Latuda for BP1?

[hagar]

Hey fellow crazies. I have a question for you. 

 

For reference, I am on: lithium 1800mg, Invega 9mg, and amitriptyline 200mg. My diagnosis (the one relevant to this thread, anyway) is BP1.

 

So, I've been having a depressive downswing the past month or so (after a short hypomania in January). I've been blaming it on winter (but my light box has not been helping this time). My lithium and AD dosages were already upped in December. Anyway, it seems to be getting worse, and one idea my psych nurse has is switching my Invega to Latuda.

 

Now, I'm very wary of leaving Invega behind because I've been on it at varying dosages for 3 years or so. It hasn't always helped my cycling moods particularly well, but has kept psychotic symptoms and full-blown mania at bay (it seems). Would switching from Invega to Latuda be risky for me? Is Latuda known for being particularly good at keeping manic psychosis away? Would it be possible to be on both of them at the same time without some horrible interaction?

 

Also, for those of you who are on or have been on Latuda- does it actually help depressive episodes in your experience? I mean, I know it was recently approved by the FDA for them, and it's true that all the paid actors in the commercials for it seem really happy, but... 

 

Any input is much appreciated. Thanks! 

[hagar]

That's what worries me the most about it- that it may be too activating for me. Which would be nice to get me out of this pit, but I don't want it to push me too far up. Thanks for the input, sylvan.

[CeremonyNewOrder]

Latuda did nothing for me. Of course that is just my experience and it has worked for others. I would be worried about switching the Invega if you think it's been overall helpful. I know I want to switch my Invega to something else because of a certain side effect but then again I'm scared of becoming destabilized. I've never taken amitriptyline but is it possible to increase the dose to combat the depression? Btw I've wanted to be on two antipsychotics at once but various pdocs advised against it.

[hagar]

Latuda did nothing for me. Of course that is just my experience and it has worked for others. I would be worried about switching the Invega if you think it's been overall helpful. I know I want to switch my Invega to something else because of a certain side effect but then again I'm scared of becoming destabilized. I've never taken amitriptyline but is it possible to increase the dose to combat the depression? Btw I've wanted to be on two antipsychotics at once but various pdocs advised against it.

My psych nurse says she won't increase the amitriptyline dose anymore unless I'm willing to go IP and do it. I have absolutely no idea why, and can't find any justification for it online, but I guess she knows best? It's frustrating, because amitrip is what pulled me out of a major endless depression back in 2012. I'm scared I'm going to end up IP again regardless, and I do not want that. I've been out since last July and I don't wanna go back. I haven't asked her if I could take both APs together, but I'm supposed to give her a call Monday so I'll probably ask then. I have a feeling she will say no as well. 

[tamagotchi]

Just a shot in the dark, but do you think your December med changes might have contributed to your recent hypomania and current downswing?  I had some depression issues with lithium which is the reason it comes to mind for me, have you been on this much lithium before?

[hagar]

Just a shot in the dark, but do you think your December med changes might have contributed to your recent hypomania and current downswing?  I had some depression issues with lithium which is the reason it comes to mind for me, have you been on this much lithium before?

I hadn't considered that, but I suppose it's possible. I've only been on lithium since last July. I was at 1600mg but my levels were in the low range and I was already experiencing some milder depressive symptoms (which I wrote off as just a case of the winter blues), so we increased the dose and now they're in the alleged good range. Definitely a good point to bring up with my psych nurse. Thanks!

[tamagotchi]

I think it can be an individual thing how high your lithium levels need to be, for me it was effective around .6 and not so great above that, even though the majority of people need higher levels.  But, like I said it's a shot in the dark and may not have anything to do with it!

[hagar]

I'm only on 200mg is the thing. I didn't think this was a particularly high dose? But that is a great idea actually, thank you! I will definitely bring this up to her. I would love to be able to tackle this episode with the meds I'm already on before it gets any worse. 

[AnnaBanana]

Well, I am BPII and I have taken Latuda for 3 years. I'm on 60mg now, but started out at 40mg. Yes, it is very good for depression. When I first started taking it, it was only for Schizophrenia, they hadn't yet approved it for BPII depression, so I was taking it off label. I do believe it was in trials then, just not fully classified for it yet. I had a few side effects in like the first month, but they went away after that. I love love love  this medicine and you couldn't pry it out of my cold dead hands! It's not activating for me. I, like you, have issues with my mood dipping in the winter, (though it hasn't been as bad this winter as previously) and we just added Lamictal to my cocktail to counteract that. I'm not a doctor, but being as it's first treatment was actually schizophrenia, I'd say it would also be good for psychosis. I hope that regardless of what med combo you go with, you find one that suits you.

[mellifluous]

 

Latuda did nothing for me. Of course that is just my experience and it has worked for others. I would be worried about switching the Invega if you think it's been overall helpful. I know I want to switch my Invega to something else because of a certain side effect but then again I'm scared of becoming destabilized. I've never taken amitriptyline but is it possible to increase the dose to combat the depression? Btw I've wanted to be on two antipsychotics at once but various pdocs advised against it.

My psych nurse says she won't increase the amitriptyline dose anymore unless I'm willing to go IP and do it. I have absolutely no idea why, and can't find any justification for it online, but I guess she knows best? It's frustrating, because amitrip is what pulled me out of a major endless depression back in 2012. I'm scared I'm going to end up IP again regardless, and I do not want that. I've been out since last July and I don't wanna go back. I haven't asked her if I could take both APs together, but I'm supposed to give her a call Monday so I'll probably ask then. I have a feeling she will say no as well. 

 

 

i don't have bipolar so may not be as helpful for you, BUT: i take two antipsychotics almost always at this point (until friday it was prolixin depot+zyprexa dissolvables...switching to haldol depot+zyprexa) so you can definitely be prescribed more than one. i've been prescribed up to three at once in the past. also, i highly doubt i'll ever be able to take just one again to cover all of my symptoms. again, i don't have bipolar so that could make a huge difference, but i wouldn't rule out being able to take two concurrently until talking with your prescribing physician. best to you x

[Wonderful.Cheese]

I am SZA but bipolar type. Latuda did nothing for my psychosis. It wasn't for me. But I know a lot of people like it. So take my experience with a grain of salt.

And like mell, I'm on two antipsychotics. I have also been on up to three. But that was when I took latuda with my seroquel and abilify. I was taken off the latuda. I had really high hopes for latuda working for me. Like working very well. But nope! Didn't happen. Unfortunately.

Good luck though if you try it!! I hope it will help you a lot.

[hagar]

Thanks you guys! I really appreciate it. I will keep you posted.