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Old 03-04-2019, 03:22 AM #1
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Default need med change, too much hypomania

My depressive symptoms are much better controlled (see med list below and maybe my self care like exercise helps depression more) than my sneaky hypomania which comes on slowly, makes me fun and energized but then a little farther up and I am jangled, poor at prioritizing, cant choose direction in selecting or proceeding toward goals, agitated, irritable, oversharing, tactless. I want to get off wellbutrin. Cant take antipsychotics, really bad for me. Hate to rely on Xanax and never have.
More tegretol gives me word loss. What are the alternatives? IDEAS, please.
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tegretol 400 mg
wellbutrin 75 mg
Xanax as needed
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Old 03-04-2019, 08:37 AM #2
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Default Re: need med change, too much hypomania

That's tough that you can't take antipsychotics or higher doses of Tegretol. I agree that using benzos for moodstabilization is far from ideal. I agree that talking to your psychiatrist about your Wellbutrin may be good. Otherwise, are there any other moodstabilizers you might consider? There are several. Ones I know are available in generic are lamotrigine (Lamictal), oxcarbazepine (Trileptal), gabapentin (Neurontin), divalproex sodium (Depakote), topiramate (Topamax), and Lithium. Some people have success on newer ones only available in brand. Have you tried any of these others? Trileptal is similar to Tegretol.

Someone may throw a virtual rotten tomato at me for writing this, but therapy can help provide tools/strategies to people with bipolar disorder on how to manage or de-escalate hypomania and maybe mania. I don't feel it's very effective, but can be helpful. I am serious.

I know many antipsychotics have bad points. I don't quite know what makes them totally off the table for you. Have you or your doc ever considered the use of a baby dose "prn", in other words "as needed"? I do take a therapeutic dose of Seroquel XR daily, but also have a supply of "prn" regular Seroquel prescribed for me. They are just 25 and 50 mg pills. Those mini doses can be very sedating for many people, but if I'm hypomanic or manic they aren't so much, but can help at curbing an episode a bit in some cases. Sometimes just one pill helps a little, but I'm permitted to take up to 100 to 150 mg on top of my meds. If I need prns for a few days or my episode worsens anyway, I'm to call my psychiatrist. I don't include these prn Seroquel in my signature, but they've prevented many likely additional hospitalizations.
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I have Bipolar type 1

Tegretol XR generic (1200 mg)
Lamictal generic (100 mg)
Seroquel XR generic (550 mg)
Latuda (20 mg)
Klonopin generic (0.5 mg)

PRNs - Seroquel IR generic (25 to 100 mg in a day), Ativan (1 mg, up to 3 mg/day)

Others: Propranolol (40 mg), Synthroid (150 mcg), OTC multi-vitamin, OTC iron supplement (during periods), Biotin supplement (for my otherwise thin fingernails)

Last edited by BirdDancer; 03-04-2019 at 10:22 AM.
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Old 03-04-2019, 01:35 PM #3
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Default Re: need med change, too much hypomania

She’s going to try me on lithium, dropping thewellbutrin. The reason I am wildly afraid of antipsychotics is that beginning doses of latuda and risperdone caused panic attacks (which I don’t get otherwise)and serroquel didn’t agree with my mother.
I read up on most of the other meds you mentioned and many can pose problems for hypomania. Depakote often causes weight gain so no way. Trileptal probably isn’t that dif from tegretol.
I go to my t every week now, not always. Sadly I have learned SO much more about this and everything from Psych Central and from reading that I despair. Tho I talk about more structure and setting goals, she like most I had still just sits there mainly tho she is far from stupid. Venting is important, but not to that degre.
I don’t want to do excessive doctor bashing, but real change is needed in the psych industry. I gave the pdoc, relatively new to me, a huge packet with timeline, psych history in paragraphs, med history. She said she would put it in my file. She probably wont even read it. I’ve changed psych professionals so often that I am considering going to UCLA for a meds eval. They saved my ex’s life when I took him for a second opinion there on medical issues.
Thanks, Bird Dancer, I always respect what you say because you have worked out a pretty good mix on yr meds and have a great relationship w yr h on top of it. I admire that!
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tegretol 400 mg
wellbutrin 75 mg
Xanax as needed
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Old 03-04-2019, 02:22 PM #4
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Default Re: need med change, too much hypomania

I take Trileptal, it's similar to Tegretol I guess. I was on Depakote but decided to switch because of weight gain. My doctor said it's generally tolerated better/ has less side effects than Tegretol does. I'm on 1200 mg a day and I haven't been manic in probably over a year now
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Old 03-04-2019, 02:22 PM #5
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Default Re: need med change, too much hypomania

Just read your update, good luck with the Lithium, hope it helps you
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Old 03-04-2019, 03:12 PM #6
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Default Re: need med change, too much hypomania

Good luck with the Lithium, luvyrself! I hope it works out for you. Some docs are determined to get patients to therapeutic levels, but I know a couple of people who benefit from lower doses. That's something to keep in mind.

I'm sorry you had such panic from two antipsychotics. I've never heard of that with them. You might want to keep a future option open to others, though. I've had a real variety of experiences even within the same medication categories. And how one person reacts is different than another. It's the truth. Without antipsychotics, I would likely have been hospitalized many more times than I have.
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I have Bipolar type 1

Tegretol XR generic (1200 mg)
Lamictal generic (100 mg)
Seroquel XR generic (550 mg)
Latuda (20 mg)
Klonopin generic (0.5 mg)

PRNs - Seroquel IR generic (25 to 100 mg in a day), Ativan (1 mg, up to 3 mg/day)

Others: Propranolol (40 mg), Synthroid (150 mcg), OTC multi-vitamin, OTC iron supplement (during periods), Biotin supplement (for my otherwise thin fingernails)
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Old 03-04-2019, 04:30 PM #7
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Default Re: need med change, too much hypomania

luvyrslf, thinking about you...
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Old 03-04-2019, 09:20 PM #8
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Default Re: need med change, too much hypomania

I’ve been on Lithium for 4.5yrs. Hopefully you have success on it. Just remember to drink at least 2 litres/day.
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Psych meds: Lithium, Saphris, Seroquel XR, Propanolol (tremor and anxiety)
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Old 03-04-2019, 11:22 PM #9
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Default Re: need med change, too much hypomania

I hope lithium works for you but if not just remember everyone reacts to different meds differently. Lithium gave me a minor tremor I wasnt willing to live with. Depakote has been completely weight neutral for me. And some meds say they are more safe as in not mania inducing but definitely caused it for me. If you have negative side effects you can always choose to change to something else.

Keep us updated on how this works out
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Bipolar 1
Borderline Personality Disorder?

Meds:
Depakote
Welbutrin
Seroquel

I didn't want any flowers, I only wanted
to lie with my hands turned up and be
utterly empty. How free it is,
you have no idea how free.
- Sylvia Plath
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