[CaminoDeOro]

Wait... why did I think this was a good idea?

Soooo I've been ultrarapid cycling for weeks, we replaced zyprexa with seroquel 3 months ago and have been experimenting with the dose. The cycling has been pretty intense, my skills are better and better every time now and I've experienced worse while being less functional, so I've been able to white-knuckle it. The reason I bothered staying on it so long: because of positive effects on my mood, I felt it was necessary to gather as much info as possible about how seroquel affects me at different doses before giving up on it or doing something else.

I feel that seroquel helps my baseline mood a bit and also that I bounce back from negative external events faster. I was sort of at an impasse at the pdoc today. Can we keep that good mood effect from seroquel (zyprexa doesn't do that for me) and regain stability (which zyprexa does do) somehow? Additional factors: I may have 5 weeks starting now with no "scheduled disasters" happening. Every month for months I've had one or two things known in advance that disrupted my life. Having 5 weeks without is a rare opportunity to rock the boat a little more on the med search. BUT right after those 5 weeks I may travel over the holidays which will cause instability no matter what, though I would be among old friends.

So how the hell do we proceed, considering all that?

And to reiterate, the cycling has been moderately strong. I've had worse but this is like a familiar but highly unpleasant carnival ride. It's not good.

Anyway uhhh we decided to stop the lamictal over the course of a week, then wait a week, and then start pristiq (desvenlafaxine). Check in after 4 weeks.

Now I'm anxious and questioning the wisdom of this. Med changes are guaranteed to cause ripples or worse of some kind. First off the lamictal, then onto an SNRI within 4 weeks? Wow. We do have very specific suspicions leading to the trial of pristiq, but still.

This is indeed an aggressive strategy. We stated that outright in the session. The appointments are so short, 30 minutes, she doesn't have time to warn me about stuff so it's up to me to think it through, which inevitably happens after the fact. I need to watch closely for true hypomania or high-amplitude cycling to develop and get ahold of her if it does. If things get crazy and worst comes to worst I just take a loading dose of my hoarded zyprexa and allllll the uproar will stop and then I get back in to reassess the plan.

Yeah this is gonna be a fun "no scheduled disasters" month. :|

[HALLIEBETH87]

Was the lamictal
Strictly for depression or mood stabilization?

[bioChE]

Why don’t you just take Zyprexa PRN?

[CaminoDeOro]

Lamictal was added long ago in an attempt to fight depression. We thought maybe it was having some effect so we left it for a while, but then by the time I figured out it was likely doing nothing, I had a lot more urgent matters to attend to re: meds, and it's been nonstop ever since, so we're just pulling it now.

Re: zyprexa PRN: not actually a bad question, hmm. Aside from fears of increasing the risk of TD or something, my guess would be that I need more consistent stabilization, but that's just a guess. It may be worth mentioning that to my pdoc. That being said, if I'm using PRN zyprexa to kill a mixed or hypo state I'll typically crash immediately sooooooo... ugh

[CaminoDeOro]

So far I'm down to 125mg of lamictal from 200, I am reducing 25mg a day. I actually don't really feel any different, of course I've been crappy and unstable for weeks, but this doesn't feel like it's making it worse. The taper is nice, I was worried I'd be stuck with that weird fuzzy / wobbly jello feeling I get when I go too long between lamictal doses (typically when I wake up), but nope! It hasn't gotten worse.