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Available on Amazon:  Cafer's Mood Stabilizers and Antiepileptic Drugs Lumateperone (CAPLYTA) Pronunciation: luma TEP er ohn / cap LIE ta  “’Lum inated Cap lighter” Antipsychotics are represented  with spooky mascots. Year of US release: 2020 ❖ Antipsychotic (SGA) ❖ D2 antagonist - ⇩DA ❖ 5-HT2A antagonist - ⇧DA ❖ Glutamate modulator FDA-approved for:  ❖ Schizophrenia Lumateperone is a new antipsychotic that purportedly modulates glutamate in addition to the usual SGA mechanism of blocking D2 and 5-HT2A receptors. However, the official prescribing information does not mention glutamate, suggesting the FDA saw insufficient evidence for lumateperone being a first-in-class novel antipsychotic. It appears to be equally effective as risperidone (Risperdal) with fewer side effects other than sedation (Citrome, 2016). Lumateperone’s D2 receptor occupancy is lower than most other antipsychotics. This means extrapyramidal side effects are unlikely. The other antipsychotics with

Excerpt from  Cafer's Mood Stabilizers and Antiepileptic Drugs Topiramate (TOPAMAX)  toh PEER a mate / TOH pah max “Top at max (speed on) Top (of) pyramid” ❖  Antiepileptic   ❖ Voltage-gated sodium and calcium channel blocker    ❖ Glutamate ⇩ FDA approved for:   ❖  Focal seizures   ❖ Bilateral tonic-clonic seizures   ❖ Lenno x-Gastaut syndrome  ❖ Migraine prophylaxis  ❖ Obesity, long-term tx  (in combination with phentermine) Used off label for: ❖ Alcoholism (relapse prevention)  ❖ Bipolar disorder (adjunct)  ❖ Weight loss (monotherapy)  ❖ Binge eating disorder  ❖ PTSD Nightmares Topiramate is prescribed by psychiatrists for several off-label uses. The most compelling data is for preventing alcohol relapse . Although not FDA-approved for alcoholism, it is recommended in the 2015 US Veterans Affairs guidelines for moderate/severe alcohol use disorder.  Nicknamed "Dopamax” or “Stupamax”, topiramate commonly causes cognitive problems including “ brain fog ”, psychomotor s

Excerpt from  Cafer's Mood Stabilizers and Antiepileptics Levetiracetam (KEPPRA)   Pronunciation: LEE ve tye RA se tam / KEP ruh “Levitate Keeper”   ❖ Antiepileptic  ❖ Inhibitor of glutamate release FDA approved for: ❖ Focal seizures (adjunct)  ❖ Juvenile myoclonic epilepsy (adjunct)  ❖ Bilateral tonic-clonic seizures (adjunct) Used off label for:  ❖ Other types of seizures Levetiracetam entered the U.S. market in 2000 as an AED with a novel mechanism of action. It binds SV2A, a synaptic vesicle glycoprotein. This reduces the release of glutamate, the brain’s principal excitatory neurotransmitter, thereby preventing hypersynchronization of epileptiform burst firing. Levetiracetam has become one of the most prescribed medications for the treatment of epilepsy. It is not prescribed by psychiatrists . Advantages of levetiracetam as an AED include efficacy for a broad-spectrum of seizure types, lack of cognitive impairment , and  lack of drug interactions . It can be started at an e

Excerpt from  Cafer's Mood Stabilizers and Antiepileptics Zon is amide (ZONEGRAN)  Pronunciation: zoe NIS a mide / ZAHN uh gran “Zone is mighty, Zone is grand” ❖ Antiepileptic  ❖ Voltage-gated sodium channel blocker  ❖ Glutamate ⇩ FDA approved for: ❖ Focal seizures Used off label for:  ❖ Other types of seizures  ❖ PTSD nightmares  ❖ Sleep-related eating disorder  ❖ Obesity  ❖ Binge eating disorder  ❖ Alcohol use disorder  ❖ Migraine prophylaxis  ❖ Parkinsonian symptoms associated with Lewy body dementia Zonisamide (Zonegran) is a broad-spectrum antiepileptic drug (AED) that blocks sodium and calcium channels and increases dopaminergic and serotonergic transmission. It is unrelated to other antiseizure medications.  Zonegran can cause weight loss: Zonisamide decreases appetite and has been shown to decrease binge-eating. Cognitive impairment including “ brain fog ”, confusion, difficulty concentrating, and word-finding difficulty are relatively common. It is not used as a moo