Somewhere on the spectrum?

Hi there,
Im a 32 year old male who's been on AD's his whole life. Have never been able to get the right med down, because I always have the worst side effects. Long story short, my Psych and I walked through a wash-out period (no meds except ambien), which lasted about 3 months. I felt good, but it seemed more and more like I wasn't getting "rested" at night. Had a couple of sinus infections and then chronic migraine, and then BOOM, hit a depressive episode like I've never known. Didn't have the energy to make it down the block. My dr. called in 50mg Pristiq (something I've been on and responded ok to in the past) and I started it at 3pm on a Sunday. DID NOT SLEEP THAT NIGHT. Called out of work. Dr. tried stabilizing with Seroquel, had bad reaction. Finally, Zyprexa. Been taking 5mg at night. I've been groggy, but it's been working. Since it's almost poison, my Dr has me coming off of it after a week on 5mg at night. He said I can try to not take it (which I did last night), or take 2.5mg for a few nights first.

As you guys may know, it's hard for me to differentiate the anxiety from the agitation/worked-up nature of hypomania. I'm so "bipolar light" I don't know what's what. But the racing thoughts and agitation are just too much. Per Dr orders, I tried stepping off the Zyprexa last night. Had to take 2.5mg this morning things were just so wonky, the agitation and racing thoughts. I'll probably be taking 2.5 at night til I see him again this coming Friday.

Also, I'm taking 20-30mg of Prozac. Trying to find that right dose that doesn't push me into hypomania, right. I know I probably need an AD on board at least. And the doctor mentions Lithium/Depakote/Lamictal as next steps in the Mood Stabilizer realm.

I've read so many horror stories and stuff online. Do any of you guys have any experiences you could share if you've had a similar go of it?

I'm really glad you're there!
Matt

Hi Matt. I'm glad you're here. I take Lamotrigine, which is the generic for Lamictal. I take 150 mg., which is a good dose for me. I've tried Lithium, and wasn't crazy about it. But it could work for you. Give a low dose a try. I know nothing about Depakote. Do some research on it.

Hi Matt, sorry it has taken me so long to reply.
I was on AD at first. Celexa, Effexor (blah) and Prozac (yeah). Prozac on its own made me manic. After that, I was on lithium and any combination of many other things. I have stayed on lithium because it does stabilize me but doesn't do much for my depression. I finally was able to convince my pdoc to try prozac with the lithium. First try didn't go so well but I am giving it a try again and so far it is ok at 40mg. I think 40 mg is as high as my pdoc will go. If depression shows up again, it is back to the drawing board. I personally will not take Depakote or Seroquel because my weight is a big issue for me and those are too risky for me. I do have Zyprexa for emergencies. I haven't taken it.
If it makes you feel better, I have had little issues with Lithium. It took me a little time to adjust to it (upset tummy at first) but overall, no side effects. I am on 1500mgs and used to be on 1800mg. At 1800mg, I did feel a bit "foggy". I have been on it for about 10 years now. Lamictal just did nothing for me...no good or bad. My pdoc has mentioned trying that again.
Good luck and keep us updated. J

I do have issues with Seroquel as far as the weight myself. But I do like the fact that I can sleep at night along with Ambien. Being Diabetic, I have to watch my blood sugars, so I have to be careful of what I eat.

Lamictal worked well for me but I have to take it twice a day. But now that I've been on it at the max dose for 10 years, it's not working as well. I have been on so many over the years that I don't even remember.

Thank you everyone for the responses!
I've been on-boarding with the lamictal and also taking trintellix. Things seem to be improving greatly! Thank you again!!

Hi Matt.... I was on lithium for twenty years and it worked wonders for me. The only reason I don't use it anymore is because my kidney function went down which is a long term side effect. Now I use lamictal and geodone together and I've been stable without the lithium for a year and a half. There are so many combinations of medications to try. Ask your doctor to maybe focus on the newer drugs... less side effects. Good luck and know in time you will find the right medicine combo and it will get better.

Generally Lamictal is a common choice for people with "light" bipolar since it predominately focuses on easing depression. Lithium can be good for both ends of the spectrum, but for some it does have more side effects generally. Depakote, from my experience, is very good for mania, but not so good for depression. Depakote, from my experience, is the most weight unfriendly of the 3. I was able to either stay trim or lose weight on Lamictal and Lithium. But some people gain weight on Lithium.

Lamictal's side effects for me were cognitive impairment at higher doses (I take just a low dose for depression protection now and that's no longer an issue), and some sweating. Lamictal was a bit too activating for me since I lean more on the hypomanic/manic side of the illness.

On Lithium I had the typical "peeing a lot/extreme thirst", some mild cognitive impairment, and some other stuff that passed over time.

I take Tegretol XR as my main moodstabilizer and I take Seroquel XR as my primary anti-manic. I find Seroquel XR to be more side effect friendly than regular Seroquel, though it is more expensive and tends to give me a mild morning "hangover". Tegretol XR is mostly focused on being an anti-manic or prophylactic moodstabilizer. I had some vision side effects briefly in the begging, but now I have ZERO side effects on Tegretol XR. Well, maybe slight clumsiness, but it's not a big deal.

I like Seroquel for the same reason, I don't wake up with med hangover that I had with the Seroquel XR. I take Ambien. The pdoc I had was having me taking originally 10mg, but again I woke up with a med hangover, so she dropped down 5mg., which works the best for me.

I am pretty lucky I seem to tolerate drugs fairly well, but others out there who don't. I've discovered that there is genetic testing available particularly for psychiatric illnesses that tell you which drugs you can handle and which ones that will not be helpful. Perhaps ask your doctor. Maybe you can do this without trying everything else out there.

https://www.psychologytoday.co...

https://genesight.com/patients...

hope that helps

regards Sam

I see it's been awhile and I'm pretty late to this, but if you haven't abandoned this site yet, mattd9931, I'd like to say that lifestyle changes are the most effective solution. I'm with you on the bad prescription medication experiences, I used to be on Effexor, Wellbutrin and Abilify on varied doses here and there, and the side effects outweighed the benefits entirely. I had serious short-temperedness and fits of rage that left behind bad memories. I also gained a lot of weight very suddenly and probably surpassed my overweight threshold by about 5 to 15 pounds. Several months after quitting, I weigh quite a bit less than I did before starting the meds.

Of course, everyone is different and everyone will have their own reactions to medications, but I'd highly recommend having a go at things like cognitive behavioral therapy (Often known as CBT), there are many success stories out there of people who overcame depression after years of suffering. Doesn't have to be CBT, there's a number of ways to go about it.

And let's not forget that it's crucial, in times like these, for others to know what we're dealing with. Going about it alone is very, very difficult, and can be immensely less of a burden as a team effort.