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    Includes Expert Content
    Is depakote 1st or 2nd line of defense? (bipolar 1 with dellusions) what about limictal as a mood stalblizer??
    reneegigliotti responded:
    Good Dr. G question.
    Joseph F Goldberg, MD responded:
    Dear blessed, Depakote and lithium are both considered the traditional first-line treatments for mania. Neither alone treats psychosis (delusions, hallucinations) very well though so an antipsychotic often gets added. Nowadays the pharmaceutical manufacturers of atypical antipsychotics advertise their branded products quite heavily to doctors and patients alike, leading to probably a much wider misperception that antipsychotics are routinely first-line over lithium and Depakote...which are generic drugs and therefore don't get their rightful airplay. Lamotrigine has little if any antimanic properties and no antipsychotic properties. Its role would mainly be for preventing depression relapse. Dr G.
    blessed8991 replied to Joseph F Goldberg, MD's response:
    wow!!!! really...lamictal is mostly for depression instead of mania or both...that is helpful. I do think I will change back to depakote or at least discuss it with my doc. What do you think of latuda?? I currently take abilify and saphris...both very low doses. Thanks!!

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