[Crystal_Teal]

I have bipolar 1. I started having symptoms in 2011 and have had 4 episodes since then. Currently I have been off meds a few months per discussion with my doctor but my family would like to see me medicated to avoid another episode. I haven't had symptoms since may 2016.

How can I tell if a medication works if I'm not currently experiencing any symptoms? Any med you suggest? I really want the least amount of side effects and I don't want to gain weight like I did with Zeprexa. I experience manic episodes that sometimes turn into psychotic episodes where I get delusional. I also experience depressed episodes where I feel like I'm on autopilot and have no personality or opinion and am not independent. Any advice is much appreciated.

[Travelinglady]

Hi, Crystal Teal, and welcome to Psych Central! I've found Wellbutrin to be a good antidepressant and Lamictal was acceptable as a mood stabilizer. But I haven't had any psychotic episodes, so you might need something stronger.

[ofthevalley]

Latuda works well for my psychosis (I am schizoaffective). I took zyprexa before but the weight gain was too much so we switched to Latuda. It's also approved for bipolar depression.

[HALLIEBETH87]

Latuda helps my mood and with psychosis

[Guiness187055]

Abilify works great for me.

[Shazerac]

Welcome to psych central

[still_crazy]

i take abilify, trileptal, and a low dose of lamictal, plus a whole bunch of supplements. Abilify -can- cause weight gain, but it generally doesn't cause the same amount of weight gain as zyprexa, seroquel, or risperidone. it also usually does not cause significant prolactin elevation. akathisia is more of a problem w/ abilify than some other tranquilizers.

Trileptal is 'off-label' for mood disorders. I think most of the data comes from European studies. Seems to help me w/ agitation and moodiness. Minimal blood work; a baseline sodium blood level check, then another one I think 12 weeks or so into treatment.

Lamictal is popular for people w/ recurrent dips into depression. I take a low dose, but some people take 400mgs+ (my psychiatrist told me he goes up to 600mgs...why, I have no idea...). requires very slow increases to the target dose to avoid the risk of a potentially fatal rash (its rare, thank goodness). higher doses can cause concentration difficulties. i do not think its known for causing changes in weight, but i could be wrong.

Like I mentioned above, I take lots of vitamins w/ my psych drugs. Its called Orthomolecular. Its mostly just very high doses of common vitamins--vitamin C, vitamin E, B vitamins, etc.--to help one get "more mileage" out of the psych drugs and reduce the risk of some adverse effects.

here's a link to free information on Orthomolecular, if you're interested: DoctorYourself.com: Andrew Saul's Natural Health Website

hope this helps.

[Nammu]

Welcome

Everybody experiences meds differently. General rule of thumb is to avoid AD completely to avoid getting triggered into mania. I was on a AP and a mood stabilizer but quit the mood stabilizer as it was making it hard for me to experience emotions. I feel my AP ( latuda) is quite stabilizing. But I was on that cocktail for almost 3 years before quitting the mood stabilizer.

Along with med a schedule especially a sleep schedule is highly effective at keeping the episodes away.

I have bipolar type 1 and have had psychosis in both full blown manias and severe depressions. I can not take antidepressants. Of course a psychiatrist is the most knowledgeable and qualified person to recommend medications, but if you were me, I would not go on an antidepressant unless it was necessary. It would only spell trouble for me.

That's great that you've been stable for so long. I also feel your choice to take at least some bipolar medication for preventative purposes is a good idea. I would think your doctor would start you on a low dose, and only increase it a lot if you did start experiencing mood issues. You surely know that low doses of many (not all) meds are tolerable.

From my experience, many pdocs try to give patients the first line medications as a start. These usually include Lithium or one of the anticonvulsant moodstabilizers. From my experience, Tegretol XR and Lamictal are the friendliest in terms of weight and other side effects. Too much Lamictal is activating for me, but not for others. I did have some side effects initially on Tegretol XR, but now I don't, and I'm on a very high dose. Most people take half or just over half of my dose of 1400 mg.

Nowadays some pdocs seem to just use low dose antipsychotics as the new "moodstabilizers" for fairly stable people. From what I've seen Abilify, Latuda, Seroquel or Seroquel XR, and Geodon are common. I've never taken Latuda, so can't share experience on that, but I've taken the others. Any could potentially be good. You'd have to see. I, personally, wouldn't take meds like Risperdal, Invega, Zyprexa, or the 1st generations unless I really had to. All of them gave me bad side effects.

[sonjaward809]

I find Abilify helpful as well as Trileptal. They have lessened how severe my episodes can be. I've tried Risperdal, Seroquel, and Geodon too but they either sedated me too much or I couldn't feel anything.