BethRags and Soupe du jour,

Thank you for your welcoming responses to my post. I appreciate the fact that both of you took the time that you did to read my post and respond to it, and I found the messages that both of you wrote to be supportive.

To respond to the question that BethRags asked, probably the biggest problem that I've noticed with antipsychotic medications is that they do a lot to impair my cognitive functioning, even though the overall effect that they exert on my cognition is mixed. It's also the case that basically all of the antipsychotic medications that I took significantly worsened my depressive symptoms when I kept taking them for long enough. It was even the case for me that two of the antipsychotics that I took (Seroquel and Geodon) worsened my manic symptoms and my psychotic symptoms in a way that was intolerable early into my trials with the medications, despite the fact that I'd still say that the antipsychotics that I've taken have generally helped to reduce the severity of my manic symptoms and my psychotic symptoms.

I found Abilify to be the most tolerable of the antipsychotic medications that I've taken and took the Abilify dose that I found to be the most tolerable (5 mg) for about 7.5 years. However, the years that I spent taking Abilify were very frustrating years for me, with the functional impairment that I experienced during that time having been very significant both because of how the medication affected me and because of the mental illness symptoms that I still had to deal with (mostly cognitive dysfunction and depressive symptoms) despite what the medication was doing. I tried taking a few other medications and a very large number of dietary supplements during the time that I spent taking Abilify to try to improve the treatment response that I had with Abilify, but I didn't succeed in doing much to improve my response. Another problem that I've experienced that's likely tied to having taken Abilify is that I've developed neurological symptoms that the neurologist that I see basically diagnosed as parkinsonism. It's been more than five years since I stopped taking Abilify, but the neurologist that I see has told me that he suspects that Abilify was involved in causing the parkinsonism that I still experience.

So, what I've written above basically sums up a lot of the problems that I've experienced in connection with the antipsychotic medications that I've taken. I still can't rule out the possibility that antipsychotics might play a helpful role in the treatment of my mental health problems at some point in the future, but right now, I'm focusing on trying other medications that are more likely to be beneficial to me (most notably the anticonvulsant mood stabilizers and certain antidepressants). I do think that the antipsychotic-centered treatment approach that I followed previously in some ways interfered with me getting the treatment that I needed for my mood disorder symptoms, but I can't be sure that following a treatment plan that involves taking an antipsychotic medication is something that I'll never do again.

To respond to the questions that Soupe du jour asked, I am seeing the psychiatric treatment professionals that I see on a regular basis. The main psychiatric treatment professional that I see is a physician assistant, but she works with a psychiatrist who was involved with diagnosing me at my initial appointment at the treatment center that I go to, and I can talk to the psychiatrist that my physician assistant works with if I need to. I have an appointment with the physician assistant that I see coming up in about two weeks, and even though I don't know what prescribing decisions the physician assistant will make, I expect that she will need to make several medication adjustments before I'll be able to get the sort of medication response that I'm hoping to achieve. So, meeting with the psychiatric treatment professionals that I see on a frequent basis certainly is something that I'm expecting to do early into the process of seeing the professionals that I'm currently seeing.

With respect to what Soupe du jour asked about how things are for me currently as far as my mood state is concerned, I think that I'd say that I'm in my usual mixed affective state that basically consists of experiencing manic symptoms that are superimposed over the anergic depressive symptoms that I usually experience. Some of the manic symptoms that I find to be particularly problematic are distractibility, psychomotor agitation, irritability, and racing thoughts, but the way I usually experience my bipolar symptoms involves me needing to contend with the symptoms that I listed above (along with depersonalization and derealization that I also experience) with a level of energy for my own conscious thinking that is diminished due to my depressive symptoms. I will say that even though I'm currently contending with the same mixed affective symptoms that I usually contend with, the Depakote that I'm taking is helping to improve my cognition and reduce the severity of my manic symptoms.

Thanks again to both of you for your responses to my post.

shadow2000