My husband developped a strong skin reaction to carbamazepine for bipolar. He discontinued it. The doctor wants to put him on valproic acid (depakote), but he ( my husband) is not willing to try a third medication and would rather return to lithium that gave him unconfortable feelings. Which one is best with least side effect to treat bipolar mania. Hope someone will be able to help me.
There is no way to tell you which is best. Everyone reacts differently to these meds. Did the lithium help him? Depakote is a good drug for many people. Its what he's willing to try.
Due to the nature of these meds their effectiveness is very individualized and there is no way of telling (especially from the Internet) what will and will not work, which side-effects (if any) will be experienced, etc.
However, based on the information in your post, it is obvious we do not want to continue a medication that gives us a skin reaction, nor resume one that we already know generates "uncontrollable feelings."
Neither one of those is an option as the goal is to stabilize, not intentionally take something that results in the obvious. Seems the third option is the only option, again, based on your information.
I can understand your husband's reluctance to try another medication but often with Bipolar we have to try different meds to find the right one for us. I had the skin reaction to carbamazepine too and it was scary to try another med after that but I did. I was on the generic Valproic Acid version of Depakote and it caused me ongoing intestinal issues so we changed me to the generic divalproex sodium sodium version which is another form of the same med and it has made a huge difference without all the nasty side effects.
I would suggest asking the doctor for this form of the medication to minimize side effects. There are some start up side effects of course but not as bad as some medications and less than the Valproic Acid version. Also this med has been used a very long time (almost as long as lithium) so there aren't any unexpected surprises as long as you get regular blood work which is the same as with lithium.
Take care and be well
- Depakote Drug Information
- Carbamazepine Drug Information
- Lithium Drug Information
- Valproic Acid Drug Information
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