Retired pharmacist Larry DiBello, RPh, talks about new medication

Larry DiBello was a guest speaker at the NAMI Main Line Group in November, 2014 .

Click here to view his presentation online. 

He also spoke to New Directions on Jan. 20, 2015.

He and I met for dinner at the Kitchen Bar before his talk. We each had salmon.

The man is a great raconteur. He told me his son, also Larry DiBello, is a renowned French horn player.

He and his wife Anna leave for Florida in February after his round of talks up north. Larry was looking f/w to going on "Grand Rounds" at Friends Hospital the next day.

"I learn so much," he said, while sipping on an espresso. He said it doesn't make him tired. He has a triple shot before bed.

Here is a summary of his talk. He notes that few new medications are available, as you'll read below.

NEW MEDICATIONS

Retired pharmacist Lawrence “Larry” A. DiBello, RPh, is always a popular guest speaker at New Directions. 

He admits that there are very few new meds available.

Here are excerpts from his presentation in January, 2015.

All medications that affect the central nervous system should be titrated (weaned), both when they are started and when they are discontinued. This is because nerve endings change slowly.

A teaspoonful is 5000 mg.  

SLEEP

Oleptro, is long-acting Trazodone, with an initial dose of 150 mg. May be titrated to 375 mg daily for sleep.

Silenor, low-dose doxepin, for sleep. Lasts 8 hours. Low side effects. No hangover.

Ramelteon, a sleep agent, is being studied for bipolar disorder. Rozerem sublingual, melts under the tongue, is also being tested.

DEPRESSION AND MOOD STABILIZATION

Mirapex or generic pramipexole is used in the treatment of Parkinson’s disease as it increases dopamine in the brain. In several studies it’s been found useful to treat bipolar depression and unipolar depression.

Provigil and Nuvigil, for narcolepsy, are being looked at for bipolar disorder depression and regular depression.

Stavzor – delayed release Valproic Acid (Depakote) is easier on the stomach.

Pristiq-Desvenlafaxine long-acting Effexor may be taken once daily for depression.

Aplenzin (bupropion) is long acting for depression.

Abilify Maintenance Injectable - long-acting Abilify lasts 30 days. All antipsychoitcs have “depo” or “injectable” forms.

Folic acid is a B vitamin that is helpful for depression. Most experts feel that 1.2 mgs per day help. The normal amount of folic acid in multivitamins and B Compex is only 0.4 mgs.

Deplin-L Methyl Folate 15 mg, is a much more active form of Folic Acid and other B vitamins. Generic is now available.

Omega 3 Fatty Acids also help elevate the mood. The best fish oil is the 1400 mg formulation, available at Walgreens and Walmart.

Beta Endorphin is a neurotransmitter found naturally in our bodies. It’s produced when we exercise, which all medical experts agree helps depression. It produces a mild euphoria and acts as an analgesic (pain reliever).

SOCIAL ANXIETY

Intranasal pherines for social anxiety disorder – a synthetic neuroactive pherine targets nasal chromosensory receptors.

MOOD CHARTING

Mood charts are available on the Internet through a search engine. Provides a simple means of generating a graphic representation of the changes in your illness over the time since your last doctor visit.

Allows patients and caregiver a systematic way to bring together important pieces of info such as: a record of medication being taken, mood changes, major life events affecting mood, helps patients see emerging patterns that may otherwise be difficult to discern.

Lawrence A. DiBello of Springfield, PA, volunteers at the Friends Hospital Resource Center. To ask him questions about medication, email him at

LarryDiBello700 @ me.com or leave a message at 215-514-5110.