Iceberg

I ran into an issue at high doses where it was more sedating than actually calming so I ended up with like a weird drowsy/agitated state that was unpleasant for all involved, also first time I ever had weight issues. At lower doses it was a pretty good stabilizer and helped to get me out of inpatient

I agree with @Gearhead I’d at least try it out.

I take 40 ir BID- roughly the same as @notloki s 60 er. They tried switching me to Er once but I had a weird reaction so i stayed on ur- for like 7 years now and it’s been fine

I’ve never had those issues either. Though my doc was concerned about possible mood lowering but that was specifically propanolol

What other antipsychotics have you tried? The newest one, Vraylar, treats (or is at least approved to treat) all forms of BP episodes and is typically not as bad on the metabolic side. Definetly not the fastest response though. Latuda would be another option. Have u ever tried Wellbutrin? That can be good for some with BP but you’d have to get any hypomania/mixed issues locked down first. Im on a phone so can’t see if you already ruled any of those out in your sig.

Maybe not “highly” unlikely ...many transition to bilateral

There are so many formulations that it’s hard to nail down what a “typical schedule” would look like. It’s often just a combo of trial and error and what the pdoc is comfortable with. Ever tried Concerta? Another long acting form that people sometimes get more coverage from

As you said though- not everyone gets that issue. I didn’t.

Could it be that instead of the Ritalin making you tired it’s that your getting more and more tired as the first dose wears off and the 10 mg dose just isnt enough to correct it?

If it’s akathisia then yes there are options, talk to your doc. First line is ofter Lower dosed propanolol

@mikl_pls did it help at all before u stopped?

Sorry that was unclear. I meant rather than clozaril for things other than Tourette’s because it isn’t indicated for that in the US. Apparently it is in Europe though

Only ever heard of it for really severe Tourette’s. It’s more last line than clozaril

Obviously I’m not a doc but I have heard/read quite a lot about serious concerns. What taking it for ?

Nope still on both. I can’t tolerate enough clozaril for monotherapy. We are aiming to try lowering lithium after winter semester. High dose lithium is one of the few meds that got a tangible partial response so we kept it on