The Matthews Protocol for DMDD: A Comprehensive Guide
Introduction:
The Matthews Protocol has emerged as a significant advancement in the treatment of Disruptive Mood Dysregulation Disorder (DMDD) and other related mental health conditions. Dr. Danish has been utilizing the Matthews Protocol for years, adapting it with his own variations to achieve great success in patients who do not respond to the original approach. The Matthews protocol utilizes amantadine (Symmetrel) and oxcarbazepine (Trileptal), two medications that generally carry a lesser burden of side effects compared to other neuroleptic mood stabilizers frequently employed in managing DMDD.
This guide provides an overview of the protocol, its effectiveness, approach to treatment, potential side effects, contraindications, and its off-label benefits. It also explores how these adaptations can offer additional therapeutic options, enhancing the protocol's flexibility and applicability to a broader range of patients.
Effectiveness of the Matthews Protocol:
The Matthews Protocol has shown a consistent success rate of over 75% in treating DMDD by addressing the root cause of the brain abnormality using anti-epileptic medications. This high success rate underscores its effectiveness in stabilizing patients and reducing the need for hospitalization.
Approach to Treatment:
The Matthews Protocol involves a phased introduction of medications, beginning with Amantadine and followed by Trileptal (oxcarbazepine). This method helps in pinpointing any side effects and understanding their causes more effectively.
Starting with Amantadine:
For children under 100 lbs, treatment begins with a dose of 25 to 50 mg each morning, which is increased by 25 mg every 5-7 days.
Common side effects include dizziness, insomnia, and nausea. It is important to monitor these effects closely to adjust the treatment as necessary. Please read our blog here to learn more.
Introducing Oxcarbazepine/Trileptal:
Trileptal, also known as oxcarbazepine, is an anti-seizure medication that can help both bipolar disorder and disruptive mood dysregulation disorder. .
Some potential side effects include dizziness, fatigue, and a risky rash that requires particular attention, especially in individuals of Asian descent. Please read our blog here to learn more.
Alternative Medications:
In certain cases, patients may not respond well to amantadine or Trileptal due to various factors such as side effects or lack of efficacy.
To accommodate these individuals, we explore alternative medications, including substituting memantine in place of amantadine. For more information on memantine, visit our blog here.
Similarly, for those who may not tolerate or benefit from Trileptal, we consider using lamotrigine as an alternative, aiming to achieve the desired therapeutic outcomes while minimizing adverse reactions. For more information on lamotrigine, visit our blog here.
FDA Approval and Off-label Benefits:
The Matthews Protocol uses medications that are FDA-approved for other conditions but are used off-label in the treatment of DMDD. Research supports the off-label use of these medications due to their effectiveness in stabilizing mood and reducing irritability in affected patients.
Sources:
https://www.rdmdd.org/drmatthews-tribute-rdmdd
https://www.mindalignpsych.com/blog/implementing-the-matthews-protocol-for-dmdd-at-mind-align-psychiatry
https://www.nami.org/About-Mental-Illness/Treatments/Mental-Health-Medications/Types-of-Medication/Oxcarbazepine-%28Trileptal%29
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2686935/
Conclusion:
At Philadelphia Integrative Psychiatry, we specialize in diagnosing and treating DMDD and related disorders. Our holistic and integrative approach ensures that we consider all aspects of our patients' well-being in developing personalized treatment plans. If you or a loved one are seeking support for DMDD or similar conditions, please visit our website www.phillyintegrative.com or contact us 610-999-6414 to begin a journey toward balanced and comprehensive mental wellness.
