[CopperStar]

I experience mostly episodes of dysphoric mania.
- Insomnia
- Racing, scrambled, chaotic thoughts of dark/morbid nature
- Agitation, irritability
- Paranoia
- Delusions ranging from mild to very severe
- Mild, brief hallucinations
- Suicidal ideation
- Severe anxiety with hostility to perceived threats
- Jittery, frequently pacing and talking to myself
- Substance issues, self-medicating (THC, non-presc. Xanax, alcohol)
- Random intense grief
Etc, etc, etc

Have not had any medication for several years now but recently got insurance. So I found a psychiatrist and went to see her. She does not want to put me on a mood stabilizer, she wants me to just take an atypical anti-psychotic. I think this is because I have had several episodes of severe delusions that totally messed up my life plus some mild hallucinations. My moods are more covert I think because I isolate a lot and internalize most of my emotions. So I think she is trying to nip psychosis in the bud and then see if that works. Just my guess, though. I don't know.

She is pushing for me to start with Abilify but I am scared of it after reading reviews that say it can make you even more agitated and restless. My sleep is already sparse and erratic and I am already very agitated most of the time. So I'm scared of it now. She told me to research options though so I think I get to have a say in what I try.

I am extremely nervous about this though. I have been using alcohol, weed and Xanax from other people to try to control my symptoms for a long time now, also chain smoking like a pack a day of cigarettes on average. Part of the deal here is that I will stop drinking, using weed or taking Xanax and give the medication an honest try.

So I am worried about increase irritability from not self-medicating anymore even though I plan to stop once I have a proper medication, but I am still nervous about it. And then with these reviews I am even more nervous.

I read about Seroquel since it is supposed to be more sedating but some reviews say it made their psychosis worse.

Then there is Zyprexa but a lot of stuff says that it will not help much with the depression aspect only the mania symptoms.

This feels extremely daunting and I'm just nervous as all hell. I know that I have anxiety, agitation and paranoia anyway, too, so I can't even tell how much of my nervousness makes sense and how much is just symptoms.

I have managed to stay out of the hospital for several years now, although I have had multiple episodes where I probably should have been hospitalized. Instead I just lost apartments, lost jobs, lost friends, lost independence. But I stayed out of the hospital and managed to not traumatize my family.

I am so nervous that a medication is going to destabilize me really bad after reading these reviews and that all of my will power will be overwhelmed by it. I really don't want to go to the hospital or stress out my family.

I even know that reading reviews is a lot like a hypchondriac looking up symptoms online and then thinking they have the worst possible thing. I know that. I know that the reviews probably only depict a small fraction of people who had bad reactions. But still the risk is there, and I am still really anxious about it.

Has anyone here had a bad reaction to starting a medication? How did you handle it? Or anyone else here also get really nervous about starting medication? I am just sort of venting and relating I guess.

I also don't know how to pick one. It is so individual and at the end of the day I feel like doing all this research has just wound me up for no reason because I still can't really choose or predict what will happen.

I have about a week to decide.

How did you go about trying to choose which medication to try?

And can just an anti-psychotic really handle BP 1? Is it normal that she doesn't want to use a mood stabilizer? What I read about lithium doesn't sound so scary because everything is saying it has a strong anti-suicide property. But she said no lithium and no depakote. I didn't look into depakote don't know about it, but lithium kept coming up in articles about BP.

[wildflowerchild25]

I was nervous about starting medication as well. I started on celexa and abilify two years ago and it was terrible. Made me super agitated and mixed. I think it was the celexa because since then other SSRIs have done the same. Anyway it was a lot of trial and error but I've settled on Invega (antipsychotic) and Wellbutrin. I've been successful in this combination since December. So I think it is possible to treat bp1 with an antipsychotic alone (even though I need an AD as well). You don't necessarily need a mood stabilizer. But really everyone reacts so differently to each led that all you can do is pick the one that sounds best for you and go with it. Reviews can help but don't tell the whole story. You just have to take the plunge. And if you react poorly call your pdoc and try again. Learn coping skills if you haven't already to help you through the bad episodes hopefully without hospitalization.

Good luck! I'm sorry if I didn't make much sense. I tried.

[~Christina]

The Med Merry Go Round can be daunting.

It's virtually impossible to find the right med or combo of meds on the first or even 3rd try. It's just the nature of the beast( Bipolar) even when you find a good med(s) they can need adjusting down the road.

One trap a lot of people fall into is when a Pdoc starts a person on numerous medications at the same time, how could anyone know what med is causing a problem ?

Most all psych meds have the standard same side effects.. Many go away once your on the medication a little while some side effects never do away.

If your not comfortable trying particular meds let your pdoc know.. You Pdoc needs to work closely with you to find the best treatment for you.

So my advice...

1.Start one medication and give it a few weeks before another is added ( if needed)
2.Write down any side effects your having.
3.Ask your Pdoc for instructions about what to do if you have problems and its outside of office hours.
4. Will your Pdoc make changes over the phone about medications or must you go in for an actual appt ?
5.and most of all ..... Have patience, it takes time to find something that you can tolerate and it help stabilize your Bipolar

Welcome to PC

[BeyondtheRainbow]

Attempt 2 (stupid internet connection blacking out):

I was very afraid to go on meds too. I had to have a friend talk to me on the phone while I took my first lithium. But over time meds have made an enormous difference. I hate them sometimes and they don't always work but I have a constant mixed episode with frequent dysphoric mania so any help is good help.

I've been on all the atypicals but 2 I think (that I can't take because of allergies or interactions) and just started my 2nd AP (I was on Seroquel and now am on loxapine as well) in the last 2 weeks. My hope is that I will be able to lower my Seroquel dose and get off the mood stabilizers I'm on. The time I was best ever I was just on an AP, lithium and an AD, and klonopin and I'd love to get back to that with the addition of the 2nd AP.

I went through all the atypical APs pretty quickly because of bad reactions/allergies. I did not want to take Seroquel because I'd worked in a place where it was misused and I was afraid of it. When I finally had to go on it I discovered it was the most effective med I'd been on. When I had Emsam added I did great for a long time.

For me sedating APs have worked best. Actually sedating meds have worked best except for my very stimulating AD (which means I need to have the ability to have a lot of sedation from my other drugs).

I won't go through my history of experiences because I don't want to scare you since you are unlikely to have any of the same reactions. (The same reason reading reviews isn't good along with the fact that people are more likely to post negative reviews than positive). But I did need to try a number of meds to find the one that worked well.

I'm surprised that your dr. is avoiding depakote and lithium since those are very standard and well-trialed meds. But they do require frequent labs in the beginning and that might be the reason she wants to avoid it.

I'm glad she is giving you input into the decision. That's a sign of a good dr. I try to base most of my decisions on what my pdoc says, what my therapist says if he knows the med well enough to have an opinion, and drug profiles (which I'm not allowed to read anymore; I'm supposed to rely on my pdoc. Sometimes I"m better than others at this). I will ask on here but even with trusting people here I try to remember that people have really different experiences and beliefs. There are people on here who are able to refuse any meds that cause weight gain; while I'd love to do that I have mostly only benefitted from weight gain meds (although my new AP is causing weight loss so far which is awesome).

I hope you are able to make a decision you feel very comfortable with and that you do well on whatever med you choose.

[Wander]

Medications effect everyone differently so it is impossible to know how they will effect you. Just try them and monitor how you feel each day so you can report it back to your doctor. Sometimes there are side effects that only last for a few days as your body adjusts to the med so it is worth persevering for a week if you are having side effects. Of course, if the side effects are causing you harm then stop the med. I have tried nearly 20 different meds over the years and most had little side effects. A couple had bad ones that passed in a few days and one was disastrous.
With the symptoms you are experiencing it is worth giving the meds a try as it must be awful feeling the way you do. Hopefully they will give you some relief. If not there are plenty more you can try. Sometimes it takes a while to find the right meds so be patient.

[raspberrytorte]

I can understand, except the only meds I'm afraid to take are AD's because they make me manic (tried two, both did the same thing, second one even when I was on a mood stabilizer too).

For AP's I've only been on abilify, zyprexa, risperidone, and seroquel. Abilify made me restless and agitated (akashia? Spelling on that is probably wrong), and it gave me an annoying eye twitch, so I wasn't on that very long, but everyone is different.

Right now I take seroquel. Out of them all it works the best for me, besides the slight weight gain and seroquel sweet tooth.

Actually, I hate seroquel because it works so well for me! I stopped taking it because it was making me fat, became severely unstable and suicidaly depressed, and now that I've started it again I feel much better. Even our babysitter commented on how much better I seemed because I was smiling and laughing and apparently I haven't done that at all in about a month!

Zyprexa caused major weight gain for me, in a very short period of time, but worked. Like rainbow, I think I do better on the sedating AP's.

Anyway, I guess my point is that everyone reacts differently.

Oh, and I agree with everything christina said.

Good luck! Try not to be scared. Hugs.

[BlackSheep79]

Everything Christina said. Especially the med merry go round. Diagnosed 8 years ago and on meds the whole time and still switching up because BP can change. I started out BP 2 and then I had rapid cycling for awhile. I was then diagnosed as BP 1 and I have had one mixed episode. So yeah your meds may change and even if you do find the right one it may need to be tweaked from time to time.

Also like Christina said give each med some time, a lot of them have to build in your system and sometimes the bad side effects at the beginning do dissipate. But after that time there is a side effect that you just can't live with call your pdoc. Seroquel has made me very stable for a long time but I've decided I just can't deal with the diabetes it has caused, so I'm currently taking a chance, instructed by my pdoc, to see how I do off of it. Christina covered everything I would have said from my experience. I hope it works out, but honestly it's a lifelong battle we have to fight.

[CopperStar]

Thank you for all the input and advice. She said she didn't think I needed something "heavy" like lithium, then suggested Abilify. I had told her about my symptoms and especially that lately I have terrible insomnia, have been seeing things and am extremely agitated all the time. Then I went home and researched Abilify and the negative reviews, almost all of them were complaints of how it made them feel even more agitated, restless and aggressive. Some reported that they became violent. I just feel like I am about at my limit in terms of containing how I feel all the time. Some days I just want to smash all of the dishes and scream at the top of my lungs. I really don't need anything that might make me even more agitated and wound up. So the Abilify just seems like a terrible idea.

I also got the feeling that she wasn't take me all that seriously, because I am not fully into an episode right now, it started a few weeks ago and is still only moderate. I was able to sit there and speak steadily, I wasn't acting furious. I was being polite and docile. Compared to some of the people in the waiting room I probably didn't seem that severe of a case. But what am I supposed to do, just let loose and smash something on her desk in order to get a proper medication. It's very frustrating.

[Disorder7]

I mainly experience the same dysphoric mania that you do. My pdoc has never suggested Lithium or Depakote. Maybe they're for people who experience depression and "happy" mania. I don't know. I'm the mean bipolar.

Abilify did in fact make me nervous, restless, and gave me blurry vision.
I told my pdoc and he immediately switched me to seroquel. Well, it is sedating, that's for sure.

To be honest, I'm not very med compliant. I hate them all, except for Xanax. I know I should be responsible and take my meds. I know I'm playing with fire. But I still don't take them most of the time.

Take care.

[CopperStar]

Originally Posted by Disorder7

I mainly experience the same dysphoric mania that you do. My pdoc has never suggested Lithium or Depakote. Maybe they're for people who experience depression and "happy" mania. I don't know. I'm the mean bipolar.

Abilify did in fact make me nervous, restless, and gave me blurry vision.
I told my pdoc and he immediately switched me to seroquel. Well, it is sedating, that's for sure.

To be honest, I'm not very med compliant. I hate them all, except for Xanax. I know I should be responsible and take my meds. I know I'm playing with fire. But I still don't take them most of the time.

Take care.

I also use Xanax to make the agitation temporarily go away when it gets really bad. But I don't have a prescription for it, I get it from other people who have a surplus and are willing to sell, trade or share. I confessed this to the pdoc and she told me that was a bad idea. I was like no **** lol. But I haven't had other options until recently with getting insurance.

[BeyondtheRainbow]

It sounds like you really feel abilify isn't the right med for you. My personal experience was that it was very stimulating and so I'd agree with that but I'd bet you could find plenty of people who were sedated.

You can always ask to go on at a very low dose and move up. With Abilify we did that because it was my first AP and my pdoc "had a feeling". Which was accurate and I'm not completely sure why she chose it except that I was so freaked out by APs that maybe she thought I'd be more accepting of it. (I worked with psychiatric patients and had some messed up views of drugs based on the way the psychiatrists where I worked used them which wasn't always as recommended. Sometimes they just were shutting their patients up; they got paid the same no matter how much they had to do for the patient each month so it was in the dr's best interest to sedate everyone and the dr just wasn't very ethical on a number of things. Like once he wrote "patient feeling depressed following death of mother." That was true. 4 weeks later he wrote "depression resolved". So why was the patient still crying about her mom with me all the time? And when is grief (new grief) depression? He wouldn't increase her meds and she was having a very hard time with the grieving process with so little support; she was also grieving loss of full use of an arm due to a severe fracture. But she was fortunate he didn't just drug her up even more (drugs being the cause of the fracture in the first place).

Going totally on my abilify experience I'd want to try something else but that's just me and it was truly a rough drug for me; it caused akathesia which a number of drugs have but it also caused low blood pressure and several falls from that. I was only on it a few days. I just found it really stimulating and then the side effects weren't fun. But I can't say I was going to be happy about ANY AP at that time; I just didn't want to go there. I hadn't had overt psychosis yet and was willing to wait for it but my dr felt this was better.

It's important to try to set a time that you'll commit to trying a drug in your head. Obviously you break that if something goes wrong but if it's just side effects then try to get yourself to wait it out for a while and let the dosage be adjusted and the like for a while before you give up. I'm on my 65th cocktail right now and that is one thing I've learned (because I never can just give up a med unless there is good reason because there are a limited number left to try and some of them are more risky than others for me because of prior reactions). I have only quit 2 drugs without staying on them for 6-8 weeks without having a severe reaction and one of them later was shown to not be much of a mood stabilizer at all and the other (Latuda) I really wanted to try again but I needed samples and the sample person didn't get back to my dr in time for me to go on it at my last visit and I absolutely needed to be on something then. So loxapine it is and while it is weird to be on a med I can't even find much about on the internet because it is old and unused (and my pdoc doesn't even remember much about it including when she last used it) it is helping so strange choice by a dr who knows me REALLY well and has reasons to put me on whatever she chooses, it's not hard to wait it out. I get nauseous most nights after I take it and that's about the only side effect (on an incredibly low dose). So waiting it out for a few months will be easy. Committing to the med is almost as important as choosing it because as of now there just isn't a scientific way to choose meds (they are working on it though; I'm in a clinical trial for this).

It's just not an easy situation. I think it gets easier with time though.

[Capriciousness]

Originally Posted by CopperStar

I experience mostly episodes of dysphoric mania.
- Insomnia
- Racing, scrambled, chaotic thoughts of dark/morbid nature
- Agitation, irritability
- Paranoia
- Delusions ranging from mild to very severe
- Mild, brief hallucinations
- Suicidal ideation
- Severe anxiety with hostility to perceived threats
- Jittery, frequently pacing and talking to myself
- Substance issues, self-medicating (THC, non-presc. Xanax, alcohol)
- Random intense grief
Etc, etc, etc

Have not had any medication for several years now but recently got insurance. So I found a psychiatrist and went to see her. She does not want to put me on a mood stabilizer, she wants me to just take an atypical anti-psychotic. I think this is because I have had several episodes of severe delusions that totally messed up my life plus some mild hallucinations. My moods are more covert I think because I isolate a lot and internalize most of my emotions. So I think she is trying to nip psychosis in the bud and then see if that works. Just my guess, though. I don't know.

She is pushing for me to start with Abilify but I am scared of it after reading reviews that say it can make you even more agitated and restless. My sleep is already sparse and erratic and I am already very agitated most of the time. So I'm scared of it now. She told me to research options though so I think I get to have a say in what I try.

I am extremely nervous about this though. I have been using alcohol, weed and Xanax from other people to try to control my symptoms for a long time now, also chain smoking like a pack a day of cigarettes on average. Part of the deal here is that I will stop drinking, using weed or taking Xanax and give the medication an honest try.

So I am worried about increase irritability from not self-medicating anymore even though I plan to stop once I have a proper medication, but I am still nervous about it. And then with these reviews I am even more nervous.

I read about Seroquel since it is supposed to be more sedating but some reviews say it made their psychosis worse.

Then there is Zyprexa but a lot of stuff says that it will not help much with the depression aspect only the mania symptoms.

This feels extremely daunting and I'm just nervous as all hell. I know that I have anxiety, agitation and paranoia anyway, too, so I can't even tell how much of my nervousness makes sense and how much is just symptoms.

I have managed to stay out of the hospital for several years now, although I have had multiple episodes where I probably should have been hospitalized. Instead I just lost apartments, lost jobs, lost friends, lost independence. But I stayed out of the hospital and managed to not traumatize my family.

I am so nervous that a medication is going to destabilize me really bad after reading these reviews and that all of my will power will be overwhelmed by it. I really don't want to go to the hospital or stress out my family.

I even know that reading reviews is a lot like a hypchondriac looking up symptoms online and then thinking they have the worst possible thing. I know that. I know that the reviews probably only depict a small fraction of people who had bad reactions. But still the risk is there, and I am still really anxious about it.

Has anyone here had a bad reaction to starting a medication? How did you handle it? Or anyone else here also get really nervous about starting medication? I am just sort of venting and relating I guess.

I also don't know how to pick one. It is so individual and at the end of the day I feel like doing all this research has just wound me up for no reason because I still can't really choose or predict what will happen.

I have about a week to decide.

How did you go about trying to choose which medication to try?

And can just an anti-psychotic really handle BP 1? Is it normal that she doesn't want to use a mood stabilizer? What I read about lithium doesn't sound so scary because everything is saying it has a strong anti-suicide property. But she said no lithium and no depakote. I didn't look into depakote don't know about it, but lithium kept coming up in articles about BP.

Hey there. It sucks I know. I'm going to throw out some opinions and experiences and you can do what you want with them.

I have been to a lot of pdocs trying to find a good one. The good ones I have had and the awesome one I have now all say that Bipolar 1 must be treated with a mood stabilizer in the long term. If a patient is initially presenting manic then that needs to be resolved with and AP or whatever but then they need a real mood stabilizer in addition or instead or whatever. That is just what my docs said.

As for Abilify...I was basically feeling very similar to how you are now when I first got dxed and I was put on Abilify. It is different for everyone but for me it was complete hell. It stopped my dysphoric mania I guess but it made the agitation and anxiety and all of it soooo much worse. I couldn't sleep. I was crawling the walls. I was soooo uncomfortable. when I finally went off of it it was such a huge relief. I felt so happy to JUST be depressed instead of depressed and agitated beyond belief.

So what should you do?

I don't know exactly what you should do about which med but you are doing what you should be doing by reading and talking and asking. Most of all what you should do is remember that it is a partnership. You don't have to just take whatever they give you. When my first Pdoc sent me home with the Abilify sample packs I had never even heard the word antipsychotic. I had no clue. Second time around with meds years later I had researched them like crazy and decided I needed Lamictal so then I just kept going until I found one who would prescribe it for me. I was right. It is awesome for me.

Good luck!