[Nightside of Eden]

My fiance normally has a talkative, outgoing, funny personality. He also has Bipolar I. For the first few months he was medicated, everything seemed okay, but then he started to gradually become more subdued. He says his mind is simply blank and that he can't think of anything to say, which isn't a way he's ever felt before in his life. He's also tired and completely lacking his normal energy level. Naturally we assumed this way the medication (Zyprexa monotherapy at 7.5mgs/day). The doctor switched him to Geodon at a low dose, but this greatly worsened both the problems rather than helping. He then decided to go off meds completely to see what happened. His moods were fine, but he was unable to sleep more than 1-2 hours a night. Being tired but unable to sleep was NOT a problem he had prior to medication. Understandably, after 5 nights without sleep he gave in and started taking a low dose of the Zyprexa again so he could sleep. This instantly solved the insomnia problem, but the changes to his personality and some of the fatigue remains even at 3.25mgs, and, disturbingly, these symptoms remained off meds as well.

I've toyed with the idea of depression, but he's had depressive episodes before and says this doesn't feel at all like them. He doesn't act depressed either, just blank and lacking in motivation and personality.

This may not sound like an Earth-shattering problem, but to me when medication is taking away the essential aspects of someone's personality it's a VERY big problem. I also find the complete inability to stop the meds without unbearable insomnia disturbing. He was already taking the lowest dose they make of Geodon and so tapering wasn't even an option.

Has anyone else dealt with this same problem and found a solution? The two things I thought of were switching to Abilify or Lamictal, but with Lamictal I worry that the insomnia would return since it doesn't act on the brain in the same way as an AAP. Is it even possible there's an explanation for this other than meds? I intend to make an appointment with the doctor, but in the mean time I'd like to have a better idea of what could be done.

[wildflowerchild25]

I got that way on depakote. Just did not care at all. It was refreshing, actually, because I didn't feel like I had to take care of everyone beacuse I didn't care anymore. But I was only 15 when I was on it.

What other APs has he tried? And has he ever tried a mood stabilizer? I have bipolar one and I got by on trileptal alone for about six months. It only stopped working because I was dumb and stopped/started three times. The last time my brain just went hell no we won't go.

I have tried most of the usual APs and they all have intolerable side effects. I'm on geodon now and I'm dumb as a rock. But I haven't been on it long enough to see if that side effect will lessen.

I feel that stopping and starting is more detrimental to your body and brain than the med would be. I'm not surprised he couldn't sleep. Could have been withdrawal.

Maybe try to start some alternative therapies for sleep like melatonin or Benadryl and meditation practice, like progressive muscle relaxation. Then maybe - preferably with a pdoc's help - he could try going without again.

[Marshellette]

A lot of the antipsychotics will dull you. As the previous poster said, withdrawal can cause rebound insomnia. It doesn't look like the Geodon or the Zyprexa were working (Zyprexa helped me sleep but left me a zombie) so maybe he could try a mood stabilizer and sleeping pills? You can't have it two ways, either take the meds and be a zombie who sleeps or don't take the meds and be creative and never sleep. Both options aren't the greatest but we all have to get by somehow.

[Nightside of Eden]

Thanks for your reply, wildflowerchild. He was on Depakote briefly to bring him out of a manic episode. It did make him feel irritable and emotionally flat, but those feelings went away within a few days after he went off it.

You're probably right about the stopping and starting being bad, though when he stopped the Zyprexa he had no intention of going back on it. His plan was to try a new AAP or mood stabilizer if he started having mood issues again, but of course he didn't get to follow through on that because of the severe insomnia. He did try Benadryl and even Klonopin to sleep, but they didn't help. :/

The only other AAP he's tried is Risperdal, which he had a near-fatal bad reaction to. Other than the brief course of Depakote to stop a manic episode he hasn't tried any mood stabilizers. I had heard that they were often worse than AAPs for "brain fog" side-effects, but maybe something like Trileptal or Lamictal would be a better choice, always assuming the insomnia didn't continue on them.

Thanks again for you response. I'm sorry you're still dealing with bad side-effects yourself.

[Nightside of Eden]

Originally Posted by Marshellette

A lot of the antipsychotics will dull you. As the previous poster said, withdrawal can cause rebound insomnia. It doesn't look like the Geodon or the Zyprexa were working (Zyprexa helped me sleep but left me a zombie) so maybe he could try a mood stabilizer and sleeping pills? You can't have it two ways, either take the meds and be a zombie who sleeps or don't take the meds and be creative and never sleep. Both options aren't the greatest but we all have to get by somehow.

Hmm, combining a mood stabilizer with a sleeping pill wasn't something I'd considered, but it could be a good idea. Sleeping pills might bridge the gap with the withdrawl insomnia. That's definitely something we'll talk to our doctor about. Thanks.

[wildflowerchild25]

I've been on everything under the sun and the only med that has worked so far is trileptal. Geodon is working to keep me from being psychotic but doing nothing in terms of mood. And abilify did nothing for my mood either. And it's major bucks, like $650 for a month before I met my deductible. Even after it would have been 60$ a month. For the same reason I can't take latuda or saphris.

Honestly though all meds have side effects and some people get them And some don't. I'm a weirdo with meds. I always get the side effects that are rare or that no one else experiences. Like lactation from risperdal, slowing from abilify, unshakeable drowsiness from Seroquel, etc etc.

It's very frustrating to me that I have to choose between mental health or bodily health. I'm sure it's frustrating for him as well. I'm still looking for the magic combo lol.

[Nightside of Eden]

Originally Posted by wildflowerchild25

It's very frustrating to me that I have to choose between mental health or bodily health. I'm sure it's frustrating for him as well. I'm still looking for the magic combo lol.

It is terribly frustrating. I feel like the meds have taken away something very valuable and important and refuse to give it back. Being unable to help or fix the problem is making my own moods cycle farther and farther down. It's like in exchange for preventing the situations that could kill us, the meds have sucked all the joy out of living.

Obviously I don't have the same kind of side-effect from my meds, for absolutely no reason other than biology, since I'm on quadruple his dose of Zyprexa plus a second sedating anti-psychotic. But I'm as alert, filled with thoughts, and paranoid as ever. The difference is so stunning I took Zyprexa from his bottle a few times just to confirm it was really the same drug. I guess I'm "lucky", much as I don't feel that way sometimes.