[still_crazy]

it used to be that the older tranquilizers, when used in bipolar, were used at lower doses than in Schizophrenia. That or they were only used during mania or psychotic depression, and then tapered.

do you find that you do best on low dose, moderate dose, or high dose tranquilizers? has your dosage changed over time (up or down) ? I"m curious, obviously.

I was on a high dose atypical--30mgs/Abilify. I"m now on 20mgs/Abilify and doing better. Or it could be that I started doing better, so I was able to reduce to 20mgs/Abilify. I don't really know.

But...yeah...I'm kind of hoping to get the dosage down to 10-15mgs/Abilify per day, since Abilify helps some symptoms of depression @ lower doses (not so much at higher doses...this according to my current psychiatrist...), and of course...TD is -always- a concern.

so...what are your experiences with tranquilizer/antipsychotic dosing?

[Wild Coyote]

I live with BPII. I do/have tried Atypicals which target Bipolar Depression. I am always on a low dose. Right now, Abilify 6 mg.

Always good to have you around!

WC

My doses of antipsychotics have varied depending on the individual medication and/or the severity of my mood state (usually mania). Some antipsychotics seemed to pack a more powerful punch than others. For example, Zyprexa and Risperdal seemed more powerful for me than others. The two 1st generations I took were also very powerful mania stoppers. You'd think I should still be on them, but they were very side effect unfriendly. I took semi low to medium doses of them.

Abilify was more of an antidepressant for me than antimanic. It made me manic at even a high dose. I'll never take that again, plus it gave me akathisia.

Geodon was side effect friendly for 5.5 years, but I took the highest recommended dose and it was eventually not enough. A second antipsychotic had to be added on top of Geodon to curb my mania. The second one was a 1st generation at a somewhat low dose. It seemed to help, but then I got a dystonia so my psychiatrist slowly weaned me off that. And as I was being weaned off the 1st generation, Seroquel XR was added at a low-medium dose, so at one point I was taking 3 antipsychotics at the same time, in addition to Lithium, Tegretol XR, and a small dose of Lamictal, plus Klonopin.

When the 1st generation was totally eliminated, my Seroquel XR dose increased a bit to around 350 mg (a medium dose).

My psychiatrist then had to take me off Lithium because he discovered kidney damage. He did so slowly. Getting off that was luckily easy with no med increases, showing that Lithium was not that helpful for me.

Geodon eventually gave me akathisia. It was miserable, but I lived with that, taking Ativan for relief, for almost 3 years. Then my psychiatrist and I decided to eliminate Geodon and leave Seroquel XR as my only antipsychotic. The Geodon weaning was rough. Rougher withdrawals than for any other med I had taken and gone off of. We couldn't get me off of it for 1 year. As my Geodon dose decreased, my Seroquel XR increased because of mood instability.

Now I only take Seroquel XR with my moodstabilizers Tegretol XR and small dose Lamictal, plus Klonopin. My Seroquel XR dose was up to 600 mg (a medium high dose), but lately it's gone down to 450 mg (a high medium dose). I'm doing great with almost no side effects.

[Guiness187055]

Any anti psychotic that I have taken I have always been on a high dose. I was on 20 mg of zyprexa and am now on 30mg of abilify. plus 200mg of seroquel for sleep.+

[xRavenx]

They always move my AP up and down. It's usually in the high range when in a full blown Mixed Manic state, since those times are absolutely horrendous. However, my AP is usually in the moderate range dose when at baseline. I am never without an AP.

[Moreta]

High dose usually. Right now I take 280 mg of geodon. Used to be on 25 mg of saphris with it as well but went off that last year.

[still_crazy]

ok. I read about it, and one big thing about the older drugs....Bipolar I and other mood disorder people tolerated them even less well than most Schizophrenic patients. With the atypicals, Bipolar I people tolerate the new drugs better, but TD is still a very real risk.

I guess my 20/Abilify+200/Lamictal isn't terrible. I'm prescribed a very low dose of gabapentin to take as needed, but I try not to take it. Maybe its because I'm already an on a full dose anti-seizure drug, maybe its because of the supplements (high dose B3 does something to GABA receptors, to help one calm down), but...even low doses slow me down too much.

I did find risperidone effective, but it was mind-numbing, plus...I was worried about long term problems, such as prolactin elevation and metabolic problems. low dose zyprexa triggered akathisia (weird).

the only time I've taken an older drug was in a hospital. It was a b-52: benadryl, Haldol, and Ativan, plus the depakote. Holy mother of God...threw me for a loop. never again.

ok. thanks for the replies, btw. :-)