[WibblyWobbly]

How do you know when you need a med change or you just need to use coping skills? Obviously the more extreme symptoms of mania need meds. Right now I am rapid cycling. I will sleep for 3 days straight, only getting up to use the bathroom, and then I'll be up and go spend $500 on clothes and crap. I've been experiencing a lot of agitation, urges to SH and brief bouts of suicidal ideation when I'm up. The pdoc at PHP is telling me I'm highly medicated (1500mg of lithium and 120mg of Cymbalta) and that I need to use my coping skills. I told her I'm not functional and it's consuming me trying to control my agitation. I feel like my meds aren't working and I've missed 4 days of PHP because I couldn't wake up and get out of bed. Thoughts? Opinions? Personal experiences? Any meds that helped you out of rapid cycling? This has been going on about 4 to 6 weeks now.

[Blue_Bird]

That is a fairly high dose of Lithium, I used to be on 1800 mg but got toxicity.

I would explain everything you said here to your doctor and ask. What meds have you been on?

Maybe it's time to try something new.

It's possible you need both a med adjustment and better coping skills, a therapist can help you with the latter.

[BeyondtheRainbow]

I wouldn't call you highly medicated (look at my signature). You are on a good dose of lithium but lithium is about blood levels not dose and if you need that much to get the levels then you need that much.

I think it is always a combination of coping skills and meds, although when I am really bad therapy is more just talking until meds kick in. Although this time around honestly therapy has helped more than meds although even my therapist would say it isn't exactly fixing things. It has let me get some horrible depression thoughts out and that's more than the meds can do.

I really can't separate them but I do know you are not "highly medicated" and that lithium plus an AD may not be enough. You may still need another mood stabilizer to help keep you level (lithium doesn't work as well for both ends) and maybe you are on too much AD for the amount of stabilizer you have (for example I was on 300 mg of Seroquel when I went on Emsam which is pretty activating; I needed 600 mg of Seroquel immediately after starting Emsam to keep me from being manic).

It's completely a balancing act and to me both have to work together.

[WibblyWobbly]

Originally Posted by Blue_Bird

That is a fairly high dose of Lithium, I used to be on 1800 mg but got toxicity.

I would explain everything you said here to your doctor and ask. What meds have you been on?

Maybe it's time to try something new.

It's possible you need both a med adjustment and better coping skills, a therapist can help you with the latter.

Lithium is the only mood stabilizer I've tried. I've been on APs at various times in the last year and a half—Seroquel, Zyprexa and Geodon. Seroquel was the one I used most regularly but I have bouts of debilitating fatigue from fibromyalgia and I would go off it at times.

[Cocosurviving]

Originally Posted by WibblyWobbly

Lithium is the only mood stabilizer I've tried. I've been on APs at various times in the last year and a half—Seroquel, Zyprexa and Geodon. Seroquel was the one I used most regularly but I have bouts of debilitating fatigue from fibromyalgia and I would go off it at times.

I've also found Lithium 900 to be a good mood stabilizer. It keeps me out the mental hospital. I do take it with another mood stabilizer as well (AP) Risperdal 400MG. These were the first two RXs I started taking for mania. I started having SAD so my doc add Lamictal.

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