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blueoceaneyes
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Default Jun 18, 2019 at 06:46 AM
  #1
Hi all. I am very interested in medications and combinations of meds used to treat bipolar and co morbid conditions. I don't know if there is a thread like this and I apologise if there is.

It would be interesting to compare similar doses, meds and what side effects are experienced. If side effects lasts long term or only initially. I also know it is different for each person.

I am diagnosed with bd 1, c-ptsd and bpd

Medications - 600mg Tegretol, 200mg Lamictal, 150mg Toplep, 300mg Wellbutrin, 80mg Geodon, 100mg Trazodone, Ativan prn

I have never been on so many meds! (maybe this is the norm, or maybe this is still little compared to what others are taking) I have been on this for 4 months now and I feel quite stable with no significant side effects except for tremors and loss of appetite.

Would be great if you could share!

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Default Jun 18, 2019 at 09:57 AM
  #2
Yeah, being on lots of meds is pretty average for bipolar. I was told by a pdoc that he usually starts people with bipolar off with an antipsychotic, a mood stabilizer, and an antidepressant, and then goes from there. I'm on two antipsychotics (Zyprexa 10mg, and Invega 3mg), a mood stabilizer (Depakote 1500mg), and an antidepressant (Wellbutrin 300mg) along with some propanolol for tremors. I'm hoping if I'm stable for a while we can decrease or eliminate something, which can and does happen.
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Default Jun 18, 2019 at 10:04 AM
  #3
I'm glad that you're feeling stable, blueoceaneyes! I don't have a lot to share myself but I'm sure other posters will! Don't worry about taking too many meds! Hopefully your Pdoc will decrease them gradually when you start to feel better like spikes has already wisely said! Either way, keep track of your side effects and report them to your Pdoc! That way you'll be able to see if there's anything unusual! Let us know if there are ANY problems at all! Wish you the best of luck in your healing and in your life! Sending many safe, warm hugs to BOTH you and the people you love and who love you, blueoceaneyes!
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Default Jun 18, 2019 at 10:28 AM
  #4
Welcome blueoceaneyes!

I only have bipolar disorder type 1, and occasional anxiety issues that go with it. My current medication mix is shown in my signature. All of my current medications are about the most side effect friendly for me, of any I have taken so far. I guess my cocktail is considered big, though I have taken even larger cocktails. Sometimes you need it, but in my case as my moods stabilized, my psychiatrist began weaning me off a few. [Actually, in a couple cases he only began weaning me off when side effects became too problematic.] Some that I've been weaned off of only improved my situation. A couple others brought on mood episodes, and were either reinstated or the doses of another medication went up, as a result.

A couple of my current medications initially gave me side effects that eventually disappeared/eased. For example, when I first started Tegretol XR (aka carbamazepine ER), I experienced some loopy feelings and double vision. I was happy that I tolerated that. Those feelings did disappear, and now I have virtually zero side effects from that medication. I say "virtually" because it may possibly give me a little clumsiness, but nothing bad enough to complain about.

Lamictal at higher doses gave me some uncomfortable side effects, plus higher doses were too activating for me. But at my current low dose with adequate adjunct medications, I have no side effects, and it serves a purpose effectively. It's possible I could eventually go off of this, but "if it ain't broke, why fix it".

I'm only on a starter dose of Latuda. So far, zero side effects and its only improved my moods and energy levels. My psychiatrist may not raise it for a while, if ever.

Seroquel XR definitely required an adjustment period. I take it only at night, as usually done, but it used to make me wake up with a "Seroquel XR" hangover, as is often called. It required not only patience to get past some of that, but also I found that by taking it early (like at 7 pm) I avoided the hangover. I also need to fall asleep at a reasonable time (no later than 12 am). If I don't take it until 11 pm, nowadays, I usually can't fall asleep until 3 am. That's bad news! In those cases, I do have trouble when I wake up the next morning. Not just with a "Seroquel XR hangover", but usually also with a mild to moderate headache. Being precise with the timing and sleep schedule is important. Also, larger doses of Seroquel XR are not that weight friendly, however, I find Seroquel XR much "friendlier" than regular Seroquel instant release. In my case, Seroquel XR is weight neutral usually up to 500 mg. Beyond that, I struggle with a bigger appetite. Avoiding "Seroquel XR" hangover (as mentioned) is also important. When I'm too drowsy, I tend to want to eat. On the bright side, Seroquel XR is the only antipsychotic that has not given me MAJOR side effects, like akathisia, other EPS (dystonia, TD), hyperprolactinemia, or major weight gain. Other bipolar medications were far less friendly, weight-wise than Seroquel XR for me. And another good thing about Seroquel XR, for me, is that it is helpful for depression, mania, mixed states, sleep assistance, and anxiety. I can't say all of that about any other bipolar medication I have ever taken.
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Default Jun 18, 2019 at 12:50 PM
  #5
I was diagnosed as bipolar with psychotic features and now the doctors are thinking I'm maybe not bipolar. I've only ever had one episode, so only time will tell. They have since diagnosed me with 'brief reactive psychosis' and it isn't clear what caused it or if it will return. I was taking 1mg of Risperdal and 20mg of Geodon. My doctor recently weaned me off the Risperdal, so now I'm just taking the 20mg of Geodon. It is a very low dose, but I am stable. I go back to the doctor in August and he said he may consider pulling me off meds altogether if I am still doing well. I hope to make it that long with no new episodes. Actually, I'd like to go forever without a repeat. The first episode could have killed me. Scary stuff.
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Default Jun 18, 2019 at 05:59 PM
  #6
I have BP1, complex PTSD, anxiety with some agoraphobia. I’ve been on quite a few antipsychotics, mood stabilizers and antidepressants. Since I was finally diagnosed at age 47 I’ve had various degrees of success. I’m on a combo of Trileptal for mood stabilizer, Viibryd for depression (my depression is more during summer than winter), and Neurontin for anxiety. I also take a small dose of Seroquel for sleep.

One thing I do have to consider is QT prolongation of the heart. If it’s too bad I can go into arrhythmia, especially after I exercise. This happens with a lot of antipsychotics and Depakote for me.
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Default Jun 18, 2019 at 10:02 PM
  #7
Currently I'm on abililfy only but that's because I suck at taking meds. My chart has all types of dx. I have no idea what they use but whatever it is I'm on a special insurance for people with MI. I get approved for medications fast.

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Default Jun 19, 2019 at 02:37 AM
  #8
Quote:
Lamictal at higher doses gave me some uncomfortable side effects, plus higher doses were too activating for me. But at my current low dose with adequate adjunct medications, I have no side effects, and it serves a purpose effectively. It's possible I could eventually go off of this, but "if it ain't broke, why fix it".

I'm only on a starter dose of Latuda. So far, zero side effects and its only improved my moods and energy levels. My psychiatrist may not raise it for a while, if ever.

Seroquel XR definitely required an adjustment period.
Thanks BirdDancer for the feedback. Really appreciated. Personally I couldn't handle Seroquel. I was on IR before I moved to XR but I just wanted to sleep all the time. In the evenings I would become drowsy then fight it, and sleep eat on the couch, first sweet then salty, then sweet again repeating the cycle of sweet and salty over and over. I was on that for 6 months, can't remember the dose.

I was hospitalised in Feb this year, was on Geodon IM and maintenance dose thereafter. It is the first anti-psychotic I took that didn't really give me an appetite or made me drowsy as I take it two times a day now.

I think the Lamictal makes me forgetful, I am usually not like that and now I forget conversations and the tasks, I have to write everything down on a notebook.

I am just thinking what a tough time doctors must have figuring out combinations for patients as each person reacts quite different to meds.

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Default Jun 19, 2019 at 06:46 AM
  #9
I have schizoaffective disorder

Meds are trileptal, paxil, wellbutrin, seroquel, and vraylar

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Default Jun 19, 2019 at 10:13 AM
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Originally Posted by blueoceaneyes View Post
Thanks BirdDancer for the feedback. Really appreciated. Personally I couldn't handle Seroquel. I was on IR before I moved to XR but I just wanted to sleep all the time. In the evenings I would become drowsy then fight it, and sleep eat on the couch, first sweet then salty, then sweet again repeating the cycle of sweet and salty over and over. I was on that for 6 months, can't remember the dose.

I was hospitalised in Feb this year, was on Geodon IM and maintenance dose thereafter. It is the first anti-psychotic I took that didn't really give me an appetite or made me drowsy as I take it two times a day now.

I think the Lamictal makes me forgetful, I am usually not like that and now I forget conversations and the tasks, I have to write everything down on a notebook.

I am just thinking what a tough time doctors must have figuring out combinations for patients as each person reacts quite different to meds.
I'm glad what I wrote was of some help. Yes, it took some time for me to adjust to Seroquel XR sedation, but I was glad that I stuck with it. Being on disability gave me the time. I imagine those taking it, with similar initial effects, who work, must struggle a lot.

I think Geodon can be a great medication. I was on 160 mg per day (80/80) for about six and half years. For five of those years I had zero side effects. It was definitely weight neutral. My only complaint was that 160 mg wasn't quite sufficient to tame my mania beast, and therefore caused me insomnia. I had to have a second antipsychotic added. Geodon did help the mania at least mostly. I think for some people Geodon is more than enough. I only went off Geodon because after five years I developed akathisia. My akathisia grew worse and worse. Many people don't get akathisia from Geodon.

I had mild cognitive issues on the higher doses of Lamictal. I don't have them anymore at just 100 mg. If I do, I don't know about it.
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Default Jun 19, 2019 at 02:10 PM
  #11
bipolar II --tegretol, wellbutrin, cymbalta, trazodone, xanax (PRN)

other meds: Norco, Thyroid Med

So, yeah, lots of meds.

That said, no episodes in over 7 years
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Default Jun 19, 2019 at 09:49 PM
  #12
My diagnosis and meds are in my signature.

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Wellbutrin XL 300 mg
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Mixed episode/Hypomania (September 2023)
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Depression & Psychosis (July/August 2021)
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Default Jun 20, 2019 at 05:59 AM
  #13
BP2:

Lithium, seroquel, Lamictal, oxazepam, Zyprexa..... Aaaaand

Metformin to help try and push back weight gain, with a stomach pill here and there + various supplements

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