Bipolar Disorder/Riluzole

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Question
Hi Dr. Goldberg,

I was curious if you have ever prescribed Riluzole in a psychiatric context? I was recently given the drug for TRD and OCD.

Unfortunately, there is a paucity of information/experiences online; plus my own prescribing doctor has never used the drug before and the PI sheet does not list possible psychological side-effects.

The reason I was writing is because after 4 days on the standard dose of 100mg, I have noticed an increase in activation/agitation and was wondering if you were aware whether or not this might be a transient side-effect? I cannot find anything regarding mood disturbances related to Riluzole online.

Thank you

Answer
Hi David . . .

I am sorry for the delay in getting back to you but I was suddenly called out of town.

Riluzole has at times been very useful in treating individuals with hard-to-treat depressions. The usual starting dose is 50 mg twice a day but some people need to take twice that amount to get a good antidepressant effect. The side efects that my patient have developed have been gastro-intestinal . . . nausea and vomiting. I have never seen agitation/activation, but can imagine such side effects from such a medication.

I have recently been referring patients with hard-to-trerat depresssions for ketamine infusions, as they are much more effective than riluzole.

Best regards . . .

Ivan

Bipolar Disorder

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Ivan Goldberg, M.D.

Expertise

I am a psychiatrist/psychopharmacologist with many years of expereince in treating individuals with depressions, manic-depression (Bipolar Disorder), other mood disorders,. I am especially interested in the psychopharmacologic treatment of individuals with so called "treatment-resistant" syndromes.

Experience

I have been on the staff of the National Institute of Mental Health, Columbia's College of Physicians and Surgeons, and the Columbia-Presbyterian Medical Center. I am currently in full-time private practice in New York City.

A.B. Johns Hopkins University
M.D. N.Y.U. College of Medicine

I am the creator of Depression Central:http://www.psycom.net/depression.central.html

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