[JMIR]

Hi, I have a friend that takes just tegretol. He is completely functional, married, works etc. but he gets sick and gets sick is having to be hospitalized as he gets racing thoughts, somewhat paranoid and just deteriorates. It takes a few weeks to get him back on track, but it is just heartbreaking!! Anyone have any experiences with people they may know who has to be hospitalized that is on Tegretol? Ever have a neurological work up? Thanks!

[blueoctober]

Originally Posted by JMIR

Hi, I have a friend that takes just tegretol. He is completely functional, married, works etc. but he gets sick and gets sick is having to be hospitalized as he gets racing thoughts, somewhat paranoid and just deteriorates. It takes a few weeks to get him back on track, but it is just heartbreaking!! Anyone have any experiences with people they may know who has to be hospitalized that is on Tegretol? Ever have a neurological work up? Thanks!

I don't have experience with Tregretol, but unfortunately multiple hospitalization can be a real factor for a person diagnosed with BP even when he or she is on medication and is taking it as prescribed. It is quite a balancing act that our P-doc's have to take into account because they aren't only dealing with depression, but also the hypomania and/or mania. My P-doc and I have a line where I tell her I'm feeling good...... but not too good.

There are many different combo of meds for BP I have just recently had a switch from lithium to lamictal and for the past 3 weeks I have been feeling stable, but I know the symptoms will never dissapear.

It is heart breaking to see someone you care about experiencing a serious illness. Just know that he is in the safest place for him at that time. He is very lucky to have you as a friend.

[vjdragonfly]

JMIR. I have been on Tegretol, but it wasn't working for me. I haven't heard of needing a neurological work up for bp, but I'm not a doc. I know I have heard there are some conditions that can manifest itself as bp. Anyway, sorry about your friend. I hope he gets the help he needs.

Hey there. I am currently on Tegretol (400mg twice a day), and just got out of a 3 month hospital admission. However, I'm also on Seroquel and Abilify, so my situation is probably different from your friend's.

I did have 2 MRI scans done (due to my epilepsy) and I actually had some tissue damage on my frontal lobe. It wasn't enough for great concern, but at least something showed up.

I'm sorry about your friend. I hope he feels better soon.

[JMIR]

Hi Melissa, thank you for taking the time to respond. He is on Tegretol, Seroquel as well as two others, I do not have the names of those two, but for him I know Abilify was not helpful. It is such mix/match game to get the right combo of medication.

Any neurological connection with that work up with your condition. It is so odd that he can function so well for years and then, wham, just off the cliff goes his mental health!

Thank you! JMIR

[JMIR]

Originally Posted by vjdragonfly

JMIR. I have been on Tegretol, but it wasn't working for me. I haven't heard of needing a neurological work up for bp, but I'm not a doc. I know I have heard there are some conditions that can manifest itself as bp. Anyway, sorry about your friend. I hope he gets the help he needs.

Thanks for your time in reviewing my post and responding. JMIR

[JMIR]

Thank you for your kind thoughts! JMIR

Originally Posted by blueoctober

I don't have experience with Tregretol, but unfortunately multiple hospitalization can be a real factor for a person diagnosed with BP even when he or she is on medication and is taking it as prescribed. It is quite a balancing act that our P-doc's have to take into account because they aren't only dealing with depression, but also the hypomania and/or mania. My P-doc and I have a line where I tell her I'm feeling good...... but not too good.

There are many different combo of meds for BP I have just recently had a switch from lithium to lamictal and for the past 3 weeks I have been feeling stable, but I know the symptoms will never dissapear.

It is heart breaking to see someone you care about experiencing a serious illness. Just know that he is in the safest place for him at that time. He is very lucky to have you as a friend.

[JMIR]

Thanks! I am new to responding, so I hope everyone sees my responses to everyone taking the time to respond!! JMIR

[blueoctober]

JMIR I can recommend a great book for you to read called "Loving someone with bipolar disorder" by Julie Fast. It's an easy read and is very informative. Julie has BP and her co-writer is a MD. I hope your friend is feeling better soon.

[Parks]

Originally Posted by JMIR

Hi Melissa, thank you for taking the time to respond. He is on Tegretol, Seroquel as well as two others, I do not have the names of those two, but for him I know Abilify was not helpful. It is such mix/match game to get the right combo of medication.

Any neurological connection with that work up with your condition. It is so odd that he can function so well for years and then, wham, just off the cliff goes his mental health!

Thank you! JMIR

JMIR, you it the nail on the head when you said how much of a mix/match it is to get the right combo of meds. It is such an individualized thing as well. I personally found Tegretol, combined with some other meds, to be quite helpful. I was put on it as an alternative to Lithium, due to having manic episodes on the Lithium with a therapeutic blood level. After taking that for a number of years, and other meds as previously mentioned, I was switched to Trileptal due to that having less side effects. They are quite close in chemical structure.

I hope your friend finds the right combo and stabilizes. He is fortunate to have a friend like you who takes such an interest in his well being. I can only speak for myself, one doesn't forget that kind of support.

Originally Posted by JMIR

Any neurological connection with that work up with your condition. It is so odd that he can function so well for years and then, wham, just off the cliff goes his mental health!

About 5 years ago, that's how it was for me. Like falling over a cliff. No real explanation as to why things changed so drastically for me.

I've been on tegretol with some success although I've now been switched to lithium. Good luck to you.

[JMIR]

Hi thanks for your response. As follow up,

1.) How does the Trileptal work compared to Tegretol for you? My friend has always been on only Tegretol.

2.) Any change in blood work or metabolism that requires different/new medication combinations as you have gotten older?

3.) We struggle with what is next? Each time he has gotten sick, it has been a sudden change in behavior, complete disconnection/hospitalization, recovery etc.. BUT what can we do different in trying to catch it earlier to avoid hospitalization? He only does blood work 2 times a year, could it be every quarter to watch it, a neurological work up etc..

It is scary to go back to the same routine when he comes home, not knowing when it will happen again, what can we do to get are arms around it?

Thanks, JMIR

Originally Posted by Parks

JMIR, you it the nail on the head when you said how much of a mix/match it is to get the right combo of meds. It is such an individualized thing as well. I personally found Tegretol, combined with some other meds, to be quite helpful. I was put on it as an alternative to Lithium, due to having manic episodes on the Lithium with a therapeutic blood level. After taking that for a number of years, and other meds as previously mentioned, I was switched to Trileptal due to that having less side effects. They are quite close in chemical structure.

I hope your friend finds the right combo and stabilizes. He is fortunate to have a friend like you who takes such an interest in his well being. I can only speak for myself, one doesn't forget that kind of support.

[blueoctober]

Originally Posted by JMIR

3.) We struggle with what is next? Each time he has gotten sick, it has been a sudden change in behavior, complete disconnection/hospitalization, recovery etc.. BUT what can we do different in trying to catch it earlier to avoid hospitalization? He only does blood work 2 times a year, could it be every quarter to watch it, a neurological work up etc. It is scary to go back to the same routine when he comes home, not knowing when it will happen again, what can we do to get are arms around it? Thanks, JMIR

Coming out after a hospital stay a person does need time to recover, but once he is back on track he does need to manage the illness himself. Taking the meds as prescribed, self care (no alcohol, no drugs, eating well, exercise, sleeping regularly), seeing a therapist, mood charting all needs to be done by him.

Friends can be of great support and for me what I needed most from my friends is just be a friend. I am lucky in that I can see my Psychiatrist and Therapist regularly, so I didn't need my friends to fill those roles, nor do I want them too. Not making every conversation surrounded around my mood, the illness etc etc. The "how are you doing" with the raised eyebrow drove me up the wall. Having them be good influences on me i.e. not asking me out to go out for drinks etc. Certainly as a friend if you see him starting to slip speak up, but just do it in a compassionate way which I'm sure you do already. If you can pick up on the signs/symptoms before a major depression or a full blown manic episode takes hold this is ideal.

The problem with this illness is the meds can be "right", but life is life and what an average person can find stressful, this can be multiplied by 100 for a person diagnosed with BP. Stress can then trigger an episode. A lot of managing this illness for me was reading a lot of of books on BP and seeing a therapist regularly. A therapist can help increase a persons coping skills and also help us gain perspective when the illness changes our thinking. For me the meds are 60% of managing the illness and the other 40% come from lifestyle, self care, and seeing a therapist.

[Parks]

Originally Posted by JMIR

Hi thanks for your response. As follow up,

1.) How does the Trileptal work compared to Tegretol for you? My friend has always been on only Tegretol.

2.) Any change in blood work or metabolism that requires different/new medication combinations as you have gotten older?

3.) We struggle with what is next? Each time he has gotten sick, it has been a sudden change in behavior, complete disconnection/hospitalization, recovery etc.. BUT what can we do different in trying to catch it earlier to avoid hospitalization? He only does blood work 2 times a year, could it be every quarter to watch it, a neurological work up etc..

It is scary to go back to the same routine when he comes home, not knowing when it will happen again, what can we do to get are arms around it?

Thanks, JMIR

I have never noticed much difference in the effectiveness or side effects between Tegretol and Trileptal. They have both been helpful, and always used in combination with other meds. These have changed at times. Topamax, Neurontin, Lamictal, Moban, Wellbutrin, Thorazine, Prolixin, Imipramine, Nardil, Doxepin, Benadryl, Ambien, and Omega-3 supplements have been tried at different times.

As I've gotten older my metabolism has changed it seems, based on weight gain. My weight seems to fluctuate with my moods though. The weight may have as much to do with moods as anything else. My bloodwork has been done 2 or 3 times a year.

I have found that trying to have as many tools as possible to help cope with stressors to be helpful. Things such as meditation, relaxation techniques, daily excercise, trying to eat a healthy diet, regulate caffiene intake, daily mood and symptom tracking, looking for patterns in mood fluctuations, and moderating stimulation levels. Also, practicing several Eastern energy techniques, time in nature, light therapy, and basically trying to maintain a constant vigilance in being aware of my mental status. These are some things I would suggest based on my experience. Another thing that I've found helpful has been to maintain close contact with my psychiatrist. I was fortunate to have a 20 year relationship with the same one, until he died last December.

[sugahorse1]

Thank you for being such a great friend! I know that every one of us wishes we had just one friend like you - someone who genuinely cares!
I have managed to keep my BP in check (But I am only BP II, which I guess may be slightly easier to control) but I too go through major extremes - I'll be feeling perfectly fine, and the next slip into a deep depression, at times suicidal. I've often considered going off to hospital.
I cannot always explain the sudden and drastic change in my moods.

I believe that I feel emotions a whole lot more than a "normal" person. I take things very personally and can at times react violently and without really thinking.
I try and tell my boyfriend when i am teetering close to the edge. I just need someone there with me, to hold me and try keep my mind occupied.

Things that are considered "minor" stressors for "normal" people, can really spin me out. If I'm in a depressed episode and someone asks me to make a decision, I can freak out. It seems irrational, but that's how our messed up brains try and cope.

I try and sleep through my depressive episodes - that way I limit my contact with people, and also the thoughts running through my mind. I find myself being caught in a horrible catch-22; I over-react at a comment or situation, have an outburst, then feel guilty and get more depressed.

I agree with Blue - he needs to take responsibility for the majority of his illness. When he notices his moods getting out of control again, he needs to speak to his pdoc to possibly change his meds again.

You are doing a great job, and I'm sure he is VERY proud to be your friend - please never feel guilty or take it on your shoulders when he has a breakdown and is hospitalised - it is a chemical make-up that no-one can be blamed for

[JMIR]

Hello, thanks for your, my friend is on day 8 of his self admitted hospitalization and made a comment about getting out.

1.) He got transferred to a second unit because he did not take his medication.
2.) The paranoia is consuming him!
3.) This physician, who is new for the family is telling us, that if he does not give permission to speak with family member about the medications and care, that the physician cannot do so! HE IS PARANOID< HELLO!! A psych patient with paranoia saying no to the physician about NOT talking to his wife, so the physician does not! I need medication for that!
4.) As self admitted if he wants out, the physician is saying that paranoia is not sufficient to keep him in the hospital, must be a harm to himself or others to go to Baker Act, but in this case may not work! That is so wrong!

Any ideas or experience with this? JMIR

Originally Posted by blueoctober

Coming out after a hospital stay a person does need time to recover, but once he is back on track he does need to manage the illness himself. Taking the meds as prescribed, self care (no alcohol, no drugs, eating well, exercise, sleeping regularly), seeing a therapist, mood charting all needs to be done by him.

Friends can be of great support and for me what I needed most from my friends is just be a friend. I am lucky in that I can see my Psychiatrist and Therapist regularly, so I didn't need my friends to fill those roles, nor do I want them too. Not making every conversation surrounded around my mood, the illness etc etc. The "how are you doing" with the raised eyebrow drove me up the wall. Having them be good influences on me i.e. not asking me out to go out for drinks etc. Certainly as a friend if you see him starting to slip speak up, but just do it in a compassionate way which I'm sure you do already. If you can pick up on the signs/symptoms before a major depression or a full blown manic episode takes hold this is ideal.

The problem with this illness is the meds can be "right", but life is life and what an average person can find stressful, this can be multiplied by 100 for a person diagnosed with BP. Stress can then trigger an episode. A lot of managing this illness for me was reading a lot of of books on BP and seeing a therapist regularly. A therapist can help increase a persons coping skills and also help us gain perspective when the illness changes our thinking. For me the meds are 60% of managing the illness and the other 40% come from lifestyle, self care, and seeing a therapist.

[blueoctober]

Originally Posted by JMIR

Hello, thanks for your, my friend is on day 8 of his self admitted hospitalization and made a comment about getting out.

1.) He got transferred to a second unit because he did not take his medication.
2.) The paranoia is consuming him!
3.) This physician, who is new for the family is telling us, that if he does not give permission to speak with family member about the medications and care, that the physician cannot do so! HE IS PARANOID< HELLO!! A psych patient with paranoia saying no to the physician about NOT talking to his wife, so the physician does not! I need medication for that!
4.) As self admitted if he wants out, the physician is saying that paranoia is not sufficient to keep him in the hospital, must be a harm to himself or others to go to Baker Act, but in this case may not work! That is so wrong!

Any ideas or experience with this? JMIR

That can be frustrating for family and friends, but on the same token I believe we still have rights and I wouldn't want my P-doc speaking to someone without my permission. I was "lucky" when I was hospitalized in that I was committed for 1 month and then my P-doc requested me stay an extra 2 weeks and I did. The whole danger to oneself or others, I can understand why there is that criteria otherwise Psych hospitals would be overloaded. When I was admitted I was kept locked in a room in emergency for a day and a half because there was no bed available, so I have experienced over crowding.

I can also see the flip side of the criteria because a person can do a lot of damage to their lives even when "they aren't a danger to themselves or others".