If you have been taking bipolar medications for 10 years or longer (please mention length, if you would), have you noticed your cocktails reducing over their all-time high?

My cocktail is still somewhat large after 12 years, but notably smaller than at its height. It also continues to be reduced. My pdoc dislikes when I talk about "goals" for my cocktail, but I would like to get it to a point where I have virtually no side effects. I think that's possible on my mix.

[Vaporeon]

I was diagnosed with schizophrenia in 2002 but it was soon changed to bipolar with psychotic features. I honestly can't remember everything I've tried but at one point I think I was taking 5 or 6 psych meds per day. Now I'm taking 200 mg Lamictal in the morning, 3 mg Risperdal at bedtime, and 1 mg Klonopin as needed (which is thankfully not very often).

I think it's important to discuss medication goals with your doctor, as it pretty much goes without saying that the fewer medications you take daily, the fewer side effects you will experience. I hope you can find a combination that works well with minimal side effects. That being said, there's no shame in needing to take a large cocktail, since whatever keeps you stable and safe is worth the hassle of taking the meds.

[SparkySmart]

I've been on bipolar meds for ~40 years. For about a five-year period, from perhaps 2006 to 2011, I was sustained solely on Lamictal, and then the rollercoaster started again. My meds have thus been increased, both in number and dosage. The frequency and intensity of episodes have suddenly become uncontrollable, resulting in three hospitalizations this year alone and frightening instability. I'm finally on a regimen that seems to be working. I've always been anxious to keep meds to a minimum but am concerned for the future and don't think I can bear the financial and emotional impact of another year like this one.

I have an appointment this afternoon with my pdoc to assess the situation (I see him every three weeks until we get a handle on things) and hope we can at least discuss a tapering schedule.

Vaporeon, that's great that you only need two regular/daily meds. I hope they keep you well long-term and give you few or no side effects. I agree that there is nothing wrong with big cocktails, if that is what it takes for stability. I know that for a time, one high dose antipsychotic with high dose moodstabilizers were not enough to prevent some of my past manias, but as time passed (well) I discovered that not all of it was needed. I, however, am not striving for no meds. Even if my meds are reduced greatly I want something in place to act as a prophylactic.

SparkySmart, I'm sorry this has been such a tough year for you. I guess it goes to show that the illness can come back with a vengeance, despite treatment. Do you think there was a significant trigger to this last year's major instability vs. the years you did well only on Lamictal?

[HALLIEBETH87]

Ive been on bp meds for ten years almost and have tried SO many! I used to be on five and now i take three regularly and one prn.

[SparkySmart]

SparkySmart, I'm sorry this has been such a tough year for you. I guess it goes to show that the illness can come back with a vengeance, despite treatment. Do you think there was a significant trigger to this last year's major instability vs. the years you did well only on Lamictal?[/QUOTE]

Hi, BirdDancer! Yes, I had no fewer than six major stressors hit within a one-week period in November 2016. It was like a tsunami, and I knew I didn't have the resources to cope. From November to March, I was utterly numb from depression. Everything fragmented until, in March 2017, I was admitted to the hospital with a total bipolar meltdown. I think I'm still having fallout but am grateful that a first-class facility is only 60 miles away. Before this all happened, Lamictal served me well for years; in fact, Lamictal seemed almost transparent to me...no side effects, no memory issues (of which I'm aware), no fatigue. It's hard to assess what the prophylactic properties of Lamictal were since I maintained a steady state for such a long time.

My bipolar pattern seems to be stability for 3-4 years and then a crash. This pattern appears to be occurring more rapidly as I age, so I'm trying to establish priorities and make my preferences known in the event that I'm not able to do so when/if this happens again. I hope 2018 will be a GREAT year!

SparkySmart, it is a scary prospect that relapses may increase in frequency. I know that I will have some major stressors coming up within the year and a few years down the line.

If it was up to my pdoc I'd be a housewife in my current area (state in the US) forever, but that can't be. I know I need to work again, and my European husband wants to return to Europe. Surely to a place where I'll have some mild culture shock at the least, and language difficulties.

[Cocosurviving]

Hello there,

I’ve been on bipolar meds for six years. I presented as full blown manic when I went for help. I was immediately taken off Celexa and put on Lithium. A month later Risperdal. I started having problems with memory and slurred speech. Bipolar it’s self was giving me cognitive dysfunction. I gained a ton of weight but I kept taking the meds. I started taking Lamictal to help with seasonal depression. Two years later Lamictal stopped working so I tapered off. Then I tried Zoloft for a year. It gave me daily diarrhea and anxiety. I finished tapering off last week. Now I’m just on the Lithium and Risperdal. I take Ambien PRN. This year I had only depression in the spring. Historically I’ve had mania in the spring and summer. Depression in the fall and winter. I had no mania for all of 2017. I don’t know what to think. I get a little nervous thinking about it. I have not worked since May 2012. I get SSDI and it helps. I spend a lot of time doing coping skills. I stay tired a lot too.

SparkySmart...you are so strong. I take my hat off to you.

[SorryShaped]

I've been on-and-off nearly everything for bipolar over the 13 years I've had the DX. I've been on three for 12 months now, one of those for 9 years and the sleep one for 5 years, but one of them is for sleep. It isn't working on its own, but I told my pdoc that I'm using hirsuta for sleep and she actually said "if it really is working, use it." She doesn't want me on more meds, and I don't either. I've also had to use other plant medicines for pain and PTSD from all the bad relationships I've had. I'm also having huge mood dips just about the same time the sun goes down daily. I use plants and supplements for that too, about an hour before dark. She knows and said "just be careful."

[SparkySmart]

Originally Posted by BirdDancer

SparkySmart, it is a scary prospect that relapses may increase in frequency. I know that I will have some major stressors coming up within the year and a few years down the line.

If it was up to my pdoc I'd be a housewife in my current area (state in the US) forever, but that can't be. I know I need to work again, and my European husband wants to return to Europe. Surely to a place where I'll have some mild culture shock at the least, and language difficulties.

(I don't mean to hijack this thread, BTW)

Hi again, BirdDancer! I think bipolar episodes are actually expected to increase with age, though this may be an individual thing. My primary care doc and pdoc communicate because, as both say, this WILL happen again, so a Plan B should be in place. Seems wise!

Regarding work: It's best to think of working as a privilege and not a punishment, IMO. I've always been surprised when people say that I must have been able to maintain employment simply because my symptoms weren't as severe as theirs, but I beg to differ; my symptoms have been just as, if not more, disabling (13 hospitalizations at least, half manic, half depressed), and I've suffered the indignity of being fired for inability to perform to standard, as well as being hired for positions for which I had no qualifications whatsoever and predictably and miserably failed. I had to work or live on the streets, and working has provided a framework for my life, a necessary structure, and an uplifting and inspiring investment. I've been fortunate to have always had opportunities to "follow my passion," so I've had a sense of fulfillment that is deeply satisfying and worth the effort.

Your stressors may be considerable in the future. Preparation is key here. As much as you're able, try to space things out so that one or two stressors can be dealt with at a time, giving you a chance to debrief and regain balance. I would love to be an international traveler! Kudos for embracing a challenging life!

[Tucson]

I have been on meds for at least 15 years. I have been on most meds that are available to me. I cannot afford the more recent medication due to costs associated with a new drug. My all time high of meds was near the beginning of that time span. I always have been on a handful of meds, which is about five, but it peaked at something like 8 meds including two antidepressants and amphetamine salts as a stimulant. Oh yes, even l-thyroxine was added for good measure. And further I had been on two bentos at the same time, but this was changed to one, and then zero. My cocktail has been simplified once I got over that terrible episode of depression. There was a time that I was not on any benzos, but I can take one now at bed time PRN if I cannot sleep.