rexulti is to my understanding a couple of years old or so. It's the same type of medication. It helps with the psychosis and with the dissociation (checking out). Of course I don't know if it will help you and I'm not a medical professional. But that's what I'm doing. Also, the Psychiatrist says that eventually, I might be able to go off the Abilify shot which makes me nervous but certainly would be nice.

Also, I take Lithium, Lexapro as an antidepressant I remember you saying you can't do that I think, Trazodone for sleep which is an anti-depressant but it works better as a sleep aid and doesn't have an anti-depressant effect on me, then I take a high blood pressure med for nightmares. I know I'm on a lot.

I hope this message helps and I hope that you find something that helps you.