[Pookyl]

My mood’s been dropping for the past week or so. Add some situational stuff and my mood is bad. Oh and once I’m in an episode I have a complete mental blank re what to do.
I did ring the community psych nurse and she confirmed that I should have my prn’s.
I don’t want to ring my pdoc - she’s dying to increase my meds and I don’t want to give her an excuse to do so.
I have to be on a plane on Saturday morning. Any suggestions how to quickly turn this mood around?

[Movingon69]

Why don't you want her to especially if you feel your symptoms are worsening?

[Pookyl]

Thank you for responding.

Answer: Because my pdoc has been talking about increasing my Epilim (Depakote). I’m already on 1000mg and really don’t want to increase dosage because of associated weight gain.

I took an extra 50mg of Seroquel (immediate release) prn yesterday. My mood is back up to irritable.

[Pookyl]

I’ll take more Seroquel prn today as well.

[~Christina]

My advice when nose diving is do the exact opposite of what you want to

Stay in bed? Get out of it and make the bed

Clean with the 15 minute timer go 15 mins rest 15 wash rinse repeat

Take a walk numerous times a day

Avoid sitting on the couch too easy to fall over and sleep lol

Cook a few new things , food network can be entertaining

So yeah do the exact opposite than you wanna do.

[Pookyl]

Originally Posted by ~Christina

My advice when nose diving is do the exact opposite of what you want to

Stay in bed? Get out of it and make the bed

Clean with the 15 minute timer go 15 mins rest 15 wash rinse repeat

Take a walk numerous times a day

Avoid sitting on the couch too easy to fall over and sleep lol

Cook a few new things , food network can be entertaining

So yeah do the exact opposite than you wanna do.

Thanks. That what my sister said too. Mind you it does mean I’m all dressed up with no where to go. Hubby said to take myself out to lunch. I might do that - it’ll prevent the falling asleep on the couch scenario.

[~Christina]

Lunch sounds great !!

I haven’t done that in forever.

[AspiringAuthor]

Depakote can be a strong anti-manic agent, which, esp. synergistically with Lithium, can mean that you are taking too much antimanic stuff and not enough antidepressant stuff. If anything is a candidate for a dose increase in your mix, it is Latuda, not epilim. I agree that given Depakote is such a bad med in terms of weight, you do not want to go above 1000. Maybe ask for a blood test for a depakote level - if she sees it is high enough, she won't push an increase on you. Ask her what she thinks about upping Latuda.

[Pookyl]

Originally Posted by ~Christina

Lunch sounds great !!

I haven’t done that in forever.

It was nice. I then came home and slept on the couch for 90min.

[Pookyl]

Originally Posted by AspiringAuthor

Depakote can be a strong anti-manic agent, which, esp. synergistically with Lithium, can mean that you are taking too much antimanic stuff and not enough antidepressant stuff. If anything is a candidate for a dose increase in your mix, it is Latuda, not epilim. I agree that given Depakote is such a bad med in terms of weight, you do not want to go above 1000. Maybe ask for a blood test for a depakote level - if she sees it is high enough, she won't push an increase on you. Ask her what she thinks about upping Latuda.

I have a tendency to almost always run manic and mixed. I’m rarely depressed. The only thing that stopped my sui mixed mood in Nov ‘17 after 10 months was Epilim/Depakote, so I can on a logical level understand the increased need for it. My blood levels are sub therapeutic so that’s another reason she’s considering an increase in dosage.
She doesn’t want to up the Latuda because I’ve had a drop in cognition since starting on it.
I have a really complicated medical history so I can sense that she’s in between a rock and a hard place.

[BeyondtheRainbow]

I know they say that 1000 mg of epilim is about where the weight gain starts but I was on 3000 mg and didn't really gain weight from it. I gained weight from the lithium and seroquel I took with it but depakote was pretty weight neutral for me. I was in a clinical trial when I went on it so it was easy to track weight gain and I only gained 8 lbs from it. Lithium was much worse for me. It was very hard to keep my level therapeutic and then it had to be quite high for it to actually work for me so my metabolism of it was probably part of the issue but especially if you aren't at a therapeutic level a little high dose might not be so bad.

[AspiringAuthor]

Originally Posted by Pookyl

I have a tendency to almost always run manic and mixed. I’m rarely depressed. The only thing that stopped my sui mixed mood in Nov ‘17 after 10 months was Epilim/Depakote, so I can on a logical level understand the increased need for it. My blood levels are sub therapeutic so that’s another reason she’s considering an increase in dosage.
She doesn’t want to up the Latuda because I’ve had a drop in cognition since starting on it.
I have a really complicated medical history so I can sense that she’s in between a rock and a hard place.

Then it is difficult (in her shoes and esp. in yours)

If you are benefiting from the synergy between Lithium and Epilim, and, you are subtherapeutic on both, but do not gain weight on Lithium, then there is the option of raising Lithium, not Epilim, but arriving at the same result.

How are you doing, Pookyl?