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  #1  
Old Nov 11, 2018, 06:26 PM
pacman_789 pacman_789 is offline
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Hi, I have a question about antipsychotics for bipolar.. For those of you on one of these meds (Abilify, Seroquel, Latuda, etc.), how do they make you feel compared to mood stabilizers like Lamictal or lithium? Do most of you take them alone or in conjunction with an antidepressant? When I was on a mood stabilizer, I had to take an SSRI with it or I felt completely blah and apathetic. They helped with the mania but not the depression. Just trying to set my expectations for how they might help with depression vs. mania.

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Andrew
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  #2  
Old Nov 11, 2018, 06:44 PM
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I take Clozaril in conjunction with an antidepressant (Pristiq). The Clozaril makes me feel much less hyped up during the day and I actually fall asleep at night (I take 100mg in the morning 200mg at night). It definitely works better than lithium or other mood stabilizers in that it keeps me from having full blown psychosis, lithium would just keep me from going manic but I would still have hallucinations and delusions and such. So yeah, it helps with mania and psychosis, but not enough with depression to not need an antidepressant.
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  #3  
Old Nov 11, 2018, 06:53 PM
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Tryingtobehappy5 Tryingtobehappy5 is offline
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I have tried seroquel and risperidone. The seroquel made me extremely tired to the point where I couldnt function and that was in combination with an AD. The risperidone I only took for a couple weeks while I was IP and just after. But I was in the middle of a manic episode which settled down a bit but then I convinced myself I was in a nightmare. Im not really sure what it was doing because I freaked out and went off so quick.

Mood stabilizers definitely havent affected me the same way. I have taken them with and without ADs. Depakote alone I feel was making me cycle every couple weeks although Im told thats not possible. After a really bad episode after a year on depakote they added an AD and lithium. I found this killed the last of the mania but didnt do anything for the depression. So I just quit everything.
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  #4  
Old Nov 11, 2018, 07:08 PM
still_crazy still_crazy is offline
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not a big fan. -all- psych drugs seem to cause problems and most are mind numbing to some extent, but...wow. the "antipsychotics"/tranquilizers make life more bearable, but that comes at a cost, from day 1.

so...as a band aid while I try to get my life mind straightened out, OK. for life? not something I really want, and honestly....I don't even know that years and years and years of tranquilizer consumption is all that safe, just in terms of overall health and well being.
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  #5  
Old Nov 11, 2018, 07:25 PM
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Pookyl Pookyl is offline
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I need my Seroquel (AP). If I skip a dose I deteriorate very quickly.
I’ve had Abilify in addition to Seroquel in the past but hated the way I felt. I think it made me mixed as I was really agitated.
I have found that I need both mood stabilisers and AP’s.
AD’s are a massive no no for me.
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  #6  
Old Nov 11, 2018, 07:27 PM
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Blueberrybook Blueberrybook is offline
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I take Seroquel with Wellbutrin and Lamictal. For me, it's been a lifesaver and has helped a lot with mania (sleep too). Lots of people are very tired on it or gain weight, but everyone is different; Seroquel has been weight neutral for me though I do exercise a lot. However, before that, the pdoc tried me on extended release Seroquel, and I was a mess. I only wanted to sleep, eat when I needed to. I had no energy to exercise at all. I just couldn't function. Can't say about weight; I think I was on it less than 2 weeks when I called and told her I just couldn't function on it; then she tried me on the regular release and I was fine.

I took Abilify quite some time, but I don't think it did a thing for me.

I don't know with Lamictal if I really feel anything taking it though maybe it stops the moods swinging back and forth so much?

The Seroquel helps with the mania, the Wellbutrin with the depression. I haven't had bad mania lately, so maybe the Seroquel is helping. On the other hand, I've been mixed forever, and that is no fun either. The Wellbutrin maybe gives me energy, at least sometimes. IDK, maybe stress, things like that factor into it.
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Last edited by Blueberrybook; Nov 11, 2018 at 07:41 PM.
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  #7  
Old Nov 11, 2018, 07:37 PM
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It's such an individual thing-- how we each react to certain meds.

If I was deciding for myself, I wouldn't take other people's accounts into consideration. I have found doing so is usually a huge mistake.

That said, I'd recommend as little exposure as possible to both 1st and 2nd generation antipsychotics. However, if you need them, you need them!


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  #8  
Old Nov 11, 2018, 07:40 PM
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I don't like taking them, because of the potential side effects such as tardive dyskinesia. Seroquel made me very sleepy. The doc had prescribed it at bedtime and it did really knock me out.
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  #9  
Old Nov 11, 2018, 08:07 PM
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As Wild Coyote said meds are definitely different for each individual, but i will give you my thoughts; I have been on a Antipsychotic alone for most of treatment. Seroquel really does do the trick at least for me. I had such a bad reaction to a few big name Antidepressants that I think my doctor is afraid to combine the too, even though the Seroquel would probably balance it out. I've also had a reaction to a few other Antipsychotics. I was on Lamictal alone for a few days, but while I was on it I was withdrawing from Effexor and the NP I was seeing at the time didn't tell me that what I was feeling was probably Effexor withdraw and not a reaction to the Lamictal like she thought. I haven't been brave enough to try Lamictal alone again, so I stick with the Seroquel and the Buspar since I at least know these work.
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  #10  
Old Nov 11, 2018, 08:12 PM
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I seem to need an AP for psychosis purposes. I’m on haldol right now as most of the ones I tried didn’t work or had unacceptable side effects. I’m afraid to ask to go to PRN because I don’t know if it’s helping keep my mood stable or not and I can’t afford to destabilize at this point. In the past when I’ve gone off medications they don’t work when I go back on them.

The only AD I could tolerate without going manic was emsam. It’s an maoi. All others made me manic or just didn’t work at all.
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  #11  
Old Nov 11, 2018, 08:27 PM
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It's interesting because meds I could not tolerate 10 years ago, I can now tolerate. So it can change for each individual.


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  #12  
Old Nov 11, 2018, 08:50 PM
Anonymous46341
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I third what Wild Coyote and TheSeaCat wrote. Experiences vary.

I've been medicated for bipolar disorder for around 14 years now. I have always taken either Lithium and/or an anticonvulsant moodstabilizer and at least one antipsychotic the whole time. During my very worst years with full blown manias with mixed features (often with psychosis), some psychiatrists also added an antidepressant. I'm certain that the antidepressants created my worst years. They were incredibly destabilizing for me, if not immediately, they were within weeks. That pattern was repeated so often that my private psychiatrist said no antidepressants again. That was about eight years ago. I have not been hospitalized these eight years. He was right...for me. But antidepressants may be helpful for others with bipolar disorder.

It's hard to generalize how some meds made me feel compared to others, even within the same class of medications. And when you say "feel" what exactly do you mean? It's a complex question. Also, my experiences with many medications were often different in the early weeks of taking them than later down the line. Another also depended on my mood states at the times I was taking them, and the combinations of medications I took. On some, I even forget how I felt.

What I wrote above may not be what you want. Gosh, I could say a lot about a lot of meds and combos.

What specifically are you looking for? Which meds helped more with depression? With mania? With both? Side effects?

I've taken all of the following medications, again with at least one moodstabilizer and one antipsychotic. Feel free to ask about my experiences with any of them. My favorites have a next to them.

Moodstabilizers:
  • Lithium ER
  • Depakote ER
  • Lamictal -Good and bad
  • Trileptal
  • Neurontin
  • Tegretol XR

Antipsychotics
  • Seroquel (regular)
  • Haldol (haloperidol) - Only used for emergency injections
  • Risperdal
  • Zyprexa
  • Abilify
  • Geodon
  • Invega
  • Navane (thiothixene)
  • Trilafon (perphanazine)
  • Seroquel XR

Antidepressants
  • Cymbalta
  • Pristiq
  • Wellbutrin SR
  • Wellbutrin XR

Anxiety meds:
  • Vistaril (hydroxyzine) - antihistamine
  • Buspar (buspirone)
  • Klonopin -a benzo
  • Ativan - a benzo- Good and bad . (also used for emergency injections to calm violent outbursts)

Side effect medications:
  • Inderal (propranolol) - tachycardia, tremors
  • Synthroid (levothyroxine) - hypothyroidism
  • Cogentin (benztropine) - akathisia

Miscellaneous:
  • Librium (chlordiazepoxide) - benzo used for alcohol withdrawal relief
  • Revia (naltrexone) - for alcohol cravings
  • Campral (acamprosate) - for alcohol cravings

Also had a series of ECT treatments about 9-10 years ago.

(Before my bipolar diagnosis, I was prescribed Prozac by a university psychiatrist, Effexor and Paxil by a GP, something I had no idea about by a Taiwanese hospital doctor, and Lexapro by a psychiatrist, but only took these medications for between 2 days and a week, except Lexapro, which I took for one month before leading to my bipolar diagnosis.)

Last edited by Anonymous46341; Nov 11, 2018 at 10:27 PM.
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  #13  
Old Nov 11, 2018, 09:59 PM
pacman_789 pacman_789 is offline
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Thanks all for the responses. From what I’m hearing, I probably will need an antidepressant then in conjunction with it since it sounds like the antipsychotic is more for mania than depression. Lamictal definitely helped control mania for me, but it made my OCD worse and didn’t do much for depression, which is why I have to take Zoloft. Hoping that one day I’ll find the right combo 😊
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  #14  
Old Nov 11, 2018, 10:45 PM
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Guiness187055 Guiness187055 is offline
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Abilify kinda covers all basis for me. I am on a high enough dosage that it acts as an anti psychotic but I still get anti depressant effects also. Abilify with wellbutrin has been a life saver. I was on seroquel also and the with drawls really suck.
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  #15  
Old Nov 11, 2018, 11:05 PM
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Pookyl Pookyl is offline
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Quote:
Originally Posted by Guiness187055 View Post
Abilify kinda covers all basis for me. I am on a high enough dosage that it acts as an anti psychotic but I still get anti depressant effects also. Abilify with wellbutrin has been a life saver. I was on seroquel also and the with drawls really suck.
Actually you raise a very good point. I also am on high doses of my psych meds so I still get anti depressant effects also. So I don’t feel I need an anti depressant.
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  #16  
Old Nov 12, 2018, 01:40 AM
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BipolaRNurse BipolaRNurse is offline
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I take two antipsychotics, every day. I can't even imagine life without them, as much as I wish I could cut down on meds. They keep me stable and allow me to live my best life. Every now and then I get too big for my britches and think I can get along without them, but I usually run into trouble quickly and realize that I really DO need both APs and other mood stabilizers to keep me in line. Sometimes I wish I could make do with a single mood stabilizer, an antidepressant and an AP, but it's probably not in the cards so I just deal with it and try to remember how bad off I was before all these meds came into my life.
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  #17  
Old Nov 12, 2018, 11:36 AM
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For me? Seroquel did one, and only one, thing: made me gain 100+lbs. Pdocs keep insisting that Seroquel is helping me. My guess is that Astra-Zeneca is providing those pdocs with free cruises to the Caribbean. Think I'm joking? Well, I'm not.
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  #18  
Old Nov 12, 2018, 12:59 PM
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I'm on haldol, lamictal, and cymbalta. The haldol works the best. Without it I'm a psychotic mess.
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  #19  
Old Nov 12, 2018, 01:07 PM
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I’m on Lithium and Lamotrogine and Lorazepam. These are my main meds usually but when severely hypomanic or mixed I am given an AP to help me calm the f**k down. I have taken Seroquel, Zyprexa and Haloperidol mostly. Did try a lot of the newer ones like Abilify but they either did nothing or made me worse. I actually like Haloperidol best as it is not that sedative and hardly ever causes weight gain. Saying that, I am currently prescribed Seroquel to help me sleep and calm mania and mixed symptoms.

It is good to remember that we all have different bodies so meds work differently for all of us. Good luck.
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  #20  
Old Nov 12, 2018, 01:49 PM
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((((pacman_789)))) I hope it works out for you! Let us know how it goes. And remember to consult your Pdoc, as well.
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  #21  
Old Nov 12, 2018, 08:24 PM
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Quote:
Originally Posted by *Laurie* View Post
For me? Seroquel did one, and only one, thing: made me gain 100+lbs. Pdocs keep insisting that Seroquel is helping me. My guess is that Astra-Zeneca is providing those pdocs with free cruises to the Caribbean. Think I'm joking? Well, I'm not.
You make a valid point that some pdocs are certainly pretty deep in the drug reps pocket, but my aunt is a drug rep and they can't even give out pens with the companies name on them anymore. Most of the time if they want doctors to prescribe a medication they usually buy catered lunch for the entire office staff to not seem biased. A lot of drug reps in my area do this, It could be entirely different in some places though. I do think some docs let drug reps influence their decisions too much.
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  #22  
Old Nov 12, 2018, 09:49 PM
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Quote:
Originally Posted by TheSeaCat View Post
You make a valid point that some pdocs are certainly pretty deep in the drug reps pocket, but my aunt is a drug rep and they can't even give out pens with the companies name on them anymore. Most of the time if they want doctors to prescribe a medication they usually buy catered lunch for the entire office staff to not seem biased. A lot of drug reps in my area do this, It could be entirely different in some places though. I do think some docs let drug reps influence their decisions too much.
Some of the guidelines for drug reps vary from state-to-state. My state is now very strict and docs have to report anything over the value of $50.00, except for med samples.

There is a web site where we can run a doctor's name and can see all they have reported, including income from speaking engagements.

My last pdoc owned a large practice. He'd stopped any/all drug reps from coming into the practice. His reason? One reason was that he'd found himself starting people on a med because he had been supplied with samples and starter packs. Once he'd realized this was influencing his med choice, he'd stopped the reps from visiting.

I have several doctors and they are all skeptical of what a drug rep tells them. The docs insist upon seeing well-designed double-blind studies, etc.


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  #23  
Old Nov 12, 2018, 09:58 PM
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Quote:
Originally Posted by Wild Coyote View Post
Some of the guidelines for drug reps vary from state-to-state. My state is now very strict and docs have to report anything over the value of $50.00, except for med samples.

There is a web site where we can run a doctor's name and can see all they have reported, including income from speaking engagements.

My last pdoc owned a large practice. He'd stopped any/all drug reps from coming into the practice. His reason? One reason was that he'd found himself starting people on a med because he had been supplied with samples and starter packs. Once he'd realized this was influencing his med choice, he'd stopped the reps from visiting.

I have several doctors and they are all skeptical of what a drug rep tells them. The docs insist upon seeing well-designed double-blind studies, etc.


WC
That is true that is does vary from state to state, many of the doctors I work for refuse to see any drug rep; they don't even like samples because of the reason you mentioned that it influencing choosing and my current doctor likes the old medication because at least he knows what he's getting the patient into and at least there are studies of side effects.
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  #24  
Old Nov 12, 2018, 11:23 PM
pacman_789 pacman_789 is offline
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Thanks again everyone. I have an appointment with my psychiatrist next week, so I feel better prepared for what kind of questions to ask. She usually gives me some input as far as which medicine I want to try.
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  #25  
Old Nov 13, 2018, 01:09 PM
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Christopher1990 Christopher1990 is offline
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For the first couple years all I took was a mood stabilizer (depakote) then after my second hospitalization I've been on antipsychotics for the last 10 years. Its as if I can't function without them. I can't sleep without zyprexa. The side effects vary and these are heavy duty drugs. I feel exhausted throughout the day and am in bed 12+ hours.

They usually do the trick in stopping the mania/psychosis.
But, imo these drugs should be used short term only.

Latuda was the only ap I've taken with basically no noticeable side effects and it kind of seemed to uplift me instead of making me tired all day.
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