[Americano]

Comment on how you control your mania.
If you’d like to read my lack of control of mania below I describe it.

Description of my mania:

I take antidepressants and lamictal 300mg.

if I can only take these meds I feel high and so good I’ll smile and laugh for no reason. However I’m also very agitated, internal restlessness. And I can not stop taking other substances. Which ruins my mood but the lack of self constraint and judgement leads me back to it every time. Uppers downers you name it I’ll start taking it. Also I shop online having a compulsion to buy things I want even though it’s not financially responsible. I don’t want to quit antidepressants because I’m anxious and depressed without them. I really need help because this has taken control of most of my life. (Mainly the uncontrollable substance use that always comes back around this has been going on for a decade.)

Olanzapine aka Zyprexa works quickly, hands down.

I’m not sure that my answer would make a difference when there are upper/downer drugs in the mix. I see you’ve posted about LSD too.

I’m not judging—I know that if your meds aren’t working that self medicating is a way to try to cope.

Have you tried working with your psychiatrist on getting a drug regimen that will actually work for you?

[Americano]

The antipsychotics I’ve tried before I hated. And fiddling with my meds is so difficult because depression and anxiety hit me from the antidepressant withdrawal. Maybe I should try to taper down the stimulating Prozac as at this point I’m only getting a few hours of broken sleep at night.

[AspiringAuthor]

Prozac can cause insomnia, as can Lamictal. You need something to balance those out - a mood stabilizer or an antipsychotic. Which ones you hated and did you take them along an antidepressant?

At this point I would, as you yourself suggested, taper down on Prozac. Between Lamictal and Prozac, Prozac is stimulating to more people than is Lamictal.

As to controlling mania otherwise - I do not think you can.

[Victoria'smom]

I have Ambien that I take if I miss a night of good sleep. Zyprexa helps with my moods.

[Wonderfalls]

Mania can be dangerous to your relationships and financial situation if nothing else. Lamictal is not considered to be a strong counteraction against mania. SSRI's can trigger mania and certainly never help control it. If you really want to control your mania then you'll have to keep trying effective drugs until you find one that works and which you can tolerate. People who are well-controlled for mania (which you apparently are not) can often deal safely with an antidepressant.

[rwwff]

Depakote's my main goto, and I can use an ambien to break the sleeplessness part if I get in trouble on the up side.

I'd be much to afraid to take an ssri. asking for trouble I'd think.

[Moreta]

When I get manic I take saphris. It's one of the newer APs. Works quickly. Usually settle down within a week or 2.

[Wander]

Both Lamotrogine and antidepressants do not address hypo/mania. They are both indicated for depression. Talk to your pdoc and see if there is anything you can add to deal with the upside. I take Lithium and Lamotrogine and when mania slips through I take Haloperidol which tends to nip it in the bud. This combo works well for me most of the time.

[Nola0250]

My doc told me lamictal works for both ends, but better at controlling depression than mania. That seemed to be the case for me with slight breakthrough on both ends. Unfortunately started getting side effects as titrating up, so back down I go. Titrating Latuda up. That seems to be better. I was seeing things out of the corner of my eyes and heard a few things I am pretty sure weren't there for the last week, that's gone a low dose Latuda already.

[Blueberrybook]

Getting enough sleep is key for me, whatever meds work. Ambien induced panic attacks in me, so I can't take it. Making myself take the meds and sleep (because on some level, don't we all enjoy the mania more than the depression?). I can't be on antidepressants long (SSRIs, do better on SNRIs, I think) or they cause mania though sometimes my pyschiatrist has put me on them short term when the depression is bad.

Right now, I'm on Seroquel, an anti-psychotic, 300 mg, the instant release (timed release made me feel too much like a zombie the next day). It may be a nontraditional AP; I'm not sure about that. In some people it causes weight gain or extreme fatigue the next day, but not for me. I do get the fatigue when I take the Seroquel at night, but it gives me a pretty normal night's sleep. I also take Lamitcal (200 mg), Buspar, and Klonopin. But I also have prescriptions for hydroxyzine (usually puts me to sleep) and Trazodone (makes me stay asleep) for when I can't sleep. I hate the hungover feeling the Trazodone gives, but on the other hand, getting the mania under control and staying out of the psych hospital is worth it in my books. It's tough because meds are not an exact science and what works for one person may not work for the other.

What I really hate is sometimes I will convince myself it will be OK not to take my meds a few days, just to get a little more energy, and then I will slip into full-blown mania. Then, the cycle repeats.

[Guiness187055]

My abilify keeps me pretty steady but if I get to high I pop a zyprexa and that does the trick.

[~Christina]

When was the last time you and your Pdoc really looked at your meds and hear how your actually doing ?

I think you need a med overhaul and if nothing else a Prn if you find yourself hypo/mania situation.

[*Laurie*]

Originally Posted by Wander

Both Lamotrogine and antidepressants do not address hypo/mania. They are both indicated for depression. Talk to your pdoc and see if there is anything you can add to deal with the upside. I take Lithium and Lamotrogine and when mania slips through I take Haloperidol which tends to nip it in the bud. This combo works well for me most of the time.

With respect, I would like to point out that the main use for Lamictal (besides as an anti-convulsant) is to stabilize moods, which means it is definitely used to control mania (it markedly controls mine). Lamictal also has mild anti-depressant properties. You can google it if you want to check out my info. Oftentimes an AP is added to further stabilize moods and to help with sleep.

To answer the original question, the meds I take control my bipolar disorder quite well. I take Lamictal, Cymbalta, a low dose of Seroquel, and Klonopin. For me, sleep is essential to for my mental health. Music helps me a lot, as does doing creative things.

If you're using substances besides prescribed meds you're bound to have some major mood swings. I'm not judging you at all; I understand the pull toward drugs. All I'm saying is that making a tossed salad of a bunch of chemicals is bound to cause mood disorder. That's something I've experienced with many friends, and with my sister.

[Nammu]

The AD can be causing iritatabily and mania.

[luvyrself]

Originally Posted by AspiringAuthor

Prozac can cause insomnia, as can Lamictal. You need something to balance those out - a mood stabilizer or an antipsychotic. Which ones you hated and did you take them along an antidepressant?

At this point I would, as you yourself suggested, taper down on Prozac. Between Lamictal and Prozac, Prozac is stimulating to more people than is Lamictal.

As to controlling mania otherwise - I do not think you can.

——anti depressants can push bipolars up too high.
I totally disagree that you can’t control mania w anything but meds. Cutting back on activities, avoiding triggering /stressing situations and people when possible, minimizing overstimulation and bright light are some of the things that can help.

My current medication mix has proved to be the best one I've taken at keeping mania away. I take a high dose of Tegretol XR, a small dose of Lamictal, and a medium dose of Seroquel XR. I do sometimes take Ativan prn for anxiety, but on my mix anxiety isn't always an issue for me. I think my Seroquel XR is helpful for anxiety, as well as keeping mania away and helping with depression.

Occasionally I get depressed, but I have found that minor adjustments to my Seroquel XR and therapy help with that. Really, therapy has turned out to be a very important part of my treatment and prevention of bipolar episodes. It wasn't always like that. I had to get to a point where I was actually able to concentrate on it. Also, a very good therapist makes a difference.

If I start to get elevated in mood I can take prn Seroquel. My psychiatrist allows me to take a certain amount of Seroquel above and beyond my regular mix. If the prn doesn't seem to help, then I call him. He is good at giving me emergency appointments.

I've learned in the past that encouraging or stoking hypomania/mania is a very bad idea. It ends up hurting you in the long-run. And what goes up and stays up for a long time often goes down and stays down for a long time eventually. Since I have bipolar type 1, I have to be careful about not letting my mania get out of hand. It can get extremely bad, usually leading to emergency appointments or hospitalizations.

When I was younger (in my 20s in particular), I could have extended elated hypomanias. It felt great, but because I wasn't medicated properly (or at all), I think it worsened the course of my illness. Now I don't have extended elated hypomanias/manias. Now when I become elevated it may be elated briefly, but then turn mixed which gets extremely ugly and terrifying. The long string of manias with mixed episodes in my thirties sort of traumatized me, and ultimately disabled me. I've been disabled for years now and still struggling to get to a point where I can become as functional as I'd like/need to be. Bipolar is not a joke or a game. It's a serious illness.

I can't take antidepressants. They destabilize me in very bad ways. I do take the small dose of Lamictal with the Tegretol XR and Seroquel XR, but larger doses of Lamictal are too activating for me. That's just me. You seem to have discovered that for you antidepressants are activating, and maybe even Lamictal (or at least Lamictal isn't an effective enough antimanic). Playing with fire!

[Wonderfalls]

[QUOTE=*Laurie*;6050406]With respect, I would like to point out that the main use for Lamictal (besides as an anti-convulsant) is to stabilize moods, which means it is definitely used to control mania (it markedly controls mine). Lamictal also has mild anti-depressant properties. You can google it if you want to check out my info. Oftentimes an AP is added to further stabilize moods and to help with sleep.

________________________________________________________________'
This is the very first thing I pulled up when I googled it: "Another important finding suggests that Lamictal bipolar treatment may be mainly effective against depression as opposed to mania (this where the lithium or other anti-manic drugs come in)" It's not that it doesn't do anything, it's just that there are a zillion more effective drugs to control mania. I take Lamictal, but I also take Latuda just for that reason..

[Americano]

Well my stack that is normal is lamictal 300mg celexa 20mg and prozac 80mg (2 ssris crazy I know) but now I’m also taking gabapentin, Dexedrine(adderall) and kratom daily...that’s a lot of medications! I’ve cornered myself again!

[cool09]

Lamictal is for bipolar depression. Mood stabilizers like lithium are used for mania. And anti-psychotics are used for agitation. Geodon and Zyprexa helped my agitation.

For meds, lithium/risperdal. I can do other things to prevent or lessen mania, but not fully control it like sleeping, avoiding stimulants including caffeine, and exercising A LITTLE BIT each day.

[Americano]

Originally Posted by escapeartist

For meds, lithium/risperdal. I can do other things to prevent or lessen mania, but not fully control it like sleeping, avoiding stimulants including caffeine, and exercising A LITTLE BIT each day.

I really need to quit stimulants I think that’s the key because I take caffeine and amphs daily right now...the rollercoaster of ups and downs even without bipolar

[pirilin]

I 've never controlled mania. Nor have I wanted to. Mania is my mother. Other people do it for me.

How do I control mania?

I can't.

What tips me off?

Generally mania hits when I have either had a major change of life situation or suddenly find myself in a position of great joy and excitement.

The last such event was triggered when I came into a lot of money. Money meant I could do things. Money also led to excitement which only drove the mania further. After 10 months I had burned my way through the money and had a major crash leading to hospitalization.

I have had numerous hypomanic experiences all again of which came about after a change in circumstances. Fortunately they did not go beyond that.

Well, I will admit this time around I am really fighting to fend off full scale mania. Once again I have come into money. Once again my life is suddenly good, happy, without the day to day fears of how I would get by. Once again I am inclined to spend this money. The difference though is that this time around I have a support network that recognizes my current state and is trying to keep me in check. The most important of these is a boyfriend who I am relying upon to stay real.

[Unrigged64072835]

I can tell from my previous episodes what to look for. Loss of sleep, hyper focused on a specific activity for hours on end, spending lots of money for that activity right away, and a big sense of impatience with everybody.

How do I control it? Coordination with my pnurse for more meds or different meds. Work with my T on my behaviors. Having the support of my family. Sometimes IP if I need it.