Mania treatment for someone with tardive dyskinesia?

NolaMae · Sep 04, 2019, 03:50 PM

Hi. I have a history of tardive dyskinesia. Because of that I am unable to take an antipsychotic. What does someone do who’s manic? I’m only sleeping a few hours a night and am uncontrollably spending. I’m currently taking lithium. I can’t see that it’s helping me much and I’m gaining weight on it which isn’t making me feel any better. While I was taking Abilify I was doing well, but had to stop because of the TD. I don’t know what to do. My next appointment with my psychiatrist isn’t for a couple of months and she’s really hard to get an appointment with anyway. I’m just really really discouraged right now.

Wild Coyote · Sep 04, 2019, 06:34 PM

Hi NolaMae,

I am sorry you are having a challenging time.

It must feel very frustrating, maybe even frightening to feel like you may not have many treatment options.

Any chance you can see, or can talk on the phone with, your treating pdoc?

I have seen mania treated by using meds like Klonopin (in very high doses) and some other sedating meds. I would think your pdoc might have some good approaches when it is not possible to use an AP med.

I hope you can get in touch with your pdoc and can ask for help soon.
Please keep reaching out here to whatever level is comfortable to you!

Blue_Bird · Sep 04, 2019, 08:26 PM

There are moodstabilizers other than lithium available such as Depakote, Tegretol, Topomax, Trileptal, Lamictal , maybe discuss that with your doctor

Good luck

Pookyl · Sep 04, 2019, 11:24 PM

These are the non-medication things I do:
Confine myself to indoors
Keep the lights dim/low
Watch something like a black and white movie or anything with David Attenborough
Colour in
Jigsaw puzzles
Give my wallet, keys, (also car keys back when we had a car), phone, computer etc to my husband for safe keeping
Create a low stimulus environment and stay there if possible

Sep 05, 2019, 10:40 AM

Pookyl's suggestions are my step 1 and/or what I do in addition to a medication adjustment. There are the anticonvulsant moodstabilizers as were mentioned above. Some people have and do get full relief from monotherapy from one or more of them. I guess which varies. I do know that Depakote and Tegretol have the reputations as good antimanics, but maybe another would work. I find Tegretol to be much more side effect friendly than Depakote, but that can vary, too.

Wild Coyote · Sep 05, 2019, 10:54 AM

Quote:

Originally Posted by Pookyl

These are the non-medication things I do:
Confine myself to indoors
Keep the lights dim/low
Watch something like a black and white movie or anything with David Attenborough
Colour in
Jigsaw puzzles
Give my wallet, keys, (also car keys back when we had a car), phone, computer etc to my husband for safe keeping
Create a low stimulus environment and stay there if possible

I was glad to see this!

I have often suggested keeping lights dim, even shutting the curtains if there is bright sunlight coming in through the windows. Many have let m e know they do not think this,and other steps are helpful. I am glad to see BirdDancer suppporting your plan, too.

Bluebicycle has a website where people can download a program which will help with computer screen light, if one must use a computer when feeling manic. I should clarify, this program is used for lessening the light at night when usisng a computer. I am guessing it would potentially help anytime, especially if the room is not full of sunlight. Maybe Blue will come along and will clarify for me.

There are also yellowish/amber glasses one can use to filter out some light. I have a pair I use for migraines; I cannot recall just now where I had gotten them. I will think on this and will get back with some info if I can find it. Again, the goal is to block as much light as possible.

Thanks so much!

Wild Coyote · Sep 05, 2019, 11:06 AM

Quote:

Originally Posted by Blue_Bird

There are moodstabilizers other than lithium available such as Depakote, Tegretol, Topomax, Trileptal, Lamictal , maybe discuss that with your doctor

Good luck

Oh yes. I had not read carefully enough to see where the lithium might not be working. I agree totally with the idea that a mood stabilizer must be on board.

Everyone reacts differently to different mood stabilizers. I have seen someone in a manic frenzy relatively quickly subdued with Depakote. In addition to prescribing pills, the doctor had prescribed Depakote sprinkles for the person to use for a more immediate effect as a prn. (The sprinkles were mixed in apple sauce.) I have no idea as to whether or not this approach might helpful to anyone else.

I hope you find a helpful approach sooner than later.

still_crazy · Sep 06, 2019, 01:01 PM

i am not any sort of expert, obviously. my assumption would be that treatment would involve one of the anti-seizure drugs (trileptal and/or lamictal come to mind) with a sedative or 2 (klonopin AM, ambien PM, for instance), then a hopefully slow taper off the benzodiazepine(s) and a focus on the mood stabilizer(s). something like that, anyway.

i wish you well. :-)

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