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AyYiYikes

Lithium and still getting manic/hypomanic?

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I haven't had full-blown mania since starting lithium a few months ago after BP1 dx. Pdoc increased the dose a couple weeks ago but I went back to the previous dose because it makes me too tired at work, no matter when I take it. Yesterday I increased it to what pdoc prescribed, as I noticed getting those old irritated, p*ssed off feelings I hadn't had in a while. I was a b*tch at work and not my usual self. I could tell trouble was brewing. My anxiety became far worse. Last evening was tough: super agitated, angry at basically everything, and desperately wanting to cut off my hair (which I've done myself numerous times before dx and I've posted about elsewhere here with others). That compulsion was getting overwhelming. I talked to a relative on the phone to talk me out of it. I'm sure I must've sounded completely nuts. I haven't shared too much with anyone about what I do/have done. Anyway I didn't cut my hair (a victory). This is the first time since starting lithium I felt so agitated and heading out of control. And scared. I took Ativan and went to sleep - which is why I don't take Ativan as directed, as it makes it tough to get up for work. I'm sensitive to meds. Anyway, I took off work and slept most the day today. I've missed too much work. Been depressed for months. I'll keep the lithium at the higher dose and hope I don't feel like that anytime soon. I have a tough time practicing "self care" and being ok with staying home when it's all too much. I get super-sensitive to noise and my workplace is so loud. I don't know how much longer I can take it.

Does anyone else get mania/hypomania while on meds?

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 Yeah unfortunately it happens all the time, many people need an add on to lithium. The options are usually atypical antipsychotics like abilify or another mood stabilizer like tegretol. I'd try and tolerate the higher dose for at least several days before making a change if u can...but it may also be a good time to call the pdoc  

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Thanks, @Iceberg. I'll keep on the increased lithium and see how it goes. I've had some negative experiences with add-ons but never tried tegretol. Working makes it tough to try new meds. I will if I need to, though. Fingers crossed this will help.

Edited by AyYiYikes

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It's not the lithium dose you need to watch, it's the serum blood level.  Could you be experiencing changing serum levels?  (Not enough water?  Too much exercise/perspiration? Etc?)

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Is lithium the only med you’re taking? Is it the only one you’ve tried?

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@sbdivemaster maybe changing blood serum levels. You may be right. It's been heatwave after heatwave and I can't take the heat on this med - could be a factor, too.  Not as diligent about water as I need to be. I was previously and need to get back on that. Thanks.  @Iceberg I have had only one blood test, a few weeks after starting lithium a few months ago and it was low end .6 but I seemed ok.  With all this I have asked if I should be tested (my levels on the low side before the increase) but pdoc says not until December (2 mo. away). No, I can't find another dr as I have Kaiser (HMO). And, generally, increasing it has been ok and I'm not feeling as hypo/manic as when I posted. Only cruddy deal is I get very sick from the heat (which I never did before) and was ill last night and today, staying home today. I'm unable financially to get another car right now and it makes me sick driving in 100+F temps in an old car with no a/c. As long as I don't get fired, gotta just keep on trying to take care!

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I'm on a range of medication and still get hypomania quite frequently. Not really full blown mania though, haven't had an episode of that in years. The lithium got my mania straight down and the addition of the lamictal helped a bit with the hypo states. I think it's just finding a combination of medication that works for you. I can understand that having a job and playing around with new meds might not be the easiest thing in the world though.

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1 hour ago, Gearhead said:

Is lithium the only med you’re taking? Is it the only one you’ve tried?

Lithium and Ativan. That's it. The other things I tried, mood stabilizers, atypical AP, etc., didn't work/bad reactions. By what I'm reading I guess other people also have hypo/manic episodes on meds. I guess it just scared/annoyed me when it happened since I hadn't with being on lithium. 

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Maybe. When it started last week I upped it to the higher amount the dr prescribed, since I'd lowered it previously from being too tired. And then the problems started. Now I seem to feel much better. Maybe a coincidence. I'd think it'd take a couple weeks to make a difference. So I'll see how this dosage goes. I'll contact dr again if I feel anything close to how I did a week ago. Thanks.

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New meds are going to make you tired, or worse, but you need to try to tough out the side effects. Usually they will go away after 4-6 weeks. It sucks, but that's how it is when you start meds. Look at a Lamictal titration thread in the meds forum if you want to see the kind of side-effects people need to get through before they even reach a therapeutic level.

Have you thought of wearing earplugs at work? My husband does it just to maintain his concentration. 

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I get hypomania while on Lithium (at a therapeutic level).  I found I have to add an AAP to stay on top of it.  Have you tried this strategy?

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On 10/27/2017 at 11:53 AM, crtclms said:

New meds are going to make you tired, or worse, but you need to try to tough out the side effects. Usually they will go away after 4-6 weeks. It sucks, but that's how it is when you start meds. Look at a Lamictal titration thread in the meds forum if you want to see the kind of side-effects people need to get through before they even reach a therapeutic level.

Have you thought of wearing earplugs at work? My husband does it just to maintain his concentration. 

Will look at that and the effects - thanks. I work in social services and deal with people all day long in a busy office. Earplugs would make the job impossible and they're not allowed.

15 hours ago, phidippus said:

I get hypomania while on Lithium (at a therapeutic level).  I found I have to add an AAP to stay on top of it.  Have you tried this strategy?

I have tried AAPs but not all of them. Will look into what I haven't tried, thanks.

So far somewhat better with the lithium increase.

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