[Davidk418]

Hi - I have two psychotic episodes in the past 5 weeks and have been taking Lithium and Xyiprexa on and off. After I get out of the hospital and take the medication for a couple of days I notice that my energy level really goes down and I feel lethargic. I do not want to take the medicine if this is the result and the quality of life I will have. If you have any thoughts/ideas on how to manage bipolar disorder and maintain medium-high energy levels please let me know. Thanks so much. Happy Thanksgiving!

[Moreta]

I think it is best to stay on your medication if you've been having psychosis. You could see if they'll decrease your meds or you could ask for Provigil or Nuvigil to keep you awake. They're narcolepsy meds. I take provigil and it keeps me pretty alert during the day. Many BP medications are sedating in nature. It's about finding a happy medium.

[cmorales]

My meds made me lethargic too. I put on like 60-70lbs as a result (I stopped exercising). I made a deal with my pdoc that I could begin cutting down the dose if I joined a gym. Given that gyms are so expensive, I've yet to do this.

Although, I did recently stop taking my meds (for 5 weeks)... don't know why, exactly. I got my energy back a bit... but then I began getting symptomatic so I figured it best to go back on.

I'd say stick with the meds for now, simply because you've been psychotic recently, but definitely tell your doc that you want a lower dose as soon as is realistically possible because this lethargy, if not taken care of, can lead to physical problems. Like my weight gain, which has wreaked havoc on my blood pressure, etc.

Best of luck. I hope you get this figured out sooner rather than later.

Hi David, you should check with your doctor because I'm not so sure you want to be taking meds like lithium and Zyprexa 'on and off'. I don't know a lot about Zyprexa (except that it makes me eat, and eat, and eat, and eat) but the efficacy of lithium depends on its serum level in your blood, so if you're only taking it sporadically you're unlikely to maintain a therapeutic blood serum level that will do you any good. Doctors prescribing lithium usually order blood tests to measure the level of lithium in your blood to make sure that you're taking enough to exert any effect on your symptoms. The bad news is, once you do reach that therapeutic serum level, you're likely to feel quite lethargic, at least for a while. It's the nature of the beast. I was once a fit and vain athlete but have put on astonishing amounts of weight after 25 years of bipolar meds that rob you of your energy and increase your appetite far past your needs. I guess that taught me something about vanity and judging others for their obesity, but I have learned to choose fat and sloth over psychosis.

My customary reminder of how Zyprexa is advertised in Denmark, "Before" and "After":

[Teddy Bear]

Meds make you lethargic. Lower dosages help but don't start and stop taking meds that will mess you up.