So, this is more exploratory than anything. I accept that, as someone with bipolar disorder, taking an antipsychotic might be a necessary part of my maintenance treatment, and lately that has become more evident. I had been taking Rexulti (brexpiprazole) in varying doses since 2017 when I started it with Depakote ER (divalproex, 24-hour) and Trintellix (vortioxetine). Still taking the Depakote (now up to 1500mg), but Trintellix and Rexulti have worked their way out of the equation, as of late.
My medication regimen has taken a more classical turn due to a breakthrough hypomanic episode in Dec./Jan., and I am currently taking a combo of Depakote ER at night along with 0.5mg of Risperdal (risperidone). Because of persistent issues with depression and anxiety, I am also now taking 50mg of Pristiq (desvenlafaxine) each morning along with 50mg of Vyvanse (lisdexamfetamine) for ADHD that I have been taking for some time.
This combo seems to be working fairly well for me. When I started the Risperdal at 0.25mg/day at bedtime, I didn't really notice much difference at all during the day, but I suppose it was nice as a sleep aid. I increased to 0.5mg on Day 4 and I've parked here to try it out for a bit before deciding to increase further. The Risperdal is really to deal with those breakthrough hypomanic/mixed symptoms such as irritability and agitation, which have always been tough for me. In the beginning of my treatment (2014), antipsychotics were used as monotherapy for mood stabilization, but I could never tolerate the doses necessary to calm those symptoms, because I was easily susceptible to EPS like akathisia. Fast-forward a few years, and we've found that using an anticonvulsant as the primary mood stabilizer with the antipsychotic as a secondary has generally served me well without too much incidence of akathisia.
I started Risperdal on June 8th and increased to 0.5mg a few days afterward. So it's been almost 3 weeks at this dose. My experience so far tells me to keep increasing. I'm curious to know people's experiences on Risperdal, particularly in combination with another established mood stabilizing agent like lithium or valproate. I recognize that I take Depakote and that a combo of lithium+Risperdal may not be the same, but the mood stabilizing effects of lithium and valproate are generally regarded with equal respect in most literature for the time being.
Any thoughts on lower dose Risperdal?....particularly in concert with another mood stabilizer?
Have any of you had or have read of gabapentin being of use as an adjunctive therapy for people with treatment resistant depression/anxiety/bipolar?
I have been doing research and some sources say it helps, others say there is no strong clinical proof. I think a lot of the conflicting reports I have seen has to do with it simply not being studied en mass.
Any advice/experiences regarding this? If so, what was your dosing?
I need some energy, some motivation, some good manic voodoo. Why cant i have that without losing my damn fool mind.?
Hasnt anyone looked at that? Why must I be either lazy and lethargic or 90mph? Im always tired, always fatigued. I need to know how to get my mojo going WITHOUT my kookoo taging along every time. I cant believe nobody has studied this.
This is a long shot, but I figure I can't be the only one who has ever had this thought. Is there a way to induce a state that includes the productivity/happiness of mania - without all the extra bullshit? 😅
Mania is better than any drug, the euphoria is incomparable. Every time I skip a few days of sleep, feel an increase in energy, or anything that might be the beginning of an episode, I think - ''Please let this be the onset of the best feeling in the world. I can't do this shit anymore''. I feel so guilty admitting to that, because I know that being manic and being functional are generally not compatible. I also don't ever want to end up in hospital again, because that never fails to be a de-humanizing experience.
I have not had any symptoms of mania since my last hospital admission, three whole years ago. It was the first and only manic episode that I've ever had, and it lasted for about three months. I feel like I could have avoided hospital completely if I had experienced mania without the accompanying psychosis. If I could just achieve that level of elation without:
rapid speech word-salad delusional beliefs dangerously impulsive acts (e.g. jumping out of a car on the highway because the sky looked beautiful and I wanted a loser look) I look back on those ugly symptoms and I could never cope with them now. I go to college full-time, I work, and I have so much to lose if I lost the ability to communicate with others and behave safely. On the other hand - my life just feels so damn gray and stagnant; I miss feeling invincible.