Which one should I try now?

[gizmo]

I have bipolar, and while I rarely have mania, it is well under control. What is not under control is my exreme edginess and anxiety and depressive episodes. I'd tried lamictal, seroquel, abilify, risperdal, depokote, lexapro, Effexor, Paxil. I currently take 1 mg of risperdal (trying to get off of because my prolactin is WAY too high, causing all sorts of female problems), 20 mg BID Geodon, 2 mg xanax mostly daily (sometimes not at all, sometimes twice a day - HMO doesn't cover XR) 20 mg celexa, 200 mg topomax.

Here's the problem. Without taking the Xanax anytime during the day, I've notices since taking the Geodon that I can't sleep at night. When I do take the Xanax on the same day as the Geodon, I full-blown wet the bed. As in 7 times in three weeks, twice in the last three days. I mean, I'm an adult, I can't go around peeing all over stuff! WTF?

But here's the even worse question: What the hell can I take that will cure this agitation/anxiety/depression? The agitation is so bad I can't focus at work and get nothing done. The anxiety attacks are almost a daily occurance. The xanax fixes those, but who wants to take Xanax every day? Pdoc doesn't want to switch me to Clonzepam because he's afraid it will zone me out and make me tired, and the Xanax actually helps me focus and doesn't make me tired.

I have self-hate and some self-destructive OCD-type behaviors. My last depressive episode I said goodbye to my kids (first suicidal idealization in the 15 years I've had this disease) took a whole bunch of risperdal and started cutting on myself. The whole time, the rational portion of my brain kept saying no, but the bipolar portion was louder and wouldn't listen to reason. I ended up in quick care to take care of the wrist wound, walked around like a drunk person for the next day and a half, and had an emergency appt with the pdoc. I don't want that to happen again.

What medicine do I have to take to make this go away? I've been taking different medicines for almost two years now. I'd stick with the geodon, but I can't keep waking up in a gigantic puddle of my own piss. It doesn't seem like there's much left for me, like I'm at the end of my rope. I'm getting really desperate here!

[Guest FrannyNZooey]

I also take Geodon, but started at 40 mg BID, and in couple days 60mg BID. I had read higher doses are actually more calming. Your very low dose could be causing your stress.

This was done in a clinic setting. I felt best on 40mg, still bit shaky on 60mg, but going to give it couple weeks.

I do take just half mg of Klonopin in eve to help with Geodon Eve dose, but mostly I feel it is the trazodone taken at bedtime only, that helps me to sleep now, and feel relax.

Those are my only meds and times.

Maybe you could give low dose of Klonopin try, very low dose as I.

And perhaps ask about Trazodone for the restless sleeping, calming, I never pee self, so feel that might be stress, nerve thing.

Good luck, and keep asking.

Aly

PS I have bipolar w/ mixed plus PTSD

[DMF]

My dd takes 280 mg. (broken into 2 doses) of Geodon. First, we had lots of problems on the lower doses during initial titration including the agitation, anxiety, etc. that you described. The only thing that was different is that she slept too much. However, I know some depressive patients have a difficult time sleeping or a medication can bring that on....but please read on. Anyway, we wanted to take her off Geodon because I was concerned that she was edgier with the meds than off. Her doctor said that we needed to stay with it until we could get her to at least 80 mg. a day and, preferably, to 120 mg. a day. I wish I could remember the point of change but when it came it came quickly...no more agitation or anything else. It's like her body finally realized that it had this med in it and decided to start using it.

While I think my dd takes an excessively high dose, I am the first to tell you that this drug was the final additional to her other meds (225 mg. Effexor, 1800 mg. Trileptal, and 2 mg. Cogentin) to actually bring her moods to almost complete stability. It was seriously like a lightbulb came on in her brain and things started working better. It's been this way for several months (dancing the happy dance and saying prayers of Thanksgiving) and I pray every day that it stays this way for good. The only thing it doesn't do (which irritates me since it IS supposed to be an antipsychotic) is control her hallucinations well. They are better but she still has them.

Anyway, my point is not to give up. At least allow yourself to get to a therauptic level and then try to stick with it a couple of weeks. If that doesn't work, consider allowing your Pdoc to increase the dose. 240 mg. is not unheard of - trust me, I've checked. When she went to 320 mg. I got worried but she was having some vision problems so we brought it down some. I know some people call Geodon the drug from hell but it really has worked for us...and my daughter was one whose moods vascilated all over the place throughout the day. Also, one last thing, all the side effects have deteriorated over time (she's been on Geodon since December).

BTW, if sleep is the biggest problem, consider asking for something to help with that until you get to a higher level that might level that symptom out.

Oops, one last thing....my recommendation is slow titration (like only every two weeks). We found out it takes a lot longer to get to the right levels but it's a whole lot easier to get used to the side effects.

Good luck!

[Guest briana]

i been on ativan for one day now it makes me tire i am using it for anixerty what can i tke tahts beetter.

[LunaRufina]

i been on ativan for one day now it makes me tire i am using it for anixerty what can i tke tahts beetter.

Are you supposed to take it "as needed" or every day?

If you give it some time, the tiredness may go away, as that often happens with side effects.

You need to be patient though- giving a med one day isn't really a fair shot.

Can you provide a little more info/background so maybe we can answer your questions better?

[mika]

i been on ativan for one day now it makes me tire i am using it for anixerty what can i tke tahts beetter.

well, Klonopin has a longer half-life unlike ativan which comes quick and shortly.

[SashaSue]

Hey Gizmo - It doesn't look like you've tried Lithium. What about it?

[Phoenix_Rising]

hi gizmo,

What suggestions does pdoc have?

I've been having a lot of luck using AAPs to reduce the worst of my anxiety and depression. My pdoc also has me taking a tiny dose of Adderall for depression.

As for xanax vs klono, I feel like klono provides more coverage, but I worry that it adds to my depression. I'm also thinking about trying xanax xr. Maybe your pdoc could give you some samples of xanax xr just to see if helps.

What does pdoc say about wetting the bed? And, to clarify, it happens just when you take both Geodon and xanax?

I hope you find something that works for you.

Peace,

Phoenix

[mika]

Just wanted to add. I used to take ativan like it was nothing. no tiredness.

Now when I take it at night, I become like a zombie the next day. Maybe its the combo of my regular meds and the ativan. But ativan is necessary to stop stop oncoming seizures, sleep and anxiety. It sucks.

So I understand about being tired from ativan. Its normal but being too tired or zombie like is not normal.

[recoverymouse]

abilify has done wonders for my anxiety. I take a lot of meds but no benzos because of the potential for addiction in my case. also on lithium, remeron, neurontin, effexor and (drumroll please)... provigil.

[gizmo]

Wow, this is an OLD post. I had to read it a couple of times to really see that it was me that originally posted it!

I am doing *much* better, thanks to everyone that has asked. Since that post I have a new doctor for the past year and have been on some meds that have really helped me out... lithium, zyprexa, and topamax. The zyprexa calmed down a lot of the manic episodes and almost all of the constant anxiety I was feeling. I recently completely weaned off the xanax, and I've been taking that for a LONG time. I haven't SI in almost a year.

I have been cycling about every two months, often with some sort of life event triggering the mania. Two months is June, and I'm hoping to break the cycle for the first time since September. April was a controlled episode. I had a mania, but it was dulled by an increase in zyprexa so that I could feel the agitation and the edginess and the restlessness, but it was kindof buried under the surface.

Anyway, enough about me. Thanks for responding to my post!

[chimpmaster]

Xanax is a love/hate drug for most people. It works really well, but it has a areally short half life and is consequentially really addictive.

Talk to your dr about klonopin or valium instead. Xanax's short half life with repeated dosage can drop to 3 hrs - you NEED to sleep longer than that each night.