netsavy006 Posted March 2, 2009 Share Posted March 2, 2009 While I may be having changes with Zyprexa Zydis, I'm feeling very strange this time. It feels like I'm falling into a depression. I can't take antidepressants anymore because they raise my risk of mania or hypomania (I've been on 4; Zoloft, Pexeva (a form of Paxil), Cymbalta, and Lexapro). I've even taken Strattera (if you want to count that as an anti-depressant) and it totally changed my personality. Strattera made me very agitated and irrtable. I was yelling/hollering/screaming at Mom for no reason at all. With Zoloft/Pexeva I had gotten manic and with Cymbalta I was on for less than 2 weeks. It made me confused and daydream a lot. Lexapro worked for the anxiety and depression for 2 years and then I had a manic episode on it. I was having racing thoughts, I was speaking too fast, and I was all over the place according to me and the doctor. So I had to be taken off of it in the hospital. I was placed on Abilify 15mg/day (divided as Abilify 5mg 3x/day). It really helped my symptoms but it caused restlessness, which not even 5mg of Valium 3x/day, nor Artane 2mg 3x/day could help. In the past not even 1mg Cogentin 2x/day was fully helpful, but Cogentin I think was helpful. I don't know what to explain to the doctor tomorrow when I see her. She's a psychiatrist. We just got off of Abilify recently because of all the restlessness/akathisia and I know that Mom would be unhappy with me wanting to start over with it again. (especially since I've been on it for 5 other times at least). But I like the way I feel when I'm on Abilify despite the anxiety and restlessness. I like the emotional uplifting that it provides me. Is there a way that I could take Abilify and not get the restlessness/akathisia? Could taking Cogentin 1mg 3x/day be better than Cogentin 1mg 2x/day? I know I'd have to get off the Artane first because they'd probably interact, but just a thought. I just want to get over this bipolar mood swings. I don't like the mood state that I feel I'm in and I just want to get over the hump. Mom explains it as a withdrawal from all the med changes (which could be true, can't deny it) but I don't like the way I feel. What can I do? Thanks, Andy... Link to comment Share on other sites More sharing options...
sorrel Posted March 2, 2009 Share Posted March 2, 2009 1. How long have you been on your current meds? You need to give them a chance before concluding that something needs to change. 2. 5mg is a low dose of Zyprexa, so you still have room to go up with that. 3. You have asked this exact question before. You like the mood effects of Abilify but can't tolerate the akathisia. You've had more than enough trials to know that you're not gonna get rid of the akathisia no matter what. So it is up to YOU to decide whether the akathisia is a worthwhile tradeoff for the mood effects. I'm guessing no, since you've already discontinued it for that reason numerous times. Link to comment Share on other sites More sharing options...
netsavy006 Posted March 2, 2009 Author Share Posted March 2, 2009 1. I've been on the Topamax and Valium since October 2008 and the Zyprexa Zydis was added 2/19/09. 2. I understand that 5mg is a low dose of Zyprexa but I get restlessness/akathisia with Zyprexa if we go 10+mg with it so it's kind of a lose/lose with it too. 3. I don't know what to do about this one. The only 2 meds that my pdoc seems to use for this are Cogentin and Artane. I've heard of other users mention of Inderal and Amantadine but she will only work with those 2. I don't know why but the only thing I can think of is that she is under the school of thought is that she's under the impression of akathisia being an EPS side effect (which it may or may not be). Like I mentioned above, when I was on one trial of Abilify in the past she did use Cogentin 1mg 2x/day and it did provide some help and I was able to take 15mg/day Abilify along with the 1mg 2x/day Cogentin for a period of 2 and 1/2 months before my bipolar destabilized. (Abilify was my only stabilizer back then). That's why I asked the question do you think adding a third dose might be worth asking the pdoc about @ my appt tomorrow when I see her. I don't really know what to do med wise anymore. I feel like I'm at the end of my rope. She wants to put me on Moban for my bipolar/anxiety if things don't improve, and I read that it could cause hyperactivity, increased activity, euphoria, and restlessness; things I don't want to have. I'd rather be stable on one of the AAPs than resort to being on a typical AP (or she refers it as an intermediate anti-psychotic (if there is such a thing)). I want to get better, I really do, that's why I go to see her but I don't feel like I'm improving even with the med changes and the trials that I go through. I try real hard with the changes and give them at least 2 to 4 weeks because I know they take some time to work but sometimes it's just to hard to wait it out. Plus I'm still working off the effects from the last trials of meds. That's what complicates things. I just wish I had answers. I hope this helps explain things better and I hope that I can get some help. Please let me know what I can do in regards to whatever so that I can get some relief in whatever manner possible. Thanks, Andy... Link to comment Share on other sites More sharing options...
sorrel Posted March 2, 2009 Share Posted March 2, 2009 Zyprexa Zydis was added 2/19/09. That's less than 2 weeks ago. If it were me I would not be talking to the doc about any changes just yet. She wants to put me on Moban for my bipolar/anxiety if things don't improve, and I read that it could cause hyperactivity, increased activity, euphoria, and restlessness; things I don't want to have. That sounds like a rare, paradoxical reaction. It is normally a sedating drug. Almost all drugs have a chance of a paradoxical reaction. Don't let rare adverse effects put you off a drug. If she's suggesting it, and the Zyprexa doesn't work, try it. That makes more sense than going back to something you've been unsuccessful with 5+ times. Link to comment Share on other sites More sharing options...
netsavy006 Posted March 2, 2009 Author Share Posted March 2, 2009 She wants me to be on the Moban in combination with the Zyprexa Zydis just to inform you. I don't want to be on the Moban because of the long term risks of a typical anti-psychotic (TD especially). I know it can happen with the atypicals but they are much less and can be more reversed if caught earlier. Here was the list of side effects with Moban according to drugs.com. I'm bolding the ones that are of concern to me: Blurred vision, depression, drowsiness (especially at the start of therapy), dry mouth, euphoria, hyperactivity, nausea, Parkinson's Link to comment Share on other sites More sharing options...
gizmo Posted March 2, 2009 Share Posted March 2, 2009 I tried Abilify four times. I got akathesia four times. Each time was with a different pdoc who assured me that *this* time would be different. (Insurance sucks sometimes.) Guess what? It wasn't. If you react to a med, you react to it. That's the bottom line. You can try to mask the reaction by throwing some different medication on it, but what is that really going to do for you? Abilify caused me to do some really crazy stuff while I was on it. I believe the term was "dysphoric mania". It wasn't worth it to me. When the 5th pdoc started tinkering with the meds, I informed her that I would not be taking Abilify for a 5th time. She was cool with that. You and I are in the same boat with the Zyprexa. Perhaps going to 10 mg will mellow you out. 5 mg is on the low side. When I was manic in October, it took 20 mg to calm me down. Link to comment Share on other sites More sharing options...
netsavy006 Posted March 3, 2009 Author Share Posted March 3, 2009 Perhaps going to 10 mg will mellow you out... I can't go to 10mg or above because I get the restlessness/akathisia side effect from Zyprexa @ that dosage range too. I noticed when I was in the hospital and was tried on 10mg per night, I got restlessness that was unable to be well maintained. That's how I know I can't go to 10+mg of Zyprexa or Zyprexa Zydis. Yet, I "want" to have the same side effect on Abilify. I question myself about this... Link to comment Share on other sites More sharing options...
gizmo Posted March 3, 2009 Share Posted March 3, 2009 Yet, I "want" to have the same side effect on Abilify. I question myself about this... Perhaps it's because abilify makes you "up" and zyprexa mellows you out. I say this with caring, having faced this difficult question myself once: are you looking to abilify for stability, or hypomania? My first (and most wonderful) pdoc told me that the loss of hypomania would be the most difficult thing I would have to accept when being treated for BP. It feels so good to be in that zone, you know? I missed the "super me" until I had my first real mania. And it wasn't a nice mania, it was a dysphoric mania like I mentioned earlier. After that, every time I have a manic epidose, it's dysphoric. I now hate any version of "up". I sleep 5 hours or less a night for three nights in a row, I'm on the phone with the pdoc. I want nothing to do with it. I personally believe all those untreated hypomanias eventually triggered the big bang manias. If I am wrong or overstepped my boundaries, please accept my apologies. I do not mean ill. Link to comment Share on other sites More sharing options...
netsavy006 Posted March 3, 2009 Author Share Posted March 3, 2009 I'm looking for stability with Abilify but let me mention this about what happened today: I saw the psychiatrist today and through some luck (and crying) I was able to give Abilify a final shot. But with one word of caution. I have to manage the side effects on my own. I cannot be rushing to the ER, rushing to use the psychiatric on call service, or especially sign myself in to the hospital. One trip into the hospital, and I'm totally closed off from the building from where I'm getting my treatment. So I'm hoping that with Cogentin, Abilify and it's side effects will be easier to manage. I wish myself full luck as I manage my day to day routine. I'm on Abilify 5mg AM and Cogentin 1mg 2x/day to help manage the restlessness/akathisia side effect... Link to comment Share on other sites More sharing options...
gizmo Posted March 3, 2009 Share Posted March 3, 2009 Good luck. I don't know how you think it's going to somehow be different this time, but I honestly wish you the best. I hope it's worth what you have gambled. I would have just walked away from the abilify. Of course, I was a human guinea pig for four trials of the stuff, so I can't talk much, lol. Link to comment Share on other sites More sharing options...
netsavy006 Posted March 3, 2009 Author Share Posted March 3, 2009 Well like I said before, I was on Abilify and stabilized with Cogentin. This time instead of being on a big 15mg/day dosage, I'm only on 5mg/day, so that may help, plus I have the Valium 5mg 3x/day added on to the Cogentin. I was never on this combo before so we will have to see what happens. I hope I can manage this time. If not, I don't know what I'm going to do. My doctor was thinking of switching me over to Geodon, but I was too afraid of the heart risks associated with Geodon. I should've followed doctor's recommendation but Andy wanted to do what Andy wanted to do and now Andy has to "suffer" the consequences of his actions. We shall wait and see what happens. I took my first 5mg dose of Abilify and first 1mg dose of Cogentin when I got home (still had spare tablets in the house) and I feel ok thus far but it's only been one dose (have to give these things time to build in the system). I just hope I do better this time... Link to comment Share on other sites More sharing options...
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