We ran into a former chief of the National Institute of Mental Health at the Bipolar Conference last June and asked him what his favorite treatment was for bipolar disorder.

Find out why Robert Post leans on three medications that start with the letter L.

Welcome to the Carlyte Psychiatry podcast, keeping psychiatry honest since 2003.

I'm Chris Aiken, the editor-in-chief of the Carlet Psychiatry Report.

And I'm Kelly Newsom, a psychiatric NP and a dedicated reader of every issue.

One sign that you're at a good site conference is the sight of a man who's prowling

the poster sessions with a wry smile notebook in hand, looking like a grey-haired Robert De Niro.

It's not Robert De Niro, though.

It's Robert Post, a former chief of NIMH who helped identify the mood stabilizing effects of anticonvulsants

and the kindling theory of bipolar disorder. For three decades, Dr. Post has been

broadcasting research updates at bipolar news.org, and his most recent articles there

summarized this year's Society for Biological Psychiatry Meeting and the Bipolar Conference

where we met up with him. We asked Dr. Post what his go-to treatment is for bipolar disorder,

and he answered, the three elves, lithium, lemotrogen, and lairazidone. Nuff said.

We covered lithium last week, and we've covered Lomotrogen a lot in these podcasts.

And there is evidence that lithium and Lomotrigine work better together than either alone.

But we haven't always had the luxury of prescribing that third L, Larisidone, brand name Latuda,

because every time we've reached for it, the insurers

would require us to try the patient on a generic antipsychotic like quatyapine or a lanzapine

floxidine combination, or even worse, sometimes they'd insist on an option like respiradone

that doesn't even have any evidence to treat bipolar

depression.

...