[cashart10]

I told my doctor the 3 changes my IOP pdoc wanted to make and he disagreed with all but one of the changes. In fact, he insisted that this new pdoc was incorrect on the other two potential changes. He told me that one of the changes, taking me off of the Vyvanse would be detrimental to me. He said, "just remember, I have seen you plenty, and I know you and he has seen you once for 3 minutes." He is right. I am going to stick with my pdoc's prescribing at least until I go for a full second opinion in Sept. This is going to be total chaos I have a feeling. I am afraid to tell the IOP doc that I am not following his advise for fear he will mark me non compliant.

Furthermore, I asked my pdoc what will happen if this increase in Zoloft doesn't work and he said he will add Welbutrin. That will bring the count to 8 meds. All of the cards are stacked against me when it comes to losing all of this psych med induced weight gain. I am going to see a dietician tomorrow though and I am praying we can work together to return to a healthy weight. I feel frustrated, helpless, and still suicidal. I feel suicidal to even get off of the couch, which is disturbing. I know it will get better eventually. It simply must get better.

[Nammu]

When I was in PHP the doctor there just wanted to up my meds radically. He upped the antipsychotic and the mood stabilizer. He only upped it once and was planning to up it more but then my insurance refused to allow me to complete the program so I didn't see him again. I'm kind of glad about that , t would have been almost the max dose.

[raspberrytorte]

Eight meds. Too many in my opinion. I'm sorry.

[raspberrytorte]

Are you comfortable taking that many?

[BeyondtheRainbow]

How do you feel about the 2 opinions? (Take away your positive feelings for your dr because they seem to make you feel guilty if you don't agree with him, so start at a not-guilty place and what do you think?)

(I don't think the IOP dr will be upset. HE knew he was a 2nd opinion and that you didn't have to follow him. Just say you aren't ready to make changes yet because your own pdoc doesn't agree with him. It would be ideal if they could take but that's probably never going to happen in the real world. Is it?)

Can you get your Pdoc to actually go through each medication and tell you what it is doing, and then get him to ask you the same. My new Pdoc actually asked me what I thought each of my medications were doing for me. I was surprised, as I was actually more aware of what they were doing than I thought.

It was the first time in 15 years that a Pdoc has actually asked ME how I felt about my meds, and what I thought medications could do for me and what I was trying to achieve with them. It was a refreshing converstation. He said he would take away the information that I had given him and then see if there were any better medications I could try.

Perhaps a suggestion, so you have got a clearer picture of what you take, what it does, and see if the symptoms are still relevant and need to be treated?

xXx

I am admittedly new to the whole bipolar "game",so to speak. But i am on 3 meds. Lamotrigine and lexapro and zolpidem for sleep. I also have taken zyprexa and ativan when manic.

When I have talked to My psychiatrist and asked why some people are on so many meds, she said sometimes they take meds to counteract the side effects of their other meds. Is that what is going on with you?

I personally would have a problem with so many meds. I have said it before. I think that seems like too many.

JMHO

[Trippin2.0]

At this point I think it would be wise to consider a med overhaul and do a damn detox.


Its not like they're working if moving off the couch makes you feel suicidal, so really. What's the point of taking them and rejecting the idea of a med overhaul?


You are on so many meds its possibly exacerbating your symptoms. Yes, that's a thing, where ADs can make you suicidal and APs can make you hallucinate.

Since you're on so many, you have NO way of knowing if meds are a contributing factor to you being down the crapper.


I know you love your pdoc (a bit too much because you listen to him blindly) but really, ask him if he would be comfortable taking all your meds and watch how he obviously pulls a face.


Some people probably need to be a walking drug store, but since that's clearly not working for you, I strongly suggest you talk med overhaul.

[BeyondtheRainbow]

I think Trippin has a good point with the walking drug store statement.

I'm on 7 (8 if you count Cogentin) meds for psych right now. The plan is to get me first on to just one benzo with a PRN dose of the other that I'll rarely take then (now) to a lower Seroquel dose and eventually off my 2 weak mood stabilizers (that do something; we've tried pulling them before and I needed them) so I'll be on a lot less medication eventually. But the 7 meds are working for me. I've gone from miserable and unable to sit still, paranoid that strangers were going to kidnap me and that lightning bugs were monitoring my every move and reporting back to someone, hallucinating and terrified to starting to feel like maybe, just maybe, I'm seeing stable forming. I probably have one more increase of the loxapine but that is probably it and I may make it without that, it depends how I handle the full dose of AD.

My meds also make sense. I was sleeping and was agitated so the meds to calm me down were turned way up. Lots of Seroquel, lots of loxapine which is sedating in a different way. Valium (plus klonopin until tonight). The only stimulating med I take is my AD and it's good because it helps me stay awake but my other meds are calculated to balance out the stimulation.

I just mean that I know and understand why I take each med that I do, and I know there's a plan to get me back to a reasonable number of meds. Your meds more sound like different things are thrown at you like a dart board to see what sticks. Even this wellbutrin; good med for many people but it's another stimulant and you have so many of those. And why not just increase the sertaline further instead of adding another drug?

Your pdoc confuses me. He may be great but he has some weird ways of getting there.

[raspberrytorte]

I agree with the med overhaul thing.

[raspberrytorte]

And why would he add wellbutrin? Do you really need to be on two ADs. Why not wean you off zoloft first if it's not working and then put you on wellbutrin?

[raspberrytorte]

I mean, if you're comfortable being on all these meds, feel they're helping and your pdoc is right, that's okay. But if you're not comfortable tell your pdoc that.

[cashart10]

Originally Posted by raspberrytorte

Are you comfortable taking that many?

Not at all.

[raspberrytorte]

Have you told your pdoc?

[cashart10]

Originally Posted by BeyondtheRainbow

How do you feel about the 2 opinions? (Take away your positive feelings for your dr because they seem to make you feel guilty if you don't agree with him, so start at a not-guilty place and what do you think?)

(I don't think the IOP dr will be upset. HE knew he was a 2nd opinion and that you didn't have to follow him. Just say you aren't ready to make changes yet because your own pdoc doesn't agree with him. It would be ideal if they could take but that's probably never going to happen in the real world. Is it?)

Well, the IOP pdoc was wrong about at least one of the facts. He insisted that Vyvanse was NEVER prescribed for Bipolar but I've had 2 pdocs, as well as researched myself, that it is in fact prescribed for Bipolar depression (sometimes). I advised him of this and he just said "No, no..." This lessened my faith in him to at least some degree. My pdoc says stopping this would be detrimental and I'm inclined to agree with him. I can barely stay awake even taking it as it is now. I am persuaded by the IOP pdoc in regards to Lamictal. I already felt that the 600 MG was too high and he lowered it to 400 MG for that reason. My pdoc also strongly disagreed with this saying what I mentioned about how he knew me and my circumstances and the new pdoc did not know me. They both agreed that the Zoloft should be increased. Given this information, I am not fully confident in either pdoc but I favor my pdoc's opinions based on what he mentioned.

[cashart10]

I agree with the med overhaul thing. Me too...I'll go into detail about this in another thread.

And why would he add wellbutrin? Do you really need to be on two ADs. Why not wean you off zoloft first if it's not working and then put you on wellbutrin? No, I also think it would make sense to wean me off of the Zoloft first...just like I thought it would make sense to wean me off of either the Abilify, the Litium, or the Lamictal (or all of them and try something else) instead of just increasing to the max dose and adding something else. I just don't ever take heed of my opinion.



Have you told your pdoc? Yes. I told him in a letter a while back. I actually asked if we could start my meds from scratch. He didn't respond to that last question. What he did say was he promised to keep me on as little meds as he could equalling how sick I am. In other words, as I get better, he will decrease my meds.

[cashart10]

Originally Posted by ValentinaVVV

I am admittedly new to the whole bipolar "game",so to speak. But i am on 3 meds. Lamotrigine and lexapro and zolpidem for sleep. I also have taken zyprexa and ativan when manic.

When I have talked to My psychiatrist and asked why some people are on so many meds, she said sometimes they take meds to counteract the side effects of their other meds. Is that what is going on with you?

I personally would have a problem with so many meds. I have said it before. I think that seems like too many.

JMHO

No. I've been told (by my last pdoc) the amount of meds and the high doses of meds is because of the severity of my illness. That was when I took only 4 meds.

When I ask my pdoc about my meds (for instance when we were discussing what this new pdoc said), there is a slight unspoken friction. It's as if he is saying either stfu or drop it under his breath.

[cashart10]

At this point I think it would be wise to consider a med overhaul and do a damn detox. This is a wonderful idea and it is actually one I advocated in the past. However, my pdoc wasn't quite as thrilled with the idea as me. I dropped it, listening to him.


Its not like they're working if moving off the couch makes you feel suicidal, so really. What's the point of taking them and rejecting the idea of a med overhaul? I suppose there isn't one. My pdoc says I'm not overmedicated. He says he's "seen people he has overmedicated and I am not one of them." I think he thinks that only because before I have an appointment, I shower, fix my hair just right, put on makeup, nice clothes and jewelry. Typically, I am in pjs and am lucky to shower every three days. I am a grease ball most of the time (even when not depressed and this is contrary to who I was before I became sick). Also, I am not a "walking zombie," but I am a complete idiot who cannot open my mouth and make sense and who has wrecked my car three times in the last couple of months (and that doesn't include hitting our garbage can last week)


You are on so many meds its possibly exacerbating your symptoms. Yes, that's a thing, where ADs can make you suicidal and APs can make you hallucinate.

Since you're on so many, you have NO way of knowing if meds are a contributing factor to you being down the crapper. Yes. I am in fact nearly throughly convinced that my new psychotic symptoms are either caused by or exasperated by the Vyvanse Why else would they begin when they began?


I know you love your pdoc (a bit too much because you listen to him blindly) but really, ask him if he would be comfortable taking all your meds and watch how he obviously pulls a face.


Some people probably need to be a walking drug store, but since that's clearly not working for you, I strongly suggest you talk med overhaul. The soonest I can get a second opinion is Sept and I intend to do so then. I can't do what you did and just flush them because I take so many (and because my husband will have a cow). I feel overwhelmed.


Thank you Trippin

[Trippin2.0]

I don't mean to come across as invalidating, so I hope you don't take this the wrong way. But if you are on the wrong meds, which you seem to be, then the whole severity of your disorder is a moot point.

I mean if that's the case, then where do we draw the line, 10, 20 meds?


There are alot of people with severe symptoms who are on much less medication. Higher dosages sure, but they are RXd way less than 10 pills. And the reason they respond well is because they've taken the time and risk to find the pills that work.


To do so you need to quit what doesn't work, instead of just adding more pills to your cocktail...


I know this is not the same, but the logic remains valid... Think of it this way.

If you take one type of pain killer, and it doesn't work, do you take a different pain killer in conjunction with that one, and if it still doesn't work, do you add another and another and yet another until you find relief?


No, because that would be dangerous.


We chuck out the Tylenol or the asprin and try ibuprofen or tramadol instead... We don't keep taking the painkillers that brought us zero relief.


So if we logically know to do this with something as tried and tested (and harmless) as pain killers, why does the same logic not apply to psych meds?


I am aware you said that you're considering a med overhaul, I'm just trying to provide some logical reinforcement as to why this is a good idea.


ETA: I didn't mean flush, I know the hell I went through and would never recommend it. I'm just lucky I didn't get too sick and was stubborn enough to stick it out for those few months.

When I say detox, I mean a taper, under the guidance of a professional.

[cashart10]

Yes...that is a great point. If I were on the right meds, even if just a few, my symptoms wouldn't be as severe. And, It feels like I'll never find those meds, but if I do, and if my life returns to what it was prior to my break, I will learn to appreciate my meds. Sometimes I think, as you have experienced, I would be better without meds. I lived for 8 years unmedicated before I had my break and had to go back on meds. My symptoms prior to returning to meds (minus postpartum depression) were so mild I didn't notice them.

[BeyondtheRainbow]

You can find those meds. I put in 8 years as treatment resistant before I hit stable when I started the MAOI and was on a normal dose of Seroquel. I did great until I caught whooping cough and that destabilized me terribly and the treatments to fix it just made things worse and I never got back to where I once was after the whooping cough andc then complications after minor surgery. But I was stable on 3 psych meds for over a year and truly think I would have been fine longer if I hadn't gotten whooping cough that turned to asthma which meant meds that destabilized me. It was worth that 8 years to get that time and it leaves me with hope that I'll someday get there again, even if I am on 7 meds now. But if I didn't know why I was taking each of them, why I was on each dose, and why I couldn't be on less I would not be taking this many. I'm on this many because my dr has explained why and what the plan is for getting me off of some of them. I doubt that anything would be added at this time unless there were a huge emergency that landed me IP and then they'd take away something. I guess I'm trying to say I'm on so many because my bipolar is severe and I am treatment resistant but that doesn't mean I'm staying on 7; if I weren't on a super high dose of Seroquel I'd be coming off meds starting next month I imagine but first we have to lower the Seroquel.

I think a dr saying "this is the way it is because I know it is the right thing" is a dr saying "take my word for it and do what I say" and that's not a good thing to ever hear from a dr.