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mjs190

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Everything posted by mjs190

  1. 1. I’ve never combined the two (trazadone doesn’t do anything for me) but if your prescriber has cleared you to do so, I’d defer to them. Be prepared to possibly feel quite tired in the morning, however. As far as I know there is no interaction between the two, other than they both increase sedation. 2. It’s unlikely that 50 mg of IR will affect primary mood symptoms due to it being a very low dose, but it could theoretically improve secondary symptoms like insomnia and anxiety. 3. Seroquel has quite the dose range. I can’t speak to what 50 mg will or will not definitively do for you, but do keep in mind there’s likely some residual sedation you might feel the following day, which can mimic low levels of motivation. You’ll just have to try it out and see how it makes you feel the morning after. 4. Only the extended-release formulation is approved as an adjunct for non bipolar depression. Whether or not that translates to the IR being effective or not is likely variable from person to person and again something you’ll have to experiment with. That’s not to say it won’t help your mood symptoms, but I wouldn’t expect a massive effect from 50 mg of Seroquel IR. Although like I mentioned above, if your issues include insomnia or anxiety, it might be quite helpful. I have been on much higher doses of the XR form and found it helpful for depression, but I’m talking 400+ mg.
  2. Doc just started me on 5 mg of Lexapro for depression and anxiety related to bipolar disorder. Does anyone else successfully manage their symptoms with an SSRI? I'm treading with caution because I'm afraid it'll worsen my episode or cause me to flip into hypomania or a mixed episode.
  3. What symptoms did it help with? How did you find it beneficial as part of your cocktail? My doctor just started me on 300 mg at bedtime because nothing else seems to be helping my depression and anxiety...
  4. Thanks for responding. This past remission was about 4 months, after 6 ketamine treatments in January/February (my brain has a hard time recalling the specific time of past events.) I've had even longer periods of success, like maybe a year, even at times without AAPs on board. For a while during nursing school I was on a combination of Depakote, Lamictal, and Wellbutrin, although in hindsight I may have been mildly hypomanic, or at least a having ups and downs that weren't full-blown symptomatic of a disease course. I started taking it for a depressive episode with mixed features and high anxiety. I went from 1 mg to 1.5 mg to 2 mg finally. It made me feel energized and I had to take it in the AM because PM dosing gave me severe insomnia. At first, I questioned with my therapist whether I might be hypomanic. My speech was more pressured than usual, I was upbeat, a little euphoric at times, but no impulsivity or mixed components that I can recall. It really helped for the first month or so. But then I crashed so rapidly. Purely depressed, miserable, tearful, all the neurovegetative symptoms of a depressive episode. Latuda made me very anxious, and didn't help brighten my mood. I understand it is not a rapidly-acting medication though and I've never stuck it out long enough to find out how it may work for me. Those are the only two -dones that I have tried. And that is not the first time Risperdal hasn't worked out for me in the long-run. Interestingly, the last time I took 2.5-5 mg of Zyprexa as a PRN to quell a mixed depressive episode, it sent me into a 3 hour long rolling panic attack. Zyprexa used to be my last resort med and it consistently helped, but the past few times I have taken it, I've been hit with panic and misery. Its like AAPs are suddenly not agreeing with me after years of utilizing them with mostly success. The only one I can rely on is Seroquel XR, which I'm currently taking a high dose of in lieu of Risperdal (400 mg, maybe going to 600 mg depending on response). Perphenazine caused a lot of anxiety and racing/bizarre thoughts, as did Abilify to some extent, too. Its definitely not akathisia, as there's no inner tension. Its in my head. I just don't know what to make of it. I should mention that Haldol really, really helps settle things down for me in a pinch, without causing weird problems. Seroquel is really the only medication I know the pharmacodynamics of backwards and forwards, maybe Risperdal, too. But the others I'm not as well versed beyond the basic receptors the interact with. I have no idea why I'm suddenly responding this way to these meds, and neither does my doc, though I did read an article about Risperdal causing hypomania in patients. I can try to dig it up.
  5. Not cheesy at all and very helpful to hear, I appreciate your response toad.
  6. Sorry to bring down the mood. I'm just so fucking sick and tired of feeling like I have finally moved through my never-ending depressive episodes only to be smacked in the face by another one just a couple months later. This past episode was hell; hospitalized twice during it, medication tweaks I can't even recall, and finally a partial-hospitalization program and IV ketamine treatments. I thought I was good. I really, really thought I was good. Even semi-healed, naively (I highly recommend ketamine). And granted, this isn't nearly as severe as it could be, and I know I have my mood stabilizers and hard work to thank for that. But its just infuriating and so incredibly frustrating. I hate switching meds, I hate letting my psychiatrist down when I have to tell her my mood has started to plummet for the umpteenth time after being "good" for a period of time, and I hate feeling like I am, once again, going to drown from this disease. This all happened because I think starting Risperdal a couple months ago secretly made me hypomanic, which I interpreted as just feeling "better', and then I inevitably crashed. Normally I am in and out of wildly mixed episodes, so this purely depressive crash after pure hypomania is new to me. Its a fucking letdown, thats for god damn sure. I'm sorry for venting. I just have no where else to go. Any words of wisdom? I'm already fearing the inevitable: breakdown, hospitalization, losing/quitting my job, starting all over again.
  7. As notloki said, the three you mentioned all act differently. So there's no competing mechanism of action(s) going on. I take Depakote and Lamictal, but have never taken more unless you count Klonopin, which I am taking scheduled twice a day right now. I'm not having any issues, if thats what you're curious about.
  8. Depakote helps my irritability and agitation. Most of the antipsychotics do not help me personally, except Haldol and low doses of Seroquel. My go-to medication is Klonopin, though.
  9. Regarding Lamictal, I went off a few years ago by myself because I didn't think it was going anything. But it definitely was. I relapsed. And now that I'm back on it, I still get depressive episodes sometimes, but they aren't severe in nature, nor do they last months at a time. Usually a quick med adjustment will fix them.
  10. I was on 2 mg but it felt like too much. And 1 mg was fine, but everything feels best at 1.5 (1 mg in the AM and 0.5 mg at bedtime).
  11. Yeah my doctor briefly teetered on trying Haldol but Trilafon didn't work well for me so we settled on a re-trial of Risperdal and its actually working really well. Fingers crossed.
  12. This is exactly what happened to me. After years of taking Seroquel off and on for managing both depression and hypomania, the most recent attempt at starting it left me feeling agitated, irritable, completely panicked, and pacing my bedroom for three hours. I was pretty devastated because I loved Seroquel. I'm having a hard time finding and antipsychotic now that will address my problems; Zyprexa did this to me, too, after having my experience with Seroquel. I'm "glad" I'm not the only one who can testify to this. My doc thinks I'm weird for being so adamant about this.
  13. I have a weird reaction to atypical antipsychotics. I used to find them very helpful, but this past year they started creating almost OCD-like intrusive, bizarre, racing thoughts. I've literally tried almost all of them with the same result; never had this issue before. The only one that didn't cause as much of an issue was Risperdal, but I don't find that to be fast acting or "PRN" the way others can be. I'm currently taking 0.5 mg of Klonopin up to three times a day as needed, and it definitely helps. But there's still some "thought salad" and racing, tangential thinking going on that I really wish something like Zyprexa could fix. But last time I took it, I had a full-blown panic attack that ebbed and flowed for three hours. My psychiatrist is aware, and we've settled on mood stabilizers to manage my disorder, but I'd really like something besides a benzo to help quiet my mind. I'm thinking of asking for Haldol; one time in the emergency room I was given 5 mg of the stuff and it was the most at peace I've ever felt. Granted I was in the worst mixed episode ever. But I guess I'm just curious what works for y'all, or if you can relate to my experience at all. Thanks for reading.
  14. Discharged a few days ago. Spent 10 days in the hospital on a bipolar mood disorder unit. It was mostly helpful. Lots of med changes as you can see in my signature. Ditching Lithium because it just doesn't seem to help me personally, especially as someone with mixed episodes and predominant depressive features. Adding Lamictal for the rapid cycling nature of my illness course and for depression. Klonopin will soon be just PRN for anxiety/panic, but I'm currently taking it scheduled. Seroquel XR is coming down to a sedative/hypnotic dose because 300 mg was worsening OCD thought patterns which apparently is a thing with some AAPs according to my current psychiatrist; I discharged straight into a partial hospitalization program where I'll spend 6-7 days before fully returning to "normal" life.
  15. Currently inpatient because things got bad and we couldn’t use most APs to control my symptoms. They’ve got me on a medium dose of Seroquel XR and kept the Depakote the same while removing the lithium. The goal is to add Lamictal; I did really fucking well on a combination of Depakote and Lamictal a couple years ago and I’d like to get that level of stability back while keeping a low dose of Seroquel for anxiety and sleep; higher doses seem to have negative effects in those realms.
  16. Suddenly every AP I try (Risperdal, Seroquel, Abilify, and especially Zyprexa and Trilafon) causes a marked increase in my anxiety, to level of near- or full-blown panic. I also get OCD-type thought exacerbations, and racing thoughts in general. I've read this may be due to the 5ht-2A receptor causing OCD-like thoughts (but these were studies in schizophrenia). Any insight appreciated.
  17. Yeah, thats essentially the same thing as Depakote. I take 1,000 mg at night, down from 1,500, and I haven't gained any weight. At higher blood levels, like ~100, I gained a few pounds.
  18. Hey- Wondering if there might be some personal or anecdotal evidence out there that Zyprexa (olanzapine) might achieve an anti-depressant response without pairing it with an SSRI like fluoxetine (i.e. Symbyax, "OFC"). My doctor is trying to avoid going back on Seroquel XR and has given me the dosing wiggle room of 2.5-7.5 mg to test drive to see if we might be able to have some success. FWIW, I can't tolerate SSRI's, and am in somewhat of a mixed depressive state with high anxiety.
  19. For me, its not as sedating as the IR when it kicks in. It takes a out ~2-4 hours to start to feel the effects, in my experience. The morning hangover is a little longer lasting, meaning I tend to sleep later, but the trade-off is better coverage throughout the day. Nothing a cup of coffee and warm shower can't wash away.
  20. I've tried gabapentin very briefly and I really didn't notice much benefit I guess. Never tried Lyrica, though. Ideally I would like to stay on 25-50 mg for sleep, because if I don't sleep well, its reflected in my moods. I tend to spiral pretty quickly without at least 7-8 hours of sleep or more, which is almost impossible without Seroquel. One thing I've noticed is that Seroquel IR could potentially be causing me some anxiety. I don't know what it is about the IR form, but once it starts to kick in, I get anxious as hell. XR doesn't do this, so I may have to consider switching forms as someone else mentioned. Vistaril never worked for me, I think maybe because I've always tried it while I was on Seroquel, and MOA-wise they're kinda the same. I tried anti-depressants years ago while I wasn't on a solid mood stabilizer and I think they tended to cause me to cycle a bit faster IIRC. Cymbalta outright almost landed me in the hospital. I'd be interested in trying an SSRI now that I'm on a healthy dose of Lithium, but I'm not sure how my doctor will feel. I've read they can help anxiety if there's a mood stabilizer on board first. I've also read Depakote can help with anxiety to some extent, so I might ask about that, too. Depakote always treated me well in the past.
  21. After going IP in April, starting lithium for the first time, and literally being able to come off every single other med I was taking, the one med I just can't get rid of is Seroquel. I went from 600 mg of XR in April to 400 XR by the start of summer, 150 mg IR by the end of summer, and recently this month 50 mg IR. But now my anxiety is completely off the rails, night time is especially bad. It feels like I was inches from the finish line, and now I gotta back track on to a dose that gets this anxiety and panic under control. Anyone else feel this way in some regard? Is there anything else out there to fight anxiety symptoms for us bipolar folks? I was really aiming for monotherapy with lithium...🤦‍♂️
  22. I didn't notice any issues with anxiety when I started lithium a few months ago. For me, it didn't help my anxiety but it didn't make it worse by any means.
  23. I've come off Seroquel a couple of times in the past after being on it for years from doses ranging 50-300 mg. Each time coming off is a bit easier; first time was actual hell. I had the nausea and vomiting, anxiety, chills, insomnia, no appetite, etc. but it absolutely gets better with time. If possible I recommend using a PRN sleep aid (and maybe an anti-emetic like Zofran) because for me the insomnia and nausea were the worst. If you don't have access to that, some Benadryl (diphenhydramine) may help. Good luck!
  24. Oh! Then hopefully Depakote brings you relief. It definitely felt different than lithium for me. It was almost like taking a very mild anti anxiety med or Benzo. It calmed down my brain and helped me feel less reactive and agitated...pleasantly slowed everything down.
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