Success with same meds for a year now, but...

First off, I wanted to acknowledge that 2 to 1 and a half years ago, I wouldn't have thought it possible for me to get to where I am now. I have held a part time light duty position at a plant nursery for half a year and have been connected with them even longer with seasonal work. The only reason I am on light duty is due to a very severe physical injury from which I will eventually recover.

The meds that have been with me throughout this time period and have possibly made it possible are these: Risperidone 2mg(I go between that and 1.5), Lithium 600mg, Zoloft 50mg, and then Gabapentin 600mg at night for sleep(initially was only as needed, but I was anxious to get a good sleep and seem to invariably sleep poorly without it now). While 4 different meds may seem like a lot, the dosages with each of these are fairly modest. My previous psychiatrist had wanted me on at least 3 mg of risperidone and 900 lithium, being a textbook thinker about my schizoaffective diagnoses. But I found a better psych who was more open to the possibilities.

But the issue is this: I don't really like taking the Gabapentin so regularly, as I forget it sometimes and will have a frustrating night and subsequent day at work. I also am not sure how much I really need the lithium, since a few years ago I was subsisting pretty well on abilify and effexor, and I only find myself on these meds now and not those, just because I made the mistake of quitting cold turkey for 9 months, which landed me in the hospital(this was in Fall of 2016). I really actually wish I could streamline my meds back down to something like that again. Something on which I can sleep, but which also doesn't flatten me out so much. I'm considerably less flat on 2 mg of risperidone and 600 lithium than I was on slightly higher doses, and the zoloft seems to help with sleep a little. But I still feel very groggy a lot of the time, and also my sex drive is pretty dampened. I've talked to my current psychiatrist about this, and he has suggested experimenting with dropping down to 300 lithium for a day or two, just to see how it goes.

Sounds like the lithium drop is worth a try...