[duckrabbit]

Hey everyone—I’m new here and wanted to introduce myself. I’ve been diagnosed with Bipolar I, GAD (with obsessive-compulsive tendencies) and symptoms of PTSD (not enough to qualify for a diagnosis anymore, thanks to EMDR). I was diagnosed 4 years ago, when I was 18, and I’m still going back and forth between acceptance and denial (and everything that comes along with that).

I’m in my last year of college, and this is a particularly stressful time, as it’s finals week and I have a few papers to write. I went off my medication for bipolar in September (Latuda monotherapy; topamax for headaches, though it may have had an effect on my mood) but stayed on Gabapentin for anxiety. I’ve been on and off meds for the last four years (I have an issue with compliance) and always feel stable for a month or two right after going off, but then things get wild. I was using alcohol and various drugs pretty excessively this semester, and had a chemical health evaluation that resulted in a recommendation for residential treatment. Financially, this is the worst time of the year to enter a facility that is so costly, so I’m trying things on my own—24 days clean and sober now.

The last month, I’ve been riding an increasingly intense high. Minimal sleep, elevated/expansive/euphoric moods, everything must be done now (and it must be a masterpiece), increased libido and careless spending (I haven’t bought anything too expensive, just video games and books that I can’t afford), lots of thinking which leads to lots of talking (speed-talking is my forte), mild hallucinations (mostly at night, of the hypnagogic sort, mostly pleasant; but also during the day I think people are all around in the corners of my eyes but they’re not, etc.), people tell me I’m paranoid, and things just overall seem very special and purposeful. In the last week, irritability/agitation has been appearing. I wake up and am usually irritable for an hour or two before things go back to being great, but the irritability can also be pervasive. I guess I’m just afraid of going into a mixed episode, as I have a history of those and was hospitalized for it last fall.

I’m considering going back on meds (my rational mind tells me to do it, but I’m getting a lot of stuff done and don’t necessarily want it to end). I see my pdoc on Monday to talk about options, many of which I’ve exhausted—but there’s still enough left to try. She has tended to push AP monotherapy, but I had the cognitive side effects that I usually get from AP’s. Lithium didn’t work for me (really bad physical side effects—though I would try it again) but I don’t know why she’s not suggesting mood stabilizers. I’ve only tried Lamictal (which felt like a sugar pill for me) and Topamax.

Is an AP mono therapy effective for any of you? Has anyone tried Saphris (she’s considering that)? Or had problems with lithium but had it work a second time around?

Thanks for reading (or skimming) this long introductory message. I’m excited to be a part of this forum!

[emgreen]

Welcome to the forums! I've never been on monotherapy, so I can't help you there. I find my small list of meds (nothing over the top) helps me stay stable. I think you need to talk to your shrink ASAP to get some proper information (though I know you said you have a problem with compliance). Congrats on 24 days of sobriety...Alcohol always got me in trouble, so I gave it up. Good luck with whatever you decide.

[bioChE]

Welcome to the forum, glad to have you. I've tried monotherapy in the past, without much success. Good luck if you try other things. Being med compliant is the only real way to find benefit when you have a psychiatrist on board. Otherwise you're just shooting in the dark without knowing the effectiveness of a certain therapy trial.

[Shazerac]

Hello and welcome to psych central

It's not uncommon to be in denial about being bipolar. Who wants this? However it doesn't sound like what you are doing is working for you. Going on and off meds is messing with your head. I hate to say it but you might need to actually do what your doctor advises for more than just a couple of months at least. Getting stable and then thinking it's ok to go off meds is part of the denial process. Good luck to you and I hope you figure out what works for you.

[whoamihere]

Welcome to the forum and congratulations on your 24 days sober

[Victoria'smom]

I was on abilify alone for awhile. I did well except depression. I started to think my husband wanted me dead so I started an antidepressant. That made me to agitated so I stopped it. Right now I'm on abilify and lamictal. My pnurse wants me on at least four meds. We're negotiating. I wish pnurse believed in monotherapy. Keep that psychiatrist. I use to be on two meds when I moved here and now they want me on 4 plus a prn. Is mania your main issue?

[CloserToTheMid]

I just started Saphris with very positive results. 24 hours sober is a big deal. Congrats. I think it's a good move whether you are an addict/alcoholic or not while you are getting stabilized. The question of meds is similar to addiction issues. I could decided to start drinking again and things would be manageable for awhile, but there is zero percent chance that it would stay that way. You know that without your meds your life will become unmanageable and yet your bipolar brain keeps making the same insane choice to go off them. I'm bipolar and a drunk. One depends on the other. If I drink again, I might get ill again. If I get ill again, I might drink again. It's such a fine balance for us.

I'm glad you are here, duckrabbit!

[still_crazy]

hi. some people can do monotherapy. I was on a high dose (30mgs) Abilify all by itself until other problems popped up.

I understand your problems with APs. Abilify works for me and doesn't slow me down too much, but the other ones I tried weren't so great. Risperidone wasn't terrible, but I was worried about TD and prolactin levels, so the doctor put me on Abilify.

I have personally refused lithium, because of the horror stories. I also refuse depakote, because of hair loss and lethargy when I did try it, plus I don't like doing labs.

I don't know anything about Saphris. Is that the dissolving tablet? Some of the atypicals are supposed to be good for all parts of the spectrum--manic, depressed, and mixed. Seroquel has lots of data behind it, but that's probably because the company paid for a lot of studies. Personally, I've found Abilify to be helpful for agitation and keeping mood swings to the upper ends to a minimum, but I still get severe depression.

I hope you and your doctors find something that works well.

[duckrabbit]

Thanks for the responses. I know being compliant with meds is what is really going to help in the end. I’m working on facing the reality that I may have to take meds for the rest of my life (or a significant period of time). I just want to find something that doesn’t dull my mind, as I find most things do. We’re considering an injectable AP. In that case, I would only have to say “yes” to meds once a month, rather than making that decision every day. On the other hand, if I’m able to live with this without the help of meds (most likely resulting in a fluctuating, eccentric life), is that worth it? Idk, it’s all mixed up.

Miguel’smom—Recently I’ve had more occurrences of both euphoric and dysphoric manias. I had my first episode of depression w/ SI when I was 9 (caused by an abuse, though). My manias are definitely more overtly destructive, but the depression tends to be months, and has included catatonia (which I find really scary looking back on). I think my baseline tends to be a little excitable (goal-driven, racing thoughts, fidgety, grand ideas—but in a healthy, balanced way), but I’m still trying to figure out exactly what baseline for me looks like.

[Unrigged64072835]

Welcome to the forums!

I'm on Latuda monotherapy for BP. I take a bunch of other stuff for anxiety, though. I haven't tried Saphris, though.

[BipolaRNurse]

I wish I could get along on one med, but I'm on six and need every one of them. But whether you're on one drug or ten, med compliance is essential. You can't just go on and off meds, if you do they can stop working and/or they might not work at all the next time. For me, it took a long time and a hospitalization to get the combo right...I'm not going to risk my stability by messing around with it.

[Wander]

Welcome to the forums. You will find support here so post away! Well done on 24 days without alcohol, that will help you. Not complying with your meds prescribed on the other hand will only lead to instability. When do you see your psychiatrist? Be totally honest and hopefully you can both come up with a good plan. I am on Lithium mono therapy for BP, Ritalin for ADD and Clonazepam for PTSD/anxiety. However, when I am in an episode with BP I generally take an anti-psychotic as well. Most recently I took Abilify and it really got the mania and psychosis under control quickly. I haven't had problems with Lithium except at high doses (taken when manic). At lower doses the only side effects are occasional tremors and thirst. Good luck with your treatment.

[JustJace2u]

Welcome. I was just diagnosed in May. As hard as it is, and as much as it sucks, I've had to learn to accept the fact that meds and therapy really are the only way I'll survive. I've always hated taking meds, but at the same time, I hate feeling like crap. It's like a double edged sword. I'm currently on Wellbutrin and Lamictal. It seems to be working for the most part, especially after being hospitalized a few weeks ago and having the dosages increased. I'm still dealing with a roller coaster of feelings and emotions, but at least my SIs have subsided.