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Is this all necessary?

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I am just wondering if anybody out there knows the reason for all of this medication that we are put on? I have found it very hard to use my seroquel as needed although I hate the side effects of it.I am on Keppra also...I do not have a problem with the Keppra and it was my idea to slow down on seroquel (asked doc first). But I need it to sleep. I cannot figure out why I am on an antipsychotic. I do however understand the a/c.But why not a sleeping pill. Actually I go through a sort of aggervated fit before I finally fall asleep  on the seroquel. But for gods sake I have gained from 110lbs on August 1st  to 137lbs today!!! Now vanity I will admit that I have but come on this is fucking rediculous. I mean that rapid of a weight gain is NOT for anyone healthy. Not to mention it makes you fucking depressed to not be able to fit in ANY of your clothes.

Well anyways I do not want this under the weight issue topic. My question is really ...well I am just confused. Why an antipsychotic? Are you psychotic without knowing it when you are bipolar? I thought it was a mood diosorder. I do not hear voices my mind just races at times and I have severe insomnia over it. I also have anxiety and paranoia issues but they are just inflated not something that is unreal.The things that I get paranoid over could actually happen and in some cases have. I just have problems dealing with stress..I guess.

I am not in denial I just do not understand? I have read all of the symptoms but I still am not sure what the fuck bipolar is. Well I do but I don`t. And I cannot figure out for the life of me why all of these medicines that are suppose to make you mentally healthy kill you physically. You would think that there could be a happy medium out there somewhere. This is so frustrating.

I am not trying to tell anyone out there to question their meds. I just want to know what all of this is about. I don`t understand. Any replys I would greatly appreciate.

                                                    Becki  ;)

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Becki --

You'll find a lot of sympathetic people on this and then some people who will spew their own philosophies without regard to your experience or questions. I doubt in any of these cases you'll find an answer to your question though, since even the psychiatric community isn't able to answer it.

That said... I'm very sympathetic, and personally I believe meds do more harm in the long-run and to society as a whole then they do good. I think meds are necessary or at least warranted in many cases, though the ideal (which is so rare as to appear non-existent) would be to use meds as temporarily as possible in conjunction with understanding the factors *within one's conscious control* that have contributed to the mental imbalances so as to correct these as possible through other types of therapy and life changes. It does appear that meds, a majority of the time, are characterized by excessive trial-and-error, side effects ranging from annoying to debilitating, and a weird sort of escalating complexity of one's problems the longer they are treated *solely* by psychiatrists using drugs.

One thing I suppose most here would agree with is that you want to find a good pdoc. One who is able to listen to you *as well as* offer their training and knowledge in a dialogue. Any psychiatrist who tells you they *know* what the problem is and what the cure looks like is *LYING*. And any doctor who simply accepts your views on everything and prescribes accordingly is a *MORON*. There must be a dialogue between your experience and their (hopefully) greater knowledge of the brain. Meanwhile (this is my philosophical spewage again) it is important for you to remember that you are more than a brain, and to a pdoc you are not. Even the mind is more than just the brain (and here I am inviting all sorts of controversy if people want to jump on this). If you are 100% convinced that your problems all stem from a faulty brain, by all means continue to put all faith in psychiatry and keep searching for the wonder cocktail that corrects your life. Otherwise, negotiate with your doc to minimize negative effects (weight gain should be considered just as seriously as mental functioning) while maximizing benefits, and ALSO find emotional outlets and connections to help you sort through issues in a more human way, independent of drugs.

Here's a cool article:


A doctor daring to question the whole model of the DSM in its current incarnation and the over-adherence to the biochemical model of reality. A good read for anyone trying to make greater sense of diagnoses and pharmaceutical treatment.

It is of course important to keep in mind that Bipolar, MDD, PDs, etc, are not nothing. They are in fact descriptors of some sort of phenomena, which change over time as views change (the descriptions that is). Lumping things together into discreet "things" obscures reality, as does over-adherence to those things as having some innate "thing-ness" other than being descriptions. Bipolar, which was once manic-depression, has crossed into territories once unrelated to depression or mania. The article I included gets a little into this, about how treatments start dictating the nature of the conditions being treated, but doctors WAY to accepting of the biochemical model. In a nutshell, if anti-psychotics help X number of people with diagnosis Y, then condition Y *must* feature psychosis as a symptom, and we must update the diagnostic criteria accordingly. An outside observer might deduce that psychiatrists are not the most scientific of scientists, nor the most empathic of helping professionals. That the profession seems to be helping the pharmaceutical industry more than it's helping the mentally ill, and that the statistics back this up overwhelmingly.

So you know, take your meds, but keep asking questions like you are.

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The simplest reason is to help keep you stable, and to help keep you from potentially destroying yourself and your life while you're getting stable. That's easy.

Antipsychotics can have some uses besides psychosis. Treating mania, anxiety, and insomnia are among them. Just depends on how your brain works, that's all. You don't have to be psychotic to take them. Although...they *are* probably starting to be overprescribed.

For instance, I got Risperdal prescribed to fight an episode of agitated depression in the interim while I'm building up on my main mood stabilizers (hopeful Topamax and Neurontin will do the trick - they seem to be very, very benign side-effect wise for me).

Of course, meds should generally be used in conjunction with therapy and/or a support group.

If you have questions about things, feel free to ask your doc. Especially when it comes to side effects that you're having serious problems with. Your doc can help you decide which options might benefit you best.

It takes some time, and a lot of trial-and-error because a lot of docs either don't treat by reeeeeeally specific sub-symptoms, or not everyone has state-of-the-art brain scans available to them to help narrow down treatment options. Unfortunately, that's how it is for now.

Hopefully, you'll understand what it's all for as you start to feel better. I know where you're coming from. I'm going through it right now, in fact. I'm telling myself the same thing.

Hang in there, 'k?


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My question is really ...well I am just confused. Why an antipsychotic? Are you psychotic without knowing it when you are bipolar? I thought it was a mood diosorder.                               


Bipolar is a mood disorder but you can have psychotic symptoms associated with mania and depression. Hallucinations and delusions, often signs of psychosis, can occur during mania and depression. Sometimes people have insight into their symptoms, that is, one can be hallucninating but still recognize the fact that they are hallucinating and what they see or ear is not real. During a severe mainc or depressive episode with psychotic features some people may lose insight into their own behavior, they may become a danger to themselves or others, and some people may have to be hospitalized until a medication regime can relieve the severity of the symptoms.

As for why an antipsychotic, others have already listed the many uses for an AP other than to treat psychosis. For many people APs have mood stabilzing properties. I have taken Zyprexa before for both its anti-psychotic and its mood stabilizing properties. The manner in which Zyprexa works to treat my symptoms has caused to me to gain weight. Yes, it sucks as a side effect. But you must always ask yourself what is worse, the side effects or insanity. I think anyone who has experienced disabling mood swings, manic episodes that have lead to very risky behavior or have destroyed one's credit rating, depressive episodes where one cannot even get out of bed or has constant thoughts of suicide, would rather have psychotropic medications at their disposal, which can bring a stop to or level out an episode, than to continue to suffer.  You mention several symptoms anxiety, insomnia, racing thoughts, that respond well to Seroquel. People respond to  medications differently that is why you will see and read about all the various med cocktails used to treat people with the same illness, bipolar disorder, and bipolar disorder presents differently in many people because of our unique brain chemistreis. BTW, bipolar disorder is still referred to as manic-depressive illness by some people. One such person is Kay Redfiled Jamison a leading researcher for manic-depressive illnes and who also suffers from it as well.

Life stressors often have a negative effect on one's mood or stability and medications may have to be added or dosages adjusted during these times. Severe mental illness needs to be treated with medication. And combining medications with therapy to help you to learn how to better cope with having a chronic illness, is I think, the ideal treatment. Getting ideal treatment can be difficult. Finding the right cocktail can often take years. But as Susan mentioned untreated bipolar leads to kindling and worsening of the illness. So continue to talk with your pdoc about medication combinations that can work best for you while minimizing side effects. Use the resources of this forum as well as CrazyMeds to better educate yourelf about the illness.


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Thank all of you for your replies, I am sorry I guess I just needed to vent a little. I have a pdoc appointment tomorrow and I beleive I am just going to have to try to work it out with him. We have kind of a language barrier there but he seems to care. He was honest with me and told me he had never treated bipolar but it is a trial and error thing but every time I mention anything it seems that he just ups my meds....and that is driving me crazy.

I sorta understand what this bipolar is all about but really I do not think making a person fat and dumb is the answer...because that is not normal. I am more depressed than anything and I beleive my physical person has more to do with my mental than most would think. I guess it is just hard that I have lived my life for 27 years and now I am told that I shouldn`t have been feeling the way I was feeling because all these years I have been doing it wrong ....well it is just frustrating.

I know that  a lot of people can look at the positive effects of the meds and accept the weight gain as a side effect but I just can`t . The weight gain is just another thing that I am dealing with mentally. The seroquel makes me kinda irratable and fitful but once I do fall asleep I tend to stay that away for 8-9 hours. I beleive that the side effects (physical) does in a way  make the mental worse maybe it is just me but I feel like my mind and body both are being taken away from me. I feel I have no control over any part of my life now. The problem is that I still have my cycles and the Keppra has quietened my mind somewhat but I am still miserable regaurdless of the weight, it is just salt on the wound.

Maybe this is just the wrong cocktail I will see what he will do tomorrow. I really wish I could find another pdoc but our stupid insurance.. well he is the only one on the providers list that they will cover their part. And as far as talk therapy well I have tried but nobody will see me until I am "stable". Whatever that is. I am sorry "venting" again. Thanks again guys.


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I can't wade through all the postings so If I duplicate, apologies,

Don't get hung up on the title "Anti-psychotic.  That just happens to be the the first use it was approved for.

For example a doctor might tell you he wants you to take an anti-coagulant for your headaches. Of course he is just talking about Aspirin which has many properties, one of which is anti-coagulant.  It also is an anti-infammatory, anti-pyretic (fever), and analgesic. It is all a matter of perspective.    Many of the crazymeds are being found to have mutliple effective uses.

Why take the pills? I'm struggling with this as well, but basically, if life is just to hard to handle without doing damage to yourself or the ones around you, then you need to take them.


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This is not a good situation!!!!!

A Pdoc who has never treated a BP? HUH? 8 years of med school and Psych residency and never treated one? This is very fishy.

- You need to find a competent and experienced Pdoc.  If you have to drive a 100 miles it will be worth it to have a Pdoc who knows what the hell they are doing. A language barrier, to boot, is also not a good thing. A Pdoc often depends on picking up very sublte clues in voice inflection, use of words and mannerisms. If this doc is not completey fluent in english then it will work against you.

- Regarding therapsist turning you away. It is true that if someone is so unstable or distraught that they are breaking down in the doctors office most therapists/Pdocs will delay starting talk therapy. If you are able to handle yourself better than that then it talk therapy is very important for support. The beginning may be no more than just support, letting off steam and calming you down.  The problem solving can come later. 

Only you know how you are really doing. If you don't get any better or get worse, I think you need to search for better help.


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Okay I am just about to say fuck this. I went to pdoc today explained that the meds well I was having some problems with side effects . I had to repeat everything about 3-4 times which is really frustrating. I mentioned my weight gain and asked if the seroquel could be the culprit and his reply was and I quote "HOW DO I KNOW?" Needless to say I went crazy on his ass.  I really need to find another pdoc. I called my insurance company when I got home and they gave me some numbers for a couple other psychiatrist but a lot further away. 50 plus miles. But I think my money could be better spent.

My pdoc I seen today told me to stop seroquel I am at 700 mgs a dayJust stop it and to start on trazadone 50 mg at night along with my Keppra which is now 1000 am 1000 pm. I went to the pharmacy and they told my not to stop the seroquel to gradually wean myself off of it. Well which to do...hummm I wander I swear I beleive I could medicate myself better. The pdoc even asked me what I wanted. I told him that is what I was paying him for to figure out what I needed. This is a total fucking nightmare. This guy would be a druggies dream come true really- What do I want?

Oh my god has anybody been through this before and if you have please tell me how to deal with this.

I called the other pdocs my insuraces suggested but it will be a couple months before I can get seen so I have to deal with this guy for a little bit longer.

Another question that I asked my pdoc and got looked at like I was a complete moron. And if anyone knows the answser by all means let me know. Does the seroquel weight gain side effect level out after a period of time or do you keep gaining? Because if this is just a temp side effect then I may just have this idiot keep me on it. And any experiences with the trazodone?

In the last month this guy has had me on:

Seroquel 300mg a day up to as needed to 700 mg a day (suppose 2 stop it all today)

Keppra 500 mg a day upped to 2000 mg a day (still on it)

Welbutrin 150 2x a day for two weeks then stopped ( it drove me insane manic )

Lithium 900 mg (just for 3 days I stopped because it made vomit all day long)

And now trazodone 50 mg a night

Really has anyone had this problem? I just do not know how to deal with this. I thought I felt bad before going to get my bipolar treated but now I am starting to think that it isn`t me it is the doctors. I mean is it safe physically and mentally for you to be  yo yo`d so much with all of these meds. I feel worse than I did before I started to treat this. I really cannot see this getting any worse though.

                                                                                    Becki ;)

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I'll tackle only one item:  Lithium

? Are you still supposed to be on Lithium?  Did you just stop or did the doctor concur?

? Do you have a fast acting form or long acting like Eskalith/Lithobid.  The extended release form are much easier on the stomach

900mg can be pretty hard for start up. If you start lithium again, start by splitting one 450mg Eskalith tabs in half and stay at that level for 1 -2 weeks depending on how well you do before going to a full tab.    Drink lots of water and take with a meal.

Good luck A.M.

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Sorry I forgot to answer which one Eskalith  but it was the generic kind.


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Well sounds like my experience with a lot of pdocs. Only thing I can advise is to read up on the meds -- here and elsewhere -- and ask people who have done the drugs what their experience is. Probably won't be much more accurate than stuff your doctor could read insofar as the meds will affect you, but then you'll be paying a lot more attention to the details than any 15-minute hour doc will.

Another tip that I've taken some flak for on these boards is that anything that would normally control weight will still help independent of meds. Yoga or aerobics or whatever will not only push against the meds' side-effects but will also help stabilize your mind. In the long run lifestyle things like diet and exercise also have the advantages of being cheaper than doctors, more understandable than meds, and under your own control (to a degree). I don't think it is healthy for anyone to yo-yo on and off *any* drugs, as homeostasis alone requires stability of biochemistry for a period of time. Doctors somehow seem to be oblivious to this and will put people on and off things willy-nilly. A LOT of drugs have side effects that are most severe initially and then disappear or are minimized, so if you are feeling saner but gaining weight you might want to stick with things as they are. Any decent doctor will not change 2 things at once -- but I think we've established that you do not have a very good doctor.

Hope something here helps. Stay connected.

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My first thought is that if I were you I'd make your first priority finding a pdoc with at least some experience with BP.  If your pdoc doesn't know BP meds, you might as well be going to a GP.

Second, I'm on an anticonvulsant despite having absolutely no history of seizures, and it works wonders for my BP.  Wonders.  The only reason it's called an anticonvulsant is that's the first thing it was approved for.  So don't panic about taking an AP.  It's just a name.

In the posts you'll see over and over again that if it works, who cares what it is.  Sure, some side effects are dangerous, e.g. can kill you right away.  And when you're in the initial stages of treatment, still trying to figure out what meds work, it can seem intolerable to get one side effect after another.  Many of us give up altogether and only get back on meds in the hospital or after very unfortunate "adventures" while flipped out.

Don't be one of those people.  Be aggressive about getting good care.  In the meantime, use the meds, and get on the phone to find a good pdoc.

edited to add: I also agree with Jemini that lifestyle and thought patterns are as important as meds to control BP.  I have made tons of changes in how I live my life since being treated with meds, and none of those changes would be possible if I were still going crazy.  So I recommend getting therapy, if only to deal with your psychological reactions to the BP diagnosis and that sort of thing.

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If you're up to 700mg of Seroquel it's probably not a good idea to stop cold turkey.  Perhaps in a crisis situtaion but it would be safer if you discontinued it at a scheduled rate.  The crazymeds page recommends 25-50mgs per day every other day.  I have never taken Seroquel (and then gone off it) so I have no experience with discontinuation.  Perhaps if you check out or post on the Atypicals board you might be able to find some answers there.


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