[MuddyBoots]

My med providers both inpatient and outpatient are always obsessed with getting me on the highest dose of whatever meds I'm on ASAP. Vraylar? Yup, 6mg. Zyprexa? from 0-30mg in two days. Invega Sustenna? Let's start off at 234 and keep it there. Risperdal consta? gotta be 50mg (but at least they let me lower that one to 37.5mg after a while). Lithium? 1200mg when 900mg worked fine. Seroquel? 900mg (800mg of the XR and 100mg of IR).

Maybe this is why I keep getting side effects I can't tolerate.

[Soupe du jour]

Originally Posted by Sapien

Maybe this is why I keep getting side effects I can't tolerate.

Very likely, I think. I also find it best to take the smallest possible dose that is efficacious. My goodness, especially of Lithium. I remember having therapeutic doses at both 900 mg and 1,200 mg, yet at the beginning of my treatment they had me on the 1,200 mg. I eventually went off of it because of permanent side effects.

I was once on three moodstabilizers and three antipsychotics simultaneously. Some were at high doses, a couple lower ones. But still. Six serious meds was too much. Plus I even took a benzo, making it seven.

[Yaowen]

If that was happening to me, I would be very perplexed and concerned. Do your physicians not explain their rationale? So sorry you are in that situation.

[*Beth*]

I agree with you, Sapien. It's an odd way of prescribing. Seems I can never get my providers to prescribe anything above a minimal dose and a "we'll see."

[HALLIEBETH87]

My dr heavily doses me. I think though for me
It’s because I deteriorate very rapidly

[Mountaindewed]

My pdoc always asks me if its ok if we make a med change and if I have a suggestion he normally agrees to it. He rarely lowers anything but never over drugs me.

Why I've stuck with the man since moving out of state even with all the crap he spews. He's a good psychatrist but not good in other areas.

[MuddyBoots]

I think the reason they do this is because I am "somewhat treatment refractory" (word for word from my hospital notes).

[Nammu]

They used to do that to me back in the 80’s and 90’s they’d just add and add. I got fed up and quit all of it. Then they wised up and learned that the vast majority of bipolars aren’t to be on AD. But when I went back at the urging of of T the first thing they did was put me on a AD which threw me into a mixed episode then they wanted to throw the kitchen sink at me and I walked away again. Then I had a bad episode and went to ER psych and told the pdoc no ADs. He agreed wholeheartedly and gave me a lower dose AP and lamictal. Since then the AP has been at a medium dose and all I take.