netsavy006 Posted June 22, 2010 Share Posted June 22, 2010 Ok. I know in my other thread, I've been complaining of changing my medications around. Well, I want to do it the right way that I can do safely and doesn't put me back in the hospital. I'm sure most answers will be "none" or "don't change anything" or stuff like that, but I'm waiting to reduce my medications. What I'm wanting to know is out of what I'm on (Keeping the Lithium), what can I try to change/adjust/reduce/remove first? And how (with psych's help) should I go about doing it? Remember keeping Lithium as of right now. That leaves you with, Clozaril, Ativan, Xanax Remeron, Colace Topamax (may keep this one though, unsure yet, may actually increase, still thinking on this one) Thanks for reading and maybe willing to work with me. As you know my ideas may change from time to time, so expect changes. Thanks again, Andy... Link to comment Share on other sites More sharing options...
jarn Posted June 22, 2010 Share Posted June 22, 2010 What about your symptoms is happening that you feel a med change is necessary? What would you hope to address by changing your meds? Link to comment Share on other sites More sharing options...
tryp Posted June 22, 2010 Share Posted June 22, 2010 My knee jerk answer is "don't do it at all". But if you must do it, for the LOVE OF GOD DON'T TOUCH THAT CLOZARIL! Link to comment Share on other sites More sharing options...
netsavy006 Posted June 22, 2010 Author Share Posted June 22, 2010 What about your symptoms is happening that you feel a med change is necessary? What would you hope to address by changing your meds? I want to reduce the amount of medications I take safely without ending up back in the hospital. I don't want to be on as many medications. What I hope to achieve is to have stability with fewer medications. But I'm unsure of which med to start with? Of course I will work with a psychiatrist on all the med alterations/changes/reductions/removals/etc. I hope this helps explain it, Andy... Link to comment Share on other sites More sharing options...
jarn Posted June 22, 2010 Share Posted June 22, 2010 WHY do you not want to be on so many medications? Why do you feel that reducing the number of medications is worth the potential of instability? IF your p-doc thinks this is a good idea, then I'd go with their suggestions. I don't really think it should be up to you 'which med to start with'. You're not a doctor. Link to comment Share on other sites More sharing options...
wondernut Posted June 22, 2010 Share Posted June 22, 2010 My knee jerk answer is "don't do it at all". But if you must do it, for the LOVE OF GOD DON'T TOUCH THAT CLOZARIL! ditto ditto ditto Tryp is speaking such brilliant words here!!! I wish there was some way of getting your brain to stop looping Andy this must be really hard for you to be obsessing on your med quantity I know you have read this many times but I would feel badly after reading all your recent posts and not saying it ...I want to just offer this to you ... I personally ..from my own view of life ...think the hardest part of taking the right drugs for the right things is just resigning to take them because you need them...like eating because you need food ... and funtioning the best you can ..your providers I am sure want the same thing you do ..the least amt of drug for the most benefit ..that is how it usually works ..(USUALLY) There HAS to be another direction you can take this brain loop so it can be productive in your life instead of constantly antagonizing you ? in fact why not just say that to your doctor "how do I get myself to stop fixating on the number of drugs and just focus on something else for a while? What tools can I use and has worked for others like me to get myself to break this particular cycle?" in fact I am dealing with a brain loop myself right now (nothing to do with this subject and I have totally different set of circumstances..but I do understand brain fixations and loops) is that possible for you Andy? to just ask how to break the loop ..can you see that you are in one over your meds right now? I am not with you and can not see your life but from reading your posts ..it appears to me this is driving you literally nuts right now good luck with this and I will love to read what works for you when you find it so keep us posted! (you have to get yourself back in that program or somewhere you can get therapy or find an outlet for this kind of thing and how to stop looping yourself in this direction) Link to comment Share on other sites More sharing options...
netsavy006 Posted June 22, 2010 Author Share Posted June 22, 2010 WHY do you not want to be on so many medications? Why do you feel that reducing the number of medications is worth the potential of instability? Mainly because the more meds your on, the more complicated things get down the line. Plus I don't want to think about the long term repercussions of taking the medications I'm on now (I'm aware all medications (even Acetometaphin) has them) Because in the end I'll be on fewer medications. Ones that I can feel comfortable about their benefits/risks. I know I've played this game before, but I really am after a smaller amount of medications. I want to take fewer pills a day... Link to comment Share on other sites More sharing options...
jarn Posted June 22, 2010 Share Posted June 22, 2010 I can understand wanting to simplify your medication regime - but I agree that you really seem like you're floundering dangerously close to going off meds without being under a doctor's supervision. It's not healthy to obsess over this IMO. You need to put this as an item for discussion when you sort out your p-doc situation and deal with it, with your p-doc, then. Nothing terrible is going to happen to you because you stayed on your meds for a little while longer while you were sorting the p-doc out. The other thing - and I think it can be hard to come to terms with this - we have to treat the diseases we have, not the diseases/side effects we might get. That HAS to be your first priority, for your health and for your functioning. You are such a bright person with a lot he wants to accomplish, and you can do all that - but you need to stay stable. Think of taking your meds like your job. One of the things that sucks about being mentally ill is that we take meds that have side effects. But we could just as easily have Parkinson's and take meds that have side effects or cancer and have chemotherapy do crazy things to our bodies. It's hard to accept the hand you're dealt but I think it's important. If it helps - of all my meds, I would say Lyrica is the least 'important' or necessary. I don't like swallowing it. (Though I swallow all my other meds) But I have to take it - it does help with my anxiety and my level of functioning. Not liking swallowing it isn't a good enough reason not to take it. I was given these prescriptions for a reason. You were given your prescriptions for a reason. Link to comment Share on other sites More sharing options...
rowan77 Posted June 22, 2010 Share Posted June 22, 2010 Hi Andy, I understand your desire to change your medication regimen. It is a control thing I think. You want to be the one calling the shots regarding your medication, afterall it is YOUR body. I've been there, and to my detriment and downfall, messed around with my medications on more than one occasion and became extremly unwell, landing me in the hospital, actively suicidal. I eventually copped on that the pdoc, for the most part, knows best. Just be honest about your urges to change your meds around. When I talked to my pdoc about how I didn't want to be on so many meds, that it portrayed that I was very sick. His reply was "By being on all these medications you are preventing yourself from becoming very sick" That did it for me. I'm now very honest about feelings I may have about messing with my meds. You need to do the same Andy. If it aint broke don't fix it.... Link to comment Share on other sites More sharing options...
netsavy006 Posted June 25, 2010 Author Share Posted June 25, 2010 Well I've thought some things through and 3 medications I'm staying on are Lithium (@ 900mg/day), Topamax (increase from 100 to 200mg/day), and Clozaril (@ 100mg/bedtime). I'm thinking of switching out Remeron for Lexapro (20mg), add Lunesta (3mg), and keep the Colace (200mg). I think that keeps the 6 medications I'm on now but heres something about it. I could switch to the Lithium ER and take the 900mg @ bedtime. I could possible take the full 200mg Topamax dose @ bedtime. I already take Colace & Clozaril @ bedtime. I would take Lexapro @ bedtime as that's the current consistancy. Lunesta is an obvious bedtime medication. ----- So what I could do with this is take my psych medications @ bedtime and take my vitamins in the morning with breakfast and not have to worry about having to take medication during the day. I don't think what I've thought of is perfect or free of side effects, but it's a better alternative in my opinion than what I was planning on doing before. Link to comment Share on other sites More sharing options...
LunaRufina Posted June 25, 2010 Share Posted June 25, 2010 Wait, who is this mysterious doctor you are working with all of the sudden? Link to comment Share on other sites More sharing options...
notfred Posted June 25, 2010 Share Posted June 25, 2010 IIRC, Lexapro made you manic/mixed in the past. nf Link to comment Share on other sites More sharing options...
netsavy006 Posted June 25, 2010 Author Share Posted June 25, 2010 Wait, who is this mysterious doctor you are working with all of the sudden? Still don't have a psychiatrist yet. This was just my new thoughts for when I get the new psychiatrist. Link to comment Share on other sites More sharing options...
sorrel Posted June 26, 2010 Share Posted June 26, 2010 Colace is for constipation and is usually OTC. If you are really just dying to reduce sheer number of pills, the obvious place to start (without endangering your mental stability) would be that. I would suggest eating a very high-fiber diet with lots of water to compensate. Obviously someone has prescribed these things for a reason and my first suggestion would be to change nothing, but seeing as that it would be a bad idea to screw with your psych meds, if you really can't resist the compulsion you could at least aim it at the OTC med. Kind of a harm-reduction approach. Link to comment Share on other sites More sharing options...
bpladybug Posted June 26, 2010 Share Posted June 26, 2010 WHY do you not want to be on so many medications? Why do you feel that reducing the number of medications is worth the potential of instability? Mainly because the more meds your on, the more complicated things get down the line. Plus I don't want to think about the long term repercussions of taking the medications I'm on now (I'm aware all medications (even Acetometaphin) has them) Because in the end I'll be on fewer medications. Ones that I can feel comfortable about their benefits/risks. I know I've played this game before, but I really am after a smaller amount of medications. I want to take fewer pills a day... We all want to be on fewer meds a day honey. It took me some time to accept that I need a number of meds, and meds for thing not psyche related also. I tried going without and had problems. Such as a crazy mixed state that was a problem for my work and my marriage when I just up and quit my neurontin. Such as limping and having a lot of pain without one of my immunosupressant arthritis meds. I thought I could give them both up. wrong so very wrong I thought your big goal was to stay out of the hospital??? How long have you been stable? How long since you were in a psyche hospital? It seems like just a few weeks ago that you were preparing to leave your mom's and live more independently. I think you need some big milestones such as one year living on my own, one year without IP hsopitalization. When you reach a major milestone then you could discuss this with your doctor. Remember your Pdoc wants you to be stable, and s/he does not want you to be on unnecessary meds either. OH! I just read below to another reply. You don't have a Pdoc now? You quit that other clinic without having a new doctor????? Link to comment Share on other sites More sharing options...
Guest Vapourware Posted June 26, 2010 Share Posted June 26, 2010 I'll be a bit blunt here and pose this question - why are you asking a bunch of untrained strangers on an online forum about something as important as your medication? If you really want to make any modifications to your medication regime then it should be discussed with your psychiatrist, who can advise you appropriately about your medication. You shouldn't be making the decisions alone because you're not trained sufficiently in this area, and neither is anyone else on this board. If anything, this thread seems [at least to me] like you are looking for validation on changing your medication without sufficient professional advice. Link to comment Share on other sites More sharing options...
netsavy006 Posted June 28, 2010 Author Share Posted June 28, 2010 I have my list that I'm going to change from -- to when I finally get a new psychiatrist. I stay on the Lithium IR the way it is because I don't want to mess with my Lithium level (since it's .9) and it's stabilization. I want to increase the Topamax from 50am/50pm to 100mg BID, making it a mood stabilizer for me. I want to get off of Ativan. I (yes me making this decision) don't want to rely on benzodiazapines for the rest of my life for anxiety/panic attacks. I want to switch out Remeron 30 for Lexapro 10AM/10 @ bedtime. When I spread out the Lexapro instead of taking the whole 20mg dose at once, I don't get manic (that I remember from history). I won't stop taking the Clozaril 100mg bedtime because I don't want my psychotic symptoms to come back and I will continue the Colace for the side effect. I want to get back on Lunesta (but how can I accomplish this when the insurance wants STEP therapy, and I can't take Ambien (increased psychosis), don't want to try other meds, knowing that Lunesta works, since it worked for years. I don't really think anything I wrote changed from before but at least it shows that I haven't lost any consistency from the days prior. (I'm hoping I will get a psychiatrist soon so I can get my needs met)... Link to comment Share on other sites More sharing options...
Moody Posted June 28, 2010 Share Posted June 28, 2010 why would you want to change from remeron to lexapro, especially if there is chance that the lexapro could cause mania? Link to comment Share on other sites More sharing options...
netsavy006 Posted June 28, 2010 Author Share Posted June 28, 2010 Because Remeron only helps with sleep and bipolar depression. Lexapro helps with the bipolar depression and anxiety... There's a difference. Link to comment Share on other sites More sharing options...
MarkP Posted June 29, 2010 Share Posted June 29, 2010 My opinion would be to aim to bump up the clozapine, and ditch the benzos to the extent that you can. 100mg clozapine isn't really very much. A starter dose, essentially. Whereas, 4mg lorazepam is already pretty heavy duty. The escitalopram (why not just use citalopram instead -- far cheaper!) would be something you'd want to take first thing in the morning. Clozapine generally at night. Lunesta (eszopiclone) is basically another benzo with some horrible side effects in terms of taste. If your clozapine dose is high enough, I doubt you'd even need it, and the benzos should be PRN anyways. Link to comment Share on other sites More sharing options...
saveyoursanity Posted June 29, 2010 Share Posted June 29, 2010 I'll be a bit blunt here and pose this question - why are you asking a bunch of untrained strangers on an online forum about something as important as your medication? If you really want to make any modifications to your medication regime then it should be discussed with your psychiatrist, who can advise you appropriately about your medication. You shouldn't be making the decisions alone because you're not trained sufficiently in this area, and neither is anyone else on this board. If anything, this thread seems [at least to me] like you are looking for validation on changing your medication without sufficient professional advice. I agree with this. netsavvy, going into a new doctor with a list of changes you want to make strikes me as a Very Bad Idea. Especially when you've just been stable for what I understand is a short time. Link to comment Share on other sites More sharing options...
SashaSue Posted June 29, 2010 Share Posted June 29, 2010 WHY do you not want to be on so many medications? Why do you feel that reducing the number of medications is worth the potential of instability? Mainly because the more meds your on, the more complicated things get down the line. Plus I don't want to think about the long term repercussions of taking the medications I'm on now (I'm aware all medications (even Acetometaphin) has them) Because in the end I'll be on fewer medications. Ones that I can feel comfortable about their benefits/risks. I know I've played this game before, but I really am after a smaller amount of medications. I want to take fewer pills a day... Andy, are you currently experiencing any terribly troublesome side effects? If not, wanting to go off your meds because of theoretical future problems is one of the dumber things I've ever seen anyone here wanting to do. Your rationales and explanations of why you want to make or not make certain changes don't actually make much sense. Maybe you've noticed that most of your replies in this thread are from newer members? I think that's quite likely because longer term members have seen this pattern from you before, and recognize it as actually a symptom of your MI, and not anything they especially want to be part of. Link to comment Share on other sites More sharing options...
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