[*Beth*]

(cue Tom Petty:
I need to know [I need to know]
I need to know [I need to know]
Because I don't know how long
I can hold on
If your makin' me wait
If you're leadin' me on
I need to know [I need to know]
I need to know [I need to know])





Okay. But more seriously. Or maybe less so. But important, either way.

Let's say you're on a medication. At first, that med works well. But after a while it's not as effective. So you raise the dose. It might be okay, but it's not as obviously helpful as it was initially. But you stay on it for several months.

Then you really begin to wonder why you're taking a medication with the usual med side effects if you're pretty sure it isn't helping you. Your pdoc has given you the option of doing what you feel is best. So. How do you know what your next step is? Take the chance of stopping the med and see how you feel? Or think to yourself, This medication is probably helping me more than I realize. I'll stay on it for a few more months until...well...until what?

I'm stuck.

The medication, btw, is perphenazine (Trilafon - an AP). 16mg. It was prescribed to me for extreme anxiety, particularly anxiety that occurred at the same time every afternoon. But lately I'm feeling quite anxious 'round the clock. It seems that the med just isn't as effective as it was. So why keep taking it? Any ideas?

[MuddyBoots]

I am in a similar position with my tegretol. I decided to slowly ween myself off on my own schedule as my body feels best (pdoc is okay with this btw). I hate being on meds that I feel are doing absolutely nothing. Could you ask your pdoc for any further guidance or opinions?

Ultimately, it's your decision, and I don't think it's one that really matters much because if you decide to reduce or stop the med you can always restart it again.

[bpcyclist]

The brain does seem to get used to what we send it
Sometimes a change is a good thing

[Soupe du jour]

I think that the only way to know is to experiment (with your doctor's assistance). I've had medication "poop out" and also cases where a medication did help, but not enough. I've also had a medication that likely did next to nothing the whole time, and only realized that when I was slowly weaned off and the only change was an improvement in my quality of life. Also, I've been on a medication that seemed to be working, but really it was just my mood had leveled out all on its own. Then later down the line found that that medication brought on mania over time. Lots of scenarios! Though I am one to recommend patience with medications, I don't so much that valuable time is wasted. Especially if a medication gives terrible and/or numerous side effects.

Looking at your question a different way, I might wonder if your Trilafon is helping, but you need a "booster" or "adjunct" something or other. Such an adjunct need not always be an additional medication. It could be some change in routine, life circumstance(s), coping skills practice, and/or something else.

[Merlin]

I have a med that I go off and on when I need to. It works well to get me out of a depression, dose dependent on severity, but I don't want to be on it when I'm out, especially with mixed or hypomanic symptoms. I guess clearing it out of my system makes it work again.

[*Beth*]

Thank yous!

I'm mulling it over. I think that part of what's going on is that I have been/am using more of the coping skills I'm gaining from therapy. That said, I've found that bipolar anxiety, when it truly is that, can scarcely be controlled without medication. I'm so frightened of feeling severe anxiety, which is why I hesitate to stop the Trilafon. Every time I have that level of anxiety it has bad repercussions for months...years.

Yet, there's no healthy reason to take a med that isn't doing anything. Perhaps the best way to do this is to - first of all - drop the dose and see how I feel. Go from there.

If only I had Tom Petty's magic hat....

[*Beth*]

The Magic Hat tells me that I need to speak with my pdoc. The anxiety (or is it mania?) is climbing higher by the hour and I'm feeling at a loss as to how to proceed. I need (says in a Queen Elizabeth accent) *professional guidance*.

[bpcyclist]

Prolly better call the pdoc, maybe. A week of Klonopin never killed any of us.

[*Beth*]

Originally Posted by bpcyclist

Prolly better call the pdoc, maybe. A week of Klonopin never killed any of us.

Yeah, I spoke with her last week after I posted this. I was so relieved to have talked with her about the issue, as I was pretty spun out by that time. She wisely increased the Trilafon to 20mg. (I think 24 is max). I'm already doing substantially better. Have more objectivity, less intensity.