SOCIALIZATION FACTOR (PART 8)

DESCRIPTION OF STABILIZATION MEDICATIONS.

8) Medications to treat destabilizing effects of prosocializing medicines. Antipsychotics and mood-stabilizers.

8- A) The antipsychotics. The most significant medications are the antipsychotics -- the atypicals -- which can both activate and treat psychosis—and the typicals which treat psychosis.

8-A1) Typical antipsychotics. The typicals are the older drugs which are dopamine blocking. The can lower psychotic symptoms and do not activate as do some of the atypicals. However they cause side effects – especially tardive dyskinesia which is sometimes irreversible.

8-A1.a) Haloperidol/ Haldol. This is the most used of this class. It has the advantage of coming in many dose sizes so that it can be very carefully dosed to only the necessary minimum. Others of this class. fluphenazine/ Prolixin, thiothixene/ Navane, loxapine/ Loxitane, perphenazine/ Trilafon, molindone/ Moban. Two others thioridazine/ Mellaril* and chlorpromazine/ Thorazine* have different side effect properties which are sometimes useful because of their antihistamine sedation and alpha-1 blocking effects. Another, pimozide/ Orap* may have some special benefit for particular psychotic obsessions. ( * These three may cause potentially dangerous EKG changes.)

8-A2) Atypical antipsychotics. These have been covered in section 7-A) In general, the less activating ones are used to treat the psychotic breakthroughs of the prosocialization meds, but only clozapine/ Clozaril seems completely free from the potential of causing too much social activation.

8-A3) Dopamine depletors. The medication Demser (AMPT) and reserpine sometime are added to antipsychotics for certain psychotic dissociative states.

8-B) Mood stabilizers for treating over-activating effects of prosocializing medicines.– Currently Lithium and certain anticonvulsants are considered to be mood stabilizers of true bipolar mood swings. They also seem to stabilize behavior in the various disorders which are marked by changes in aggressiveness, defiant behavior, and disinhibited social activity.

8-B1) Mood-stabilizing anticonvulsants. The two most proven of the anticonvulsants are valproate/ Depakote and carbamazepine/ Tegretol. Oxcarbazine/ Trileptal is frequently used instead of carbamazepine/ Tegretol with the presumption that it is as effective. Of these, valproate/ Depakote is used most often not only for stabilizing true bipolar mood swings but also in situations where impulsive behaviors which look like “mood swings” are from other causes.

8-B2) Lamotrigine/ Lamictal This anticonvulsant s approved for treatment for bipolar disorder – but it also has the reputation of helping bipolar depression. It can at times cause a manic-like arousal. There are some clinicians who may have seen prosocialization effects with improved talking – but madisondoctrine has no direct experience.

8-B3) Lithium—The original mood stabilizer. It has a mild antidepressant effect. It is often added to antidepressants to treat unresponsive depression. If the individual is a true bipolar, sometimes adding the lithium can cause a state of mania or hypomania. In general, Lithium seems to add to stability and not cause over-arousal.

8-B4) “GABA acting anticonvulsants.” This is a loosely clustered group of anticonvulsants which have not proven that reliable for mood stability, but seem to have sometimes stabilizing antianxiety properties These are tiagabine/ Gabitril, levetiracetam/ Keppra, gabapentin/ Neurontin, pregablin/ which is not released yet. There needs to be more experience in the use of these medications to evaluate their ability to treat anxiety, mood stability and the socialization factor.

8-B5) Other stabilizing treatments: As outlined in this website’s section on autism, treatment of other behavioral symptoms can improve social maturation. Stable programming, treatment of rage, giddy disinhibition, obsessive-compulsion can contribute to social improvement – but are not as foundational as the basic stabilization of mood and treatment of psychotic thinking.

8-B6) Psychosocial, behavioral treatments. There is no question that individuals who have had good programming will be able to break the socialization barrier more easily. Likewise, an individual is more likely to have mood stability when living in a stable environment. The seeming higher “cure” rates of the intense programs point to a significant benefit that is possible from social activity that has not been scientifically defined as yet.