Need some suggestions

So I recently gave Depakote a try to replace Zyprexa. The idea was to be on Depakote, Lithium, and Lexapro.

Depakote worked very well, with the exception of crippling fatigue. For the 4 weeks or so that I was on it, it was literally a chore to get out of my chair. I would be on my feet for no more than a few minutes before I would find another chair to sit in. I finally couldn't take it anymore and my pdoc took me off. My energy levels climbed up immediately.

So my question is, where do I go from here? I really don't like taking zyprexa, lithium alone isn't enough, and lamictal was far too activating. Should I try another mood stabilizer, or should I go back on Depakote and suffer through the fatigue until it goes away? Will it go away?

I see my pdoc tomorrow. Some suggestions to bring to him would be nice.

What about seroquel? It's used as a mood stabilizer

I was on lithium and seroquel but I got lithium toxicity and can't take it. For at least 4 + years I took seroquel, prozac, and klonopin. But last February I had a psychotic episode and spent three weeks in the hospital. They stopped the prozac and put me on depaoke. I never had the slugginess or sleeping issues with it but it causes weight gain. Not sure I want to stay on it.

There are many many other mood stabilisers you could try. Have a search online and check out what's available. Then you can make an informed choice. Respiridone is just one alternative.

From looking through some of your other posts, it looks like you really don't like the idea of antipsychotics, for a variety of reasons. But you were considering Geodon. It can be a little sedating, but nothing that changing the dosing time can't help. It does not tend to cause weight gain and doesn't typically cause the lactation issues of Risperdal. You will likely have to have an EKG before going on it just to make sure you don't have a heart condition called Long QTc, but I think it's generally considered one of the better tolerated APs.

As far as regular mood stabilizers go, it doesn't look like you've ventured into the Tegretol/Trileptal area before. These may require blood levels to be drawn, but you're probably used to that with the Lithium. But those are another option.

A newer AP out there now is Saphris. I don't know much about it, but it may be worth looking into if you're still open to taking an AP.

If it were me, I'd probably start with the Geodon, but I've been on it before, so I know it works for me. But it would also help with whatever psychotic symptoms you have a history of, whereas the Tegretol/Trileptal won't touch that.

It's a constant balancing act for us, isn't it? I hope you find the right mix soon.

Hi there. It sounds like that Depakote didn't do well for you so I wouldn't go back on it. I like the suggestion of doing some research about new available drugs and then seeing what you PDOC suggests. Lots of good suggestions in here. I learn something everytime I read a new posting. I sure hope you find what works for you. It sure is a balancing act and everyone has to find the right cocktail to work for them. Good luck and keep us all posted on how you do!

Tegretol/trileptal are usually not enough alone for some people.
But with Lithium they can work very well.

I have been on tegretol, low dose, for a long time and find out of all my meds it has the lowest side effects.

I could not handle Depakote either. I have been on seroquel for about 8 years. I wish I never started it. I was always normal weight and I put on 80 pounds from it. I have to admit it has helped control some of my symptoms but at a high price.

If you do go on it ask your doctor about taking Metformin with it. This is a med for type 2 Diabetes. Being on seroquel makes you more susceptible to getting Diabetes like all the newer AP. Metformin protects you from this. I find Seroquel very sedating.

I am trying to slowly wean myself off it.

I was on Saphris for a little over a year. It is godawful stuff. It gave me a whole bucket full of neurological symptoms, including restless leg and trouble swallowing. It occasionally caused insomnia. I couldn't even write my own name legibly, and it gave me horrible anxiety attacks.

My daughter-in-law was on it for a while and she had all of the symptoms I had, plus she gained 20 pounds.

To top it all off, a 90 day supply costs almost $800.

I finally went to a neurologist and he said my symptoms were almost identical to early stage Parkinson's. He recommended Seroquel. I've been on it for a few months and all of the Saphris side effects are gone. My life is better.

I've been reading about it, and now that it's been out for a couple of years, the bad press is starting to roll in.

My tiredness on Depakote left after a month. I barely even notice it's effect anymore. I used to really feel it a few hours after taking my morning and night doses but not anymore.

Thanks for the suggestions guys/gals!

Trouble swallowing can be a side effect of APs? Weird. I have trouble swallowing and maybe it could be from the Zyprexa?

Anyway, my doc and I decided to start the Depakote back up at 125mg, the lowest dose available, and slowly taper up. The reason being that Depakote was effective and we want to give it one more go before crossing it off completely.

If that doesn't work, I suppose it's Tegretol/Trileptal. Really don't like APs.

I'm glad pdoc is slowly going up. You may require less to be stable.