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Does Trileptal Help With Impulsive Behavior in Bipolar Disorder Level 1?

Trileptal was not developed as a treatment for bipolar disorder, but it has shown some promise in controlling certain symptoms associated with level one, also known as type one, bipolar disorder. Its usefulness in specifically managing impulsive behavior is unclear, but it can help make manic episodes easier to tolerate.

  1. The Facts

    • Trileptal is an anti-seizure medication usually used to treat epilepsy in both children and adults. In the case of adults, it is most useful for adults who suffer from partial seizures. Trileptal is generally well tolerated, although dizziness, nausea, fatigue and tremors are possible side effects. About nine percent of adult patients discontinue its use because of the side effects.

    Trileptal and Bipolar Disorder

    • In level one bipolar disorder -- bipolar disorder in which the patient has experienced at least once manic episode -- seizures are possible. Seizures typically come on during periods of mania in the form of uncontrollably shaking limbs. Trileptal's ability to ease seizures is what has made it appealing to doctors treating bipolar disorder. Further, Trileptal is similar to another bipolar treatment, Carbamazepine, but has fewer side effects. Carbamazepine lowers white blood cell levels and puts the patient at risk of developing serious infections. Trileptal does not have this side effect.

    Effectiveness

    • There have been two major studies into the effectiveness of Trilepal in treating bipolar disorder. The Journal of Clinical Psychology published a report in 2003 that said Trileptal was well tolerated and helpful to about half of bipolar patients in controlling symptoms. However, in 2006, another study by the American Journal of Psychiatry seemed to contradict those findings. That study found that Trileptal was not significantly more effective in controlling symptoms than a placebo.

    Impulse Control

    • In the US, Trileptal is only approved for use as an anti-seizure medication, although doctors frequently use it for bipolar disorder. The drug has been used successfully in Europe, specifically for mood stabilization, since the 1990s. Trileptal can help reduce seizures during manic stages, but there is only anecdotal evidence demonstrating it helps manage other parts of manic stages, including impulse control. As Trileptal works by increasing the amount of GABA (gamma-aminobutyric acid) in the brain, thereby slowing down the transmission of nerve signals that cause agitation during manic periods, doctors believe that it can help with more than seizures for some bipolar patients. Determining whether it will work for you depends on trial and error under the management of your doctor. Your doctor will decide whether you should try this medication based on your bipolar symptoms and medical history. Note that this medication is not used to treat level two bipolar disorder as doctors do not believe it helps treat depressive stages.

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