Mood Stabilizers are either Glutamate blockers, such s Lamictal® or Lamotrigine, GABA stimulators, such as Valium® or Alcohol or both, Topamax®.
Lamotrigine is a mood stabilizer. It has traditionally been used in Epilepsy and Bipolar Disorder to stabilize the erratic brain activity that leads to seizures and mania. Lamotrigine is not used for treating ADHD per se, but Lamotrigine can make it safer to use stimulant treatment in High Risk ADHD.
High Risk ADHD starts with what we call "co-morbidity". That means that besides ADHD, about 2/3 patients with severe ADHD also have other symptoms that are impairing their function in life.
Mood and and behavioral instability (MBI) is a relatvely common co-morbidity in ADHD. It occurs in about 1/3 patients with ADHD. It can make treatment with stimulants very tricky and for most physicians, this would be the kind of concern that would trigger a referral to an ADHD specialist.
Mood and Behavioral Instability is sometimes called "Affect Dysregulation". However, that term does not say anything about behaviour.
When we use Lamotrigine in High Risk ADHD, we are aiming, not only at stabilizing mood, but also at stabilizing behaviour, specifically, decreasing the craving, impulsivity and relapses that are seen in addiction and impulse control disorder.
If you give Lamotrigine to people with ADHD plus mood and behavioral instability (MBI), you substantially decrease the likelyhood that stimulant medication is going to cause major side effects (See the poster presented at the 3rd International Congress on ADHD in the Recent Presentations section).
When we use software to analyze the responses of people on Lamotrigine, the usual response from about 80% of patients is as follows:
1. I feel more stable.
2. I feel more on an even keel.
3. I am less irritable and agitated.
4. I am less impulsive.
People with Addictions will also say:
1. I don't have as many cravings.
2. When I do have cravings, I can put them out of my mind more easily.
3. When I give in to cravings, I use less and less often.
If I do use my usual amount, I feel unwell.