[BeyondtheRainbow]

Yesterday my psychiatrist put me on an emergency dose of 1500 mg(I wrote 1600 yesterday but I was wrong about the mg/pill and it doesn't really matter, it's a ton no matter what) of Seroquel XR. I had been trying to find a workable dose of valium using liquid and she had me go back to pills. Even with all that I was awake until 4:30 AM (and I had 5 mg of valium; 2 weeks ago that was enough make me sleep 20 hours). I woke up at 9:30 pretty wide awake but fell asleep for 2 hours about 11. I never got tired although I did get so that I wasn't motivated enough to get up and act on my manic impulses to clean, clean, clean or do laundry (I'm a boring manic person ) so I was able to lay still and eventually that led to sleep. And I will take sleep any way I can get it. It's just I was sure I'd be out for the count for several days from this. I then went to a family thing which was all afternoon and evening and which involves a lot of stress because of a situation I don't want to talk about. I'm still not tired. I will take the next dose of Seroquel in about 20 minutes and valium later on.

Today I haven't heard voices as much. My thoughts are still racing and I'm still struggling to talk and get words out through the racing thoughts distracting me from within. I did get to eat Chinese since I'm off my MAOI which is very exciting since I've only had it one other time since 2009. But it's still obvious to anyone that I'm having issues.

There was another time that my agitation (that time from akathesia but it made me act manic so close enough) was so great that I was staying manic through vast doses of meds. I looked last night and at that time I was taking 850 mg of Seroquel and 10 mg of Zyprexa plus klonopin and it wasn't doing much. I can't think that this is much different than that and I landed in the hospital because I needed to be rapid-dosed on something new.

To complicate this I know I can't be on this much Seroquel very long. That I assume means I'll be adding a new AP soon. Latuda is the best option since I've been through the other atypicals and have a history of movement disorders that makes the older ones not ideal. But I have to get Latuda through patient assistance (I was going to offer to buy a week or two of it but that would be $150-$300) and since I can't start it immediately that would be an issue. My psychiatrist isn't allowed to accept sample meds as part of the hospital's policy. So (and this is my logic, not something she has said yet) if I'm going on Latuda the best place is to hospitalize me where it is paid for that way and I can get stabilized. Or an older AP can be started but I'm pretty sure that has to be IP with my history. I think that because I'm running out of med options (something that she's planned might happen for a long time so at least she has a plan; we've been waiting for new drugs to come out) the chances this can be managed at home if things don't stabilize are not good.

I don't want to be inpatient. Where I go is really a nice place for what it is. It's just that it's small so it's hard to walk out mania. It's loud, especially if you are at the end near the dayroom. I can't even watch TV with the sound low right now and meals are eaten with the TV on and fairly loud. I don't sleep well in the hospital at all and the night nurse blames this on me. She seems to think I try to beat out my meds on purpose. I'm usually the only person with bipolar and a very manic person is hard for the really depressed people to take.

Last time I had a kind of traumatic time with a roommate who was being sexually inappropriate with her boyfriend while I was in the room. I complained but it took me hours to do it b/c when there are only 10 patients it's obvious who complained and so they didn't catch it in the act. They said they'd move me the next day and the day nurse decided what happened was the evening nurses' fault and didn't move me. It happened again. This time I told my psychiatrist who happened to be the coverage and she told them to move me and what was happening. And the next day again they didn't move me for some reason. So now I'm even more wary of roommates. Last time I asked the social worker to talk to me the 2nd day I was there. I was there nearly 2 weeks. I wanted to do IOP but it would be at a different hospital and I needed help with which one, etc. She doesn't like me and never bothered to talk to me, despite many reminders and thankfully another staff person heard the final conversation. So I was being discharged and the nurse and OT were running around referring me to an IOP that wasn't about to work because they wouldn't let me see my therapist or psychiatrist and it was more babysitting than IOP anyway.

So I don't want to go back. But I know that's going to come up soon. I dread even the thought. I'd have to go buy hospital safe pants; I have none. I couldn't do some dogsitting I've committed to and so not only would there be that but my cats would have to be boarded too which I can't afford. Just so many things I don't want to deal with.

I'm just scared. I thought this dose of the 2 meds plus the no-AD would solve everything and it didn't. And I now need to go take 1500 more mg of Seroquel....I'm sorry this is so long. My brain is running too fast and I'm too worried about this to make it better.

[~Christina]

Why not ask your Pdoc for a trial of Haldol? Yep its ole school..Cheap as dirt and well studied..

I was averaging about 4 -6 hours of sleep a week for over a month. My options were limited due to a variety of reasons....

My pdoc brought it up so I opted to give it a whirl.. I hit day 3 of 2mg a day and slept for a solid 16 hours. I leveled off and was doing well, About 3 weeks on it, Some akathesia started so I took Cogentin, it helped but not enough so my pdoc and I decided to use Haldol every 2 days , then went to once every 3 days , perfect dose for me during the Crisis.

I have long since gone off Haldol and currently med free, But if/when I ever need something I would go to Haldol without a second thought.

Just a thought

[BeyondtheRainbow]

Thanks for the idea. I feel like the woman who always has an excuse. I'm really not, I'm just really difficult to medicate. My therapist wasn't around for the early rounds of anti-psychotics and until I was on Seroquel he sometimes would get a little impatient with my then fear of APs (because all that I'd tried had caused problems and 2 that I'd been on had worked and I still had to stop them. Also one, Geodon, actually caused so much facial masking and uncontrolled oral movements (think of a fat snake wearing scrubs) that the nursing home I was working at as a contracted occupational therapist asked my company to remove me because a family/families had expressed concerns I was on drugs. They wouldn't accept a random drug test or serial random drug tests, the explanation it was a side effect of meds that I was no longer taking but were still getting out of my system, they just said I was no longer welcome in their buildings anymore. I felt like an awful, ugly, hideous, undesirable person. (I later found out that my assistant had told everyone that I was psychotic and in the hospital the entire 4 weeks I was off work, even though I actually was not psychotic and was in the ER one night with a side effect issue. This led to a director of nursing who publicly and repeatedly stated in meetings where someone would say "Jen suggests this" (because I was only there a few hours a week but was the supervisor for my assistant who made fun of me continuously but I didn't know that until a couple years later when a friend quit working there and told me) and they would laugh and the director of nursing would say "what does she know, she's crazy" and dismiss whatever very valid recommendation I was making. No wonder they wanted rid of me.) So I am not only at risk, I'm very anxious about the risk that any movement disorder could lead to permanent issues that might attract attention.

I have had movement disorders on multiple meds with low risk of causing them. Since the risk is greater with the older meds they are not as safe for me. I think Haldol is one of the ones that is most likely to cause problems, if I remember right which I probably don't since the conversation about this was a long time ago. I'm much more likely to get various side effects including tardive dyskinesia which I absolutely do not want. That's why if I go on an older med I'm more likely to need hospitalization to monitor.

I think there are a few older meds that are safer than others and I'm sure that will come up soon too. I know we discussed this a year ago but then never needed to act on it because pushing my Seroquel dose up helped.

Meds are one of the hardest parts of this disorder for me and I hate times like this when I need meds that do not exist yet. This is when it will start to loop back towards is it time for clozaril and is there something else that we can use to hopefully hold off the need for clozaril for a while longer, etc. Clozaril is apparently fairly safe with the movement disorders, it's just difficult with everything else.

Originally Posted by ~Christina

Why not ask your Pdoc for a trial of Haldol? Yep its ole school..Cheap as dirt and well studied..

I was averaging about 4 -6 hours of sleep a week for over a month. My options were limited due to a variety of reasons....

My pdoc brought it up so I opted to give it a whirl.. I hit day 3 of 2mg a day and slept for a solid 16 hours. I leveled off and was doing well, About 3 weeks on it, Some akathesia started so I took Cogentin, it helped but not enough so my pdoc and I decided to use Haldol every 2 days , then went to once every 3 days , perfect dose for me during the Crisis.

I have long since gone off Haldol and currently med free, But if/when I ever need something I would go to Haldol without a second thought.

Just a thought

Originally Posted by ~Christina

Why not ask your Pdoc for a trial of Haldol? Yep its ole school..Cheap as dirt and well studied..

I was averaging about 4 -6 hours of sleep a week for over a month. My options were limited due to a variety of reasons....

My pdoc brought it up so I opted to give it a whirl.. I hit day 3 of 2mg a day and slept for a solid 16 hours. I leveled off and was doing well, About 3 weeks on it, Some akathesia started so I took Cogentin, it helped but not enough so my pdoc and I decided to use Haldol every 2 days , then went to once every 3 days , perfect dose for me during the Crisis.

I have long since gone off Haldol and currently med free, But if/when I ever need something I would go to Haldol without a second thought.

Just a thought

It sounds like you have a great pdoc, you're lucky. I've never thought of just taking an ap that I get akathisia from every 2 days or so. That's great to know.