For anyone who has taken stimulants, has a boost in your AP and/or a boost in your mood stabilizer helped prevent mania?

I want to take stimulants again, but my pdoc says I'll likely become manic again. So, I'm just wondering if boosting my med dosages might help prevent mania. Heck, I'd be willing to go on a second AP (e.g., Seroquel full time instead of PRN) if that would do the trick.

I've talked to my pdoc about this, but I'm wondering about your experiences.

[ComfortablyNumb5]

I was on stims and seroquel daily and still got manic from it. I'll. Ever touch them again. I lost my job because of it

[Sad Mermaid]

I was not on AP or MS when I was on them. Based on the strength of the mania that ensued (especially in the more recent case which necessitated Zyprexa to bring me down), I doubt that any boost would counteract the mania-inducing effect, but I have not tried, so it is just an uninformed opinion.

Do you think your doctor would risk it? I want to try a stimulant if I get into a deep depression lasting months without relief but I'm just not sure my doctor would risk it. I also go through months of soul draining fatigue. Not "I'm tired, a coffee or nap will help" but a tired you feel in your bones. No driving allowed tired. A stun could potentially give me a much higher quality of life. It's risky though and I have the exact same question as you so I will sit back and look forward to hearing from people with experience. While I have experimented with drugs of every kind I've never abused them in anyway indicating an addiction. I have abused alcohol in the past but it's minor compared to most people I know (it's possible I know a lot of alcoholics but I don't think so). When using street drug stimulants I entered a psychosis which went untreated and took a year to get out of.

[mossanimal]

I went mixed and ended up in the hospital with Adderall and Zoloft... before BP diagnosis and lamictal. Adderall, for me, was useless. I enjoyed it the first week I suppose.

[HALLIEBETH87]

I had a whack dr say once I have add and gave me adderall....made me SO so energetic and when I went back to see the regular GP (a huge whacko!!!!) he was like omg don't take that again!

Originally Posted by bluebicycle

I want to take stimulants again, but my pdoc says I'll likely become manic again.

Yep. You'll be playing with fire, and the stakes are high. I remember you mentioning important upcoming job opportunities, conferences and interviews; wouldn't you want stability instead of stimulation during such a critical period?

The last thing you want to be when interviewing for or starting a new job is manic; people may notice, or you could dangerously overachieve, setting expectations that you won't be able to consistently fulfill when you inevitably crash. Been there, done that: four years of a promising tech career ended, followed by months hiding in an ex-girlfriend's house in Silicon Valley while she had noisy sex with her new boyfriend in an adjacent room. Fond memories.

[Victoria'smom]

Whenever my son takes a stim he gets suicidal at night.

[Sad Mermaid]

Originally Posted by bluebicycle

For anyone who has taken stimulants, has a boost in your AP and/or a boost in your mood stabilizer helped prevent mania?

I want to take stimulants again, but my pdoc says I'll likely become manic again. So, I'm just wondering if boosting my med dosages might help prevent mania. Heck, I'd be willing to go on a second AP (e.g., Seroquel full time instead of PRN) if that would do the trick.

I've talked to my pdoc about this, but I'm wondering about your experiences.

Also be careful (beyond what has been said by others) as AP's change properties as their dosages change. Seroquel is a sleep aid in small doses only; it is used an as AP in large doses and the sleep inducing quality gets phased out as the dosage is upped. Seroquel also may lose its sleep-inducing qualities from constant use, so if you use it PRN now and it helps, you may lose that from going on it FT. I think the most important part is regular sleep and if you are getting it with Seroquel PRN, I would not risk losing it.

I am on Geodon which in large doses makes me depressed because its anti-manic property gets too strong for me. In small doses it's too activating for me. I have found a medium dose at which it is just right. It took a long time to find the optimal dose. If you add stimulants into the mix, trying to optimize the whole thing (AP-MS-stim), you may be looking at weeks or months of arriving at the solution, and even then the solution might evade you. So with so many opportunities lined up (conferences, etc.), it would be too risky now to enter an experimentation stage.

[still_crazy]

Way back in the day, there were neuroleptic+amphetamine combinations available in one pill. ThoraDex, Eskatrol, etc. They were used for some forms of depression and for weight loss. Those pills, of course, are no longer on the market. Some people got excellent results from them.

I seem to recall reading that neuroleptic+stimulant combinations have a higher risk of tardive dyskinesia. Kinda makes sense, intuitively.

I took Adderall with Abilify, and the combination was...weird. I felt "off" the whole time. I used Klononpin to even things out, which created additional problems.

If you choose to go the neuroleptic+amphetamine route, I'd personally recommend using Seroquel or another low potency, sedating tranquilizer as the main antipsychotic, not the Abilify. I have an acquaintance who is remarkably stable and all that on Adderall XR in the AM and Seroquel in the PM.

[ComfortablyNumb5]

I'm going to also add that when I got off stims I had to be put in an AD because when you quit stims they really drain your brain chemistry. A wack pdoc gave me the stims and when I got a new pdoc they were appalled and the state of depression the come down put me through. So my point is that using them for depression is very counter active.

[Wander]

I take 60mg of Ritalin a day with 750 mg of Lithium and have had no mania. Only been on Ritalin for about 3 months. been a little hypo this week tho...or mixed, not sure yet. That was triggered by ptsd stuff tho. But considering your reactions in the past I would only dare to try it when you had a week off work in case it goes bad.

[bioChE]

Well, I'm going to provide a counterpoint to most of this thread. My cocktail is Latuda 80mg PM, Lamictal 200mg AM, Vyvanse 40mg AM and 30mg Noon.

For me, having a stimulant in the mix is critical. It keeps my ADHD tendencies at bay, and it also keeps me awake and alert when counteracting the sedation of anything else. I should also mention I'm on gabapentin 900mg 3x/day for nerve pain.

Seriously, the Vyvanse is a godsend. It's very similar to Adderall, but is the pro form of the amphetamine, so the body has to convert it before it becomes psychoactive. In practice, this boils down to a very "smooth" lift on the front end and no real letdown on the back end. It does not provide the jittery shock to the system that IR Adderall and Ritalin cause.

I'm a fan of Vyvanse. I know in general stimulants can induce mania. In my case it doesn't, as I've been very stable on this cocktail and I've been taking the Vyvanse for the better part of a year. Good luck with whatever you and your psychiatrist decide.

Originally Posted by ElsaMars

Do you think your doctor would risk it? I want to try a stimulant if I get into a deep depression lasting months without relief but I'm just not sure my doctor would risk it. I also go through months of soul draining fatigue. Not "I'm tired, a coffee or nap will help" but a tired you feel in your bones. No driving allowed tired. A stun could potentially give me a much higher quality of life. It's risky though and I have the exact same question as you so I will sit back and look forward to hearing from people with experience. While I have experimented with drugs of every kind I've never abused them in anyway indicating an addiction. I have abused alcohol in the past but it's minor compared to most people I know (it's possible I know a lot of alcoholics but I don't think so). When using street drug stimulants I entered a psychosis which went untreated and took a year to get out of.

I became manic off Adderall (no sleep for nearly 4 days, energetic, agitated, paranoid, very mild hallucinations), so my pdoc told me to stop taking it.

He doesn't want to risk it again, but I do. lol. I want to take a high dose of Seroquel (as someone here mentioned) to make me sleep. Maybe that'll fix the issue, especially since Seroquel targets mania anyways.

I also want to try Vyvanse because of what bioChE said. And I believe st0psign said before that Vyvanse is the only stimulant that doesn't make him manic.

Originally Posted by Lefty the Salesman

Yep. You'll be playing with fire, and the stakes are high. I remember you mentioning important upcoming job opportunities, conferences and interviews; wouldn't you want stability instead of stimulation during such a critical period?

The last thing you want to be when interviewing for or starting a new job is manic; people may notice, or you could dangerously overachieve, setting expectations that you won't be able to consistently fulfill when you inevitably crash. Been there, done that: four years of a promising tech career ended, followed by months hiding in an ex-girlfriend's house in Silicon Valley while she had noisy sex with her new boyfriend in an adjacent room. Fond memories.

Yeah. I was manic when I did the interview for my current job. My soon-to-be boss said, "Wow. I've never seen someone so enthusiastic and energetic! I like it. You're exactly the person we need for the job!" So I suppose I got lucky.

I did overachieve in the past, but not when manic. That was a big mistake. Plus, my new boss is a total asshole and berates me for stupid things that don't even matter. He's just mean spirited and no one likes him. Even when I did overachieve this quarter (and was told I was a top performer), he still said I deserve no bonus "because my performance fluctuates a bit". So I guess it doesn't even matter.

[ComfortablyNumb5]

I was on 70 mg a day of vyvanse. Separated in two doses. It made me very shaky and paranoid. I wouldn't even leave my house. And the come down for me was horrible. Talk about depression and sleeping for a whole day. So it may of helped for others but honestly I think I like adderall much better. It's smoother for me with no come down.

[BipolarMama31]

My experience:

I do take adderall.

I take seroquel 300mg, Trileptal 300mg and klonopin 1mg at night.

I take pristiq 150mg, adderall 10mg in the morning.

10mg adderall around lunch.

I have big ups and big downs. The adderall does not impact my bipolar, but it does help my adhd .

I've been warned by every doctor that if I become manic/hypo, to lower the adderall or stop the lunch time dose. But I never saw that it has pushed me into mania.
But of course, we are all different and respond differently.

[still_crazy]

Stimulants do help some people, even those with a label of "bipolar I," and rarely even someone with a diagnosis of "schizophrenia."

If you're concerned about agitation, (hypo)mania, all that, but still want a stimulant...maybe ritalin, focalin, or even Provigil/NuVigil? Just a thought.

Are you sure you want to take 2 full dose antipsychotics? Its your life, your doctor, etc., but...wow. 2 antipsychotics+a stimulant would have my brain in a hot mess.

[PatternsInTheIvy]

I never had a problem with 15mg Adderall XR with 200mg Lamical and 50mg Topamax. <== Odd secondary, I know, but even atypical APs are a no-go for me with how poorly I reacted to Abilify. Also on Welbutrin and Klonopin. I did all right the combination there and didn't have issues with hypomania and wasn't pushed into mania until I had excessive stressors

[bioChE]

Blue - have you and your doc figured this out yet?