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About mmaryland

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  1. Yes that was my starting dose for about a week and akathisia was severe. But this wasn't a problem anymore when I stopped, restarted at 0.5 and titrated. Well I didn't necessarily increase the dose, I was just started on a large dose, 3mg. The akathisia initially was mild then progressively got worse, and at first I didn't know what it was. I had no idea why I had to keep pacing the floors and getting up and down off my couch. I told my pdoc and she told me to drop to 1.5mg but I dropped to 0.5mg instead and went up every 7 days by 0.5mg. It's a good sign that you've been on for 12 days without any akathisia, and I think slowly increasing the dose can prevent akathisia. Like I said, I am doing great on Rexulti now, but back when I began on 3mg and took this for 1 week, I wanted nothing to do with the drug. I am glad I gave it a second chance because it has really helped. Have you had bad experiences with akathisia pertaining to Rexulti or other antipsychotics?
  2. Thats great it is helping so rapidly. It helped me get me head straight pretty fast as well. I have been on 6-7 months and the benefits are still here I would like to come off it also, but I just cant bring myself to discontinue a medication that has helped and continues to help so much. I dont want to face mood destabilization and mania, and even though I have to get my blood drawn frequently (which is a serious phobia of mine) I cannot say more great things about Lithium and my experience. In respect to side effects, both Lithium and Depakote have their fair share of side effects that are intimidating. I believe Depakote requires blood testing too because it can mess with your thyroid. I became super informed about Lithium toxicity and its side effects so that I will be able to recognize them as soon as they appear, and this has given me some piece of mind. I only get really scared about Lithium disrupting my liver or kidney function, oh and my thyroid. But that's what the blood tests are for, right?
  3. The max dose with Rexulti is 4mg I believe. Did you take it in the AM? I noticed when I did this I had much more sedation and apathy during the day, but taking it at night time got rid of all these issues. When I was on 3mg I had severe akathisia, but I don't think this counts towards being "stimulating." I am currently on 2mg and probably will increase to 3mg next visit. I'll make sure to keep you updated and let you know if I get any stimulation. However, I don't think the stimulation from Rexulti would be anything near the stimulation Abilify gives some people.
  4. Lithium would probably be great for prophylaxis treatment of hypomania and mania. I personally have had much success with it for preventing manic relapses, and reducing impulsive behaviors. I used to drink 5 days a week and somehow after starting Lithium I magically lost the craving and desire to drink. Even when I do drink, I never finish the bottle and have more control over how much I drink. If you are having more acute hypomanic episodes, then Lithium might not be the best option for right now if you want to squash the hypomania ASAP, as it takes a few weeks to accumulate in your body. I would ask your doc about a sedating antipsychotic, like Saphris, Geodon, Seroquel, or something similar that will put you out and hopefully bring you down from your hypomania. I know Latuda is also an antipsychotic, meaning your doc might not be comfortable placing you on another antipsychotic at the same time but then again your MD could be completely fine with it. I personally use Seroquel as needed when I am feeling hypomania or mania creeping up on me and it works wonders.
  5. I have come to terms with it. I can't want my amphetamines to treat my ADHD without having my Lithium there to act as a mood stabilizer. Without Lithium, Dexedrine might send me flying into mania. Without Dexedrine, I wouldn't be able to get anything done. It is interesting the research you did, I never knew Lithium decreases noradrenaline release and dopaminergic neurotransmission or that it increases GABA. This all makes sense as to why Lithium may dampen the effects of stimulant medications, but I will take it over having zero stability in life. How long have you been taking 300mg Lithium?
  6. It's always great to have a psychiatrist who gives you options regarding your treatment so you can play an active role. However, there are some situations where the doctor needs to be in charge of the patient, emphasize compliance, and not let the patient play much of role in their medications. I am talking about a patient who is schizophrenic and so delusional that they cannot logically pick and choose their medications; it would end up in hospitalization. When I am manic, my pdoc readily gives, and actively encourages me to take, a sample pack of an antipsychotic Saphris. If that didn't work, I was given a sample pack of Latuda. Then Geodon was next. Finally she prescribed me Seroquel, since there are no sample packs of the original version anymore, and it knocked my mania out within the first 2 nights. Glad Seroquel worked because Zyprexa was next What I am trying to say is that a psychiatrist needs to treat symptoms of severe illness right away, such as bipolar disorder, and not let the patient decide whether or not to become manic. Sure you have the right to say "Ok thanks doc" and not take the pills he just prescribed for your mania, but to leave it up to a hypomanic patient whether they want to be on more or less anti-manic drugs is never going to work out.
  7. I have had middle of the night nightmares since I was young also. Sometimes this would make me go sleepwalk cry on the stairs with no memory of why or how I got there. I didnt really share them with anyone, except when I ended up crying and waking up my parents, then i obviously had to explain why I was crying. I kept them to myself mostly Today I still have nightmares 2-3x a week, but the have become more gorey and violent. I'm talking dreams of my dad trying to run my 85 year old neighbor with a gigantic lawn mower then me somehow taking it away and apologizing to the neighbor, stating my dad forgot to take his haldol and xanax tonight. Or someone robbing my house in a very sneakily way as to deceive me, ending in me and my parents getting the intruders gun and shooting him in the face. They are really disturbing and vivid nightmares but I am kind of used to them now. I've dreamt my mom was a dragon who locked me up in some cave and when I escaped she tried biting my head off, and I remember this dream from at least 4 years ago. Some are hard to forget, while others I wish I could forget right away.
  8. So I have been on Rexulti for a little over a month now. At first, in high doses like 3mg, I got severe akathisia, but once reducing and titrating slowly to 2mg I had no problem with restlessness. I started at 3mg, a high dose, which is why I got akathisia. After discontinuing, restarting, and slowly increasing this was not a problem. It is doing great for my mood, I haven't had highs or lows except the 4 days after I skipped my medication for 3 days. I found rexulti to really help me in terms of motivation, getting things done, becoming more organized and time-oriented. It has for sure helped my mania at the proper dosage (2mg). When I was at 0.5mg I did have a bout of hypomania that I fixed with some seroquel. I also have not experienced severe anxiety since beginning Rexulti. Yes I still have times at work I need to take 0.5mg Xanax and my Valium every night for seizure control, but I think Rexulti has helped in this aspect. I cant speak on depression because I experience depressive episodes or moods rarely.
  9. I gained around 10 pounds in the first 2 weeks, but I am skinny so i welcome the weight. I also have vivid dreams/nightmares but dont know if this is from Rexulti or something else. I tried taking it during the day a couple times, and I noticed I felt somnolence during the day, so now I changed back to dosing at night.
  10. How are you doing on Lamictal now? A lot of the severe side effects of psych meds occur when you first begin a med, if you increase the dosage too quickly, are coming off rapidly, or start on a high dosage of a new medication. I didn't take my meds for 4-5 days maybe a week or two ago and had no immediate negative effects, like mania or mood swings. But earlier this week I suffered from depression 2 days and a mixed episode for 1 day. I don't know if it was stopping the meds, but I never get depressed when I take my meds and rarely ever am mixed. I completely understand where your'e coming from missing the hypomania, and props to you for actually telling your doc that. However, don't you dread the consequences that come from being hypomanic? I know they vary from person to person but what makes me not miss my hypomanic and manic states is the sleep deprivation, impulsive behaviors, sexual promiscuity, reckless behaviors, memory lapses, and vicious spending on credit cards. I also think to myself, hey I could actually be sleeping right now and I can continue doing whatever is it tomorrow when I wake up. Hypomania and mania, in my experience, usually end in a mild to moderate depressive episode so thats a deterrent as well. I'm glad he asked to see you back in a month instead of 3 months. This will help to further adjust your medications and get you where you want to be. It wasn't a bad idea, it is always best to be open and completely honest with your psychiatrist because this is how you will get the best and most appropriate treatment.
  11. Strictly based on your post, although you have a 2 year relationship and your doctor is good at reading your moods and understands your personal life, and is affordable, I think it is really risky to go through trying for a baby while taking prescribed medications from a doctor who frankly does not provide sufficient information and advice. Many psychiatric medications may interact with an unborn child, and the average psychiatrist should be aware of these interactions. Yours might know some, but simply not communicate them with you. Have you directly asked him about certain medications side effects in relation to having a child? Either way, it is their duty as a doctor to inform you of potentially serious or dangerous side effects. The whole cutting your meds back during mania part confused me. Generally, manic episodes require a PRN medication to cease the mania and often the addition of a maintenance medication if not already on one. The fact that this caused you 3 weeks of hospitalization is did your doctor react to this? I cannot agree with you more that we need to be able to trust our psychiatrists ability to "catch us" before we cycle into mania or depression, but this cannot always be the case. With proper medication regimens it can become a rare event to become unhinged on unstable, but we will always have to face challenges without our pdoc. However, if the challenge or event is something that could have been prevented (possibly your hospitalization) through the actions and prescribing of your psychiatrist then I think it's time to reevaluate your doctors competency and ability to treat you appropriately. If you come to the conclusion that he is treating you sufficiently or hazardously, then I would try and see out what other psychiatrists are accepting new patients in the area for a reasonable price. I would continue to make appointments and get your meds from your current psychiatrist during the searching process, since you are stable If you do find a new one, good thing is they will most likely continue you on your regimen, but make sure to vocalize your concern over being on psychiatric medications while trying to conceive a child.
  12. I am dependent on xanax and it no longer has sedative effects one me, like it doesn't put me to sleep. Xanax definitely plays an anti-depressant role in my treatment because it alleviates the stress in my life that causes me to become depressed. Ever since the beginning Xanax has helped me during depressive episodes. It puts me in a better mood as well, at my prescribed doses. Other benzos have not had this effect, such as valium and klonopin. When I was on Klonopin 1mg twice daily my mood was really low and I didn't have interest in anything. With Valium it also leaves me apathetic after daily use at higher doses (10-20mg twice daily), so I am currently sticking to 10mg nightly, sometimes not, for seizure control. My doc also wants to taper me from Xanax to a longer acting like Klonopin and Valium, but I'm not looking forward to dealing with the low mood and apathy I previously had with these two longer acting benzos.
  13. With my 1st pdoc it went the same way trying to get Dexerdrine. "Adderall is newer, better, and many of my patients do well on it.....Vyvanse last much longer and is therefore better for ADHD than Dexedrine" but he never went into details about dopamine receptor subtypes or any pharmacological reasons as to why he wouldn't let me try Dexedrine. I could be wrong but it would seem like Dexedrine would be cleaner due to the lack of l-amp and hitting of norepinephrine receptors, but trust your pdoc on that not me. As for the brain damage, wouldn't Adderall be just as likely to cause it, theoretically, as Dexedrine given they both contain d-amp....Although Dexedrine is purely d-amp, equivalent doses to Adderall would essentially contain the same amount of d-amp. Adderall gives more adrenal stimulation also since it is more noradrenergic. Now this may be helpful for some with ADHD inattentive, but others are bothered by its effects (like me and you). As far as dosing goes, Dexedrine can be dosed lower than Adderall to achieve the same results, and with lower doses comes less side effects. I take usuaully 50mg Dexedrine (Zenzedi is dexedrine) but often take only 30mg Dexedrine Spansules with great success. On the other hand, taking Adderall 30mg XR is almost placebo to me, and even on 60mg XR I was not getting full ADHD coverage. After being bounced from Adderall XR back to Vyvanse several times I decided it was time to see a new psychiatrist. I used the same reason as you maybe the 3rd time I saw my new psychiatrist and without suggestion from me she goes "well there is Dexedrine we can try if you're having too much peripheral side effects with the Vyvanse and Adderall, but it is shorter acting than most ADHD medications." It wasn't a fight or debate at all, like @notloki said, I was allowed to try the various amphetamine-based medications, and other meds like benzos, z-drugs, antipsychotics, mood stabilizers, etcetera, until we found the medications that worked for me. I agree with your pdoc that changing meds around too much/often is not good, but it is essential while you are trying to find a cocktail that works for you. Too much change, like 3-4 meds change at a single time, is definitely not a good ideal. However, what is the harm in changing 1 medication at a time? This way you and your doctor both can figure out whether this 1 medication works for you or if its side effects make it a no-go. BTW I see in your signature than you are on Dexedrine 15mg bid, is this true? if so, who prescribed this and does your regular pdoc know?
  14. Doing laundry Washing my face, brushing my teeth, putting on deodorant Forgetting where I put things, phone, wallet Miss Doctor appointments Replying to text messages Communicating with friends Making food Paying credit cards or bills Cleaning cat's litter box and refilling food Without meds, I don't know how I would function and fulfill my responsibilities and obligations
  15. It's interesting how Vyvanse is the prodrug of Dexedrine but they both have completely different effects on me. Dexedrine feels so much smoother than Vyvanse, and doesn't make my chest as tight. Vyvanse also makes me feel terrible during the comedown. For me, I am the opposite of you. I get more depression and comedown feelings after taking Adderall XR or anything with l-amp in it. With Dexedrine, I don't "feel" it as much and the comedown is more gradual and a lot less noticeable, for me at least, without leaving me feeling shitty. Vyvanse wasn't doing this as much as Adderall, but still was giving me depressed mood, anhedonia, irritability. The switch to Dexedrine was definitely a great decision in my experience/