I thought Asenapine was doing it, but not at the cost of 3 kilos gain per week.

So,

- two overdoses in history, the first one nearly lethal

- racing thoughts a big issue and I only learned to recognize them this past summer. Mixed states with racing thought speed and depressed thought content.

- self-harm during a break from reality when not on antipsychotics, classified as the second suicide attempt because it could have led to death, but in my mind I was killing my voice in self-punishment by forcing myself in chew on and ingest OxyClean (=laundry detergent booster)

In general, organically I tend to highs and my depressions are all situational. Can be very deep, but always situational. Highs can be without reason. So this is strongly Bipolar I, with Psychotic features.

Sleep is a huge issue.

My late mother had Bipolar, without suicide attempts. I am a victim of CSA, she was not. She had more depressions, longer depressions. Essentially was addicted to Amitriptyline and tranquilizers. Suffered huge weight gain from Amitriptyline. Combined alcohol with tranquilizers (alcohol has not effect on me and neither do tranquilizers). Had tardive facial dyskinesia in the form of a tic that got worse when she was anxious. Reportedly a side effect of thorazine. Took other first generation antipsychotics.

In more than 10 years since diagnosis, I tried:

- Depakote - severe weight gain, paradoxical tendency towards hypomania unless combined with Lithium, low platelet count and severe hand tremor

- Lamictal - causing highs, insomnia.

- Seroquel - regrettably, almost caused QT-prolongation, otherwise was a good drug when combined with either Gabapentin or Atarax to ameliorate akathisia/knee jerks

- Risperdal - caused extremely deep and at times psychotic depression, pre-Diabetes and anorgasmia/vaginal dryness, Parkinsonism that was managed with Cogentin. The worst depression happened on Risperdal and essentially wiped out cognitive abilities and insight into self in that I was not able to identify that I was depressed and that depression was iatrogenic essentially. Went on for many months. Happened two times in my life. Second time I ended up in a psychotic suicidal mixed state that Geodon relieved in a matter of couple days. See below on Geodon for maintenance.

- Geodon - was side-effects-free at lower-to-medium doses but at a high dose (in combo with other drugs) caused a very scary episode of acute facial dyskinesia - my tongue moved rhythmically in my mouth and then wrapped around the upper lip. Also, did not cause enough sedation upon getting used to it and did not work effectively enough. I had breakthrough symptoms

- Lithium - abnormal creatinine (kidney function test), acne that persists upon discontinuation but is manageable with retin-A and benzoyl peroxide, hypothyroidism that persists upon discontinuation and I have to take Levoxyl for life now, weight gain (not major), erosion of foot enamel; was not effective and I had a lot of breakthrough symptoms.

- Tegretol - a tiny dose gave me supreme serene mood, but I had skin rash that did not respond to any antihistamines. Also had congestion, but it went away. The skin rash was not dangerous in that it was dry, but it was not tolerable. Even combos of antihistamines were not effective.

- Abilify - was not effective at all for hypomania. Caused word finding difficulty that persists upon my discontinuing (after about of month of taking it, I discontinued in late November but still have word recall problems). Also had one episode of loss of control over speech / facial muscles that was scary.

- Asenapine - severe weight gain

- Olanzapine - severe weight gain

- Tranquilizers do not work at all (I am kind of glad since I cannot become addicted)

- Gabapentin helps with sleep, but not with mood. I love it because when I take it, I have dreams as in normal, unmedicated sleep.

- Trazodone helped with sleep, then stopped working. I restarted once and it did not work. Now I am restarting again and it seems to work, although in combo with other drugs currently it is hard to tell.

- Atarax. Helped with sleep, then stopped working. After awhile started working again and is an option.

- Amitriptyline - severest weight gain. Plus, since the main issue is highs and I become unmanageably creative on it, it is not my drug for sure.

- Prozac smallest dose. Helped with situational depression and suicidality, but overdid it.

I have not tried Latuda or Vraylar. Concerned that they would cause hypomania and insomnia.

I have not tried Trileptal. Concerned about the suicidal risk warnings.

I have not tried Clozaril. Concerned about severe weight gain and the white blood cell count.

I can try the above (Latuda, Vraylar, Trileptal, Clozaril).

Have I missed anything? I cannot tolerate Topamax which I tried for migraines - I had severe dizziness, complete anorgasmia, aversion to food and drink with the resultant spike in migraines since my main trigger is dehydration, and general malaise, all at the smallest dose.

My daughter has epilepsy and migraines. I do not have epilepsy. I have heard of people using Keppra for bipolar off-label, even though it is only approved for epilepsy.

I manage migraines effectively now with BOTOX, promethazine, indocin and imitrex.

I just got approved for SSDI. Approval came in less than two months. I know this is highly unusual.

I feel demoralized. Asenapine worked just fine and I felt great, but I went up from 100 to 108 kilos and I was already obese. I am 165 cm (5'5'').

Would appreciate any pointers.