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Diagnosis: Bipolar 1, ADHD, THC Misuse Disorder. Age 46 Male

I've been in the psych ward for 14 days and just got released 6 days ago. It was full blown mania that brought me there. I decided to stop taking my pharmaceuticals for a week and was determined to free myself from the stigma/chains of the label bipolar.

Fast forward to now. I've been released with the following meds (Note the asterisk means I was on before my episode, but not necessarily the same dose):

*Lithium Carbonate 1200mg

Risperidone 2mg morning, 4 mg night

*Clonazepam 1mg morning, 1 mg night

*Zopiclone 7.5 mg night

Lorazepam 1 mg daily as needed max 2 mg

The clonazepam and lorazepam have scheduled tapers/stop points. Lorazepam I have about 10 days left. Clonazepam done in about 3 weeks.

I smoke a recreationally balanced cannabis strain 7mg/7mg THC/CBD. 3- 4 times a day. Used 6 bottles of beer in the past 48 hours.

 

What I am faced with is crippling anxiety, where my whole body tenses up for 2-5 seconds about 50 times a day depending on stress I am faced with as I result I suffer from muscle pain.

My next appointment with my regular psychiatrist is Dec 11.

I'm trying  to take the drugs one at a time to try and isolate the source.

This morning the cannabis has caused some anxiety and cognition problems. 

Help!

 

Edit. Today I woke up with no anxiety. Had cannabis with a little anxiety but no muscle tensing. Added the risperidone, hour later added the clonazepam, and 15 mins later added a beer. Now in muscle clenching mode.

 

 

Edited by jojam

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Does your doc know you are smoking the cannabis (marijuana)?.....

 

Edited by CrazyRedhead

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I've had muscle spasms from antipsychotics before.  I took propranolol for it, I think.  It was a long time ago.  I have absolutely no idea if that is anything like what you have, your doctor should be able to tell.  They have been able to get me in sooner with certain side effects, and they'll probably get you in if you're miserable enough that you have to experiment on your own.  

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Pretty good day. Minimal tension. I had 5mg THC edible. Feeling chill. 

Doc knows I have a problem. Awaiting appointment to tell him I'm using.

Could be the 6mg of risperidone. I've only ever been on 2mg before never higher.

I seemed to get that way of tension nearing my release. I would get so worked up about feeling trapped. They should have released me in 7 days :(

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I understand you might being doing it for pain but marijuana is not good for bipolar. I know this from experience. It will make your anxiety worst.

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25 minutes ago, CeremonyNewOrder said:

I understand you might being doing it for pain but marijuana is not good for bipolar. I know this from experience. It will make your anxiety worst.

Yeah and there it is. There are a variety of articles via WWW for this. Give me a convincing one and I might re-consider, actually I'm on the fence. I think combined with medication it can help somewhat depending on your focus needs, via work etc... be that exercising the demons from my subconscious would clear this whole mess up :P

Tell you what I will give two THC/CBD free days and let you know:)

 

 

Edited by jojam

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sativa makes me stiff and twitchy. i can only smoke indica. taking two days off sounds like a good plan in your journey to isolate what's causing what.

do you like baths? soaking in some epson salts might help with the muscle aches. hot shower helps too.

i know "breathe deeply" is like the oldest advice in the book, but when i get anxious to the point of freezing in place, i breathe very shallowly. being a bit more mindful about breathing helps me a little bit.

if i were you, i'd also want to investigate the risperidone. i've always found low dose risperidone to be pretty calming. i wonder if it's more activating at a higher dose?

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8 hours ago, echolocation said:

sativa makes me stiff and twitchy. i can only smoke indica. taking two days off sounds like a good plan in your journey to isolate what's causing what.

do you like baths? soaking in some epson salts might help with the muscle aches. hot shower helps too.

i know "breathe deeply" is like the oldest advice in the book, but when i get anxious to the point of freezing in place, i breathe very shallowly. being a bit more mindful about breathing helps me a little bit.

if i were you, i'd also want to investigate the risperidone. i've always found low dose risperidone to be pretty calming. i wonder if it's more activating at a higher dose?

Yeah I don't know if today will be my first day off. Had my morning meds, risperidone and clonazepam and now feeling stiff and anxious. That's no other drugs or alcohol today.

I have to go visit my folks on Tuesday Wednesday so I am going to choose those days.

I had an Epsom salt bath and essential oils. It felt nice until the hot water ran out :(

I do breath in through the nose out through the mouth really deep breaths I try to do 30 a day.

Thanks for the input.

 

 

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Two recommendations I would make. Firstly, echoing what others have said, cannabis CAN be destabilizing in bipolar disorder. However, if you are properly medicated and you're consuming the right kind of cannabis, it doesn't have to be so bad, and sometimes it helps people. Best to keep the THC lower and the CBD higher. I know CBD doesn't give as much of a buzz, but if you consume high CBD products that still have a little THC in them, you may feel a lot better. I have my medical cannabis card in Pennsylvania and I have two favorite products. The first one is Vireo Indigo Tincture. Which is CBD:THC in a 19:1 ratio. So very low THC but it's still there. The other is Harle-Tsu Remedi RSO by Cresco Yeltrah. The RSO concentrate is 4:1 giving for some more THC that is useful for really difficult agitation or anxiety or when I want to go to sleep. But at the end of the day, I always have more CBD than THC and I generally feel better than I do worse.

Another thing to look into is structuring your breathing a bit more. It isn't just about breathing in through your nose and ensuring you take a really deep breath. Try 4-7-8 breathing. Inhale for 4 seconds. Hold for 7 seconds. Exhale across 8 seconds. Do this maybe 2-3 times in a row (i.e. one set of 2-3 reps). You'll find it to be very relaxing in the moment if you need something to help you unwind a bit.

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Thank for the advice. I was able to talk to my pychiatrist last night. He thinks it's the high dose of riperidone which is causing the anxiety. No real plans to take me off it but switch to injection in two months. I assume less side effects with this method?

The last strain I bought was 3mg thc and 8mg cbd. I will continue to seek the ratios you mentioned.

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7 minutes ago, jojam said:

Thank for the advice. I was able to talk to my pychiatrist last night. He thinks it's the high dose of riperidone which is causing the anxiety. No real plans to take me off it but switch to injection in two months. I assume less side effects with this method?

The last strain I bought was 3mg thc and 8mg cbd. I will continue to seek the ratios you mentioned.

I suppose high dose risperidone could make one nervous due to the pro-adrenergic effects from blocking certain receptors. Not sure how Risperdal Consta will solve for that. Risperdal is Risperdal. But perhaps he means to try you on Invega (paliperidone) which may theoretically have fewer side effects than the parent drug.

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On 11/18/2020 at 10:26 AM, browri said:

I suppose high dose risperidone could make one nervous due to the pro-adrenergic effects from blocking certain receptors. Not sure how Risperdal Consta will solve for that. Risperdal is Risperdal. But perhaps he means to try you on Invega (paliperidone) which may theoretically have fewer side effects than the parent drug.

Yes that's the injection Invega. 

I picked up some 1% THC 16% CBD bud today. My two day break is out the window. I'm chronic but at least the ratio I bought today is not so bad. 

Things are slowly calming down. Driving is the worse it really tries my anxiety. It seems like I get every red light :( But overall I took a overnight stay with my folks and have felt relatively less anxiety since. 

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