Just an update based on my posts earlier during this year. I ultimately wound up remaining on the oral antipsychotic (Latuda 20mg) which I started taking after completing my 2nd probation term in this decade in January 2018 stemming from a January 2015 motor vehicle offense which ultimately slammed me with a 3rd degree felony (after already acquiring a misdemeanor for resisting arrest on foot in June 2012) related to having schizoaffective disorder and experiencing manic episodes and hallucinations. I was previously diagnosed with Bipolar 1 With Psychotic Features after the 1st incident I was involved in back in June 2012.
My main issue the entire time I was serving both probation terms was that I was always court ordered by a judge to continue taking the antipsychotics by injection and to continue my psychological treatment. My primary concerns with the antipsychotic medication was always having intolerable akathisia (inability to sit still), tremendous amounts of weight gain (My height is 5'8 with a small to medium frame and my weight maxed out in January 2018 at almost 310lb after being around 155lb until after June 2012, severe gynecomastia (recently won Risperdal / Invega class-action lawsuit), anxiety, depression, and disorganized speech (currently seeing a speech pathologist to suppress language disorder).
Following the completion of my 2nd probation term, I was initially placed on Latuda 40mg taken with food at night and then tested out Fanapt 6mg. I was still experiencing most of the side-effects and was still outright desperate to eliminate all of the symptoms I just mentioned. By the beginning of March 2018, I did ultimately try consulting with my psychiatrist about switching to a mood-stabilizer as monotherapy acting in place of an antipsychotic and accepted the risk that if I actually suffer from schizoaffective disorder and it wasn't Bipolar 1 With Psychotic Features that I would probably relapse and hallucinate again and I was even in agreement to keep a bottle of antipsychotics as a PRN and to just eat them like crazy if anything happened.
I discussed everything with him (I never considered him to be a control freak) and he said that he would eventually be willing to try my suggestion but asked me if I had any other idea in mind that involved remaining on an antipsychotic for slightly longer. I suggested to him that I'd be willing to try taking the Latuda at 20mg instead of 40mg before switching to a completely different class of drugs.
In retrospect, I'm not even completely certain if any of the oral antipsychotics including the higher dosage of Latuda or Fanapt were even that badly tolerated.. Now, I'm not condemning an entire class of drugs because I now support some of the low-dose oral antipsychotics for myself but I ultimately think that my former overall disgust and intolerance for the antipsychotics was because I was only ever taking them when I was either locked up in county jail and the overall quality of the drugs was really bad and primarily because the only time I was ever actually taking them was when I was taking court-ordered injections. That basically explains why my experience with the mental health system always sucked up to that point.
I'm not trying to speak to highly of myself here but my psychiatrist has always said that he considers me to be one of his higher functioning patients, therefore the reason why he thinks I was always so vocal about all the underlying side effects from the injections and was more sensitive to them than the majority of his patients, even at 260, 280 or 310 pounds, my weight was never really a factor for me in terms of reacting to the meds with less sensitivity.
It simply didn't matter what injection he would put me on. I was on so many of them including Invega, Aristada, and Invega and they always caused more damage than they did anything positive for me. I always felt like the compromises I had to make to not hallucinate and remain out of legal trouble were simply too much to take. The slow-release form of the injections was always too intense for me but I was honestly being completely forthright when I admitted that I didn't want another episode involving the boys in blue to occur ever again.
At the time of my last post, my dosage was already reduced to 20mg and I was still complaining on a regular basis about everything I was still feeling but it wasn't until the end of March when the restless / walking on hot sand feeling finally began to subside. My overall appetite decreased enough to where I lost over 50 pounds by the beginning of the summer (since then the weight loss has stopped at around 260lb unfortunately but I have remained generally stable in terms of my weight). I won a class-action lawsuit against Risperdal / Invega in February and my weight became low enough where my plastic surgeon agreed to perform male-breast reduction surgery on me after denying me previously because I became so overweight / obese after I was released from county jail and the results were very successful without needing revision surgery thus far.
My speech disorder did improve a little but unfortunately wasn't completely going away by the end of the summer. I still felt like I had something like aphasia where I couldn't think of common words or name common objects and the words wouldn't return to my mind until 10 or 20 minutes after the conversation took place. The speech pathologist I eventually saw for this referred me to the audiology department at my local hospital for Central Auditory Processing Testing and it was revealed that I do in fact have a language decoding disorder (my intuition was right all along) which is certainly aggravated by having schizoaffective disorder and maybe even still by the medication.
I only become somewhat anxiety-ridden and become depressed right after I take the medication with some food, therefore I normally take it right before I go to sleep. By the time I wake up, I am no longer experiencing the anxiety and paranoia but I never become psychotic.
Still, the most important thing is that I'm no longer experiencing any of that indescribable akathisia and thank god the weight gain reversed before I hit 350 and I no longer have to walk around with female-like breasts anymore.
This is easily the most balanced I've felt since I developed the mental illness in the beginning of this decade. I'm not a morbidly obese zombie with female-like breasts pacing all day and night with akathisia but I'm also not hallucinating and running away from the local police department during a welfare check or speeding from the state troopers on major highways either. The delusions are still there at certain times except mild enough where I just laugh them off most of the time and don't believe the majority my own deception.
My pdoc bumped me up to Abilify 30 mg and it didn't take but a few days for the akathisia to set in like crazy! I am at a loss of what to do about it.
Benzos don't help. Beta-blockers don't help. The only things that help are anticholinergics, specifically, Cogentin (benztropine), but I can't stand the side effects. I have never tried Artane (trihexyphenidyl) because my pdoc won't let me. If anyone can vouch for this being better than Cogentin, I will see if I can call my neurologist and see if he can call some in for me. I have also found that, strangely, Zomig (zolmitriptan) helps it, but I have an extremely limited supply of it. Is there ANYTHING else for akathisia? ANYTHING? I've researched and have read that 5-HT2A antagonists are apparently beneficial, but I don't have anything that's really much of a 5-HT2A antagonist except trazodone, and that doesn't do jack for me.
On top of all this, my mood is still in the gutter for what that's worth, and the dysphoria associated with akathisia is making it much, much worse.
Please help me! I'm pacing so much there are little trails developing in the floors around my house!
Hi all I'm new here first diagnosed with ADHD I and now with bipolar 2 and anxiety.
I'm having some trouble with the meds that I'm on. I'm taking between 25 and 50 mg of Vyvanse daily. It helps with my depression, ADHD, and binge eating, but even though I'm a big girl I'm very sensitive to meds in general so my dose is fairly low. Since I was just diagnosed with bipolar in April, the psychiatrist added a mood stabilizer which is Lamictal. It is making me super sleepy but I'm not sleeping well at night. I already know that I don't do well with anticonvulsants because I can't even take 25 mg of Topiramate without being zombie like tired all day. Also my Promethease test shows that I have a gene for processing anticonvulsants less efficiently than other people.
Lamictal seems to be doing the same thing that topiramate does to me, at least to some extent. I am also on 60 mg ER of propranolol at bedtime for a fast pulse and anxiety. I'm averaging about 5 hours of sleep right now and that is not working well for me.
I am really wanting to request doing something different than this Lamictal. I'm definitely feeling more stable, but I cannot function as a zombie with a four-year-old. What would you suggest that I talk with my pdoc about when I go back, if anything? I've made it up to 75 mg of Lamictal and it's killer. My only option I'm thinking is to quit taking it in the morning and try it at night, but that never helped with Topiramate either.
I will say that I struggle more with depression than hypomania but I do have hypomanic episodes--at least a few year with the seasonal changes and sometimes I wonder if I don't rapid cycle as well. I will also add that a concern for me would be weight gain because I'm already in the obese category, though I am losing weight--only with the help of the Vyvanse and dealing with the binge eating and ADHD for the last couple of years since I was diagnosed.
I am currently on two medications, Zoloft 100mg and Lyrica 300mg, and had sort of a weird bought of mood swings over the last two weeks that may have been just work related though I was feeling agitated one day, and flat and depressed the next few days. Now I am sort of about as normal as normal gets, for now.
Different medications have been suggested to me for managing bipolar II and I am sort of hesitant to try something in addition to what I am already on because what if my medication trial goes side ways and it makes me worse? I know start up can be rough but I just don't know if things are bad enough now to start messing around. I was feeling anxious and scared about work (enough that I took a day off to reset myself) and wondered if I could benefit from different meds that are more in-line for treating bipolar disorder.
I feel kind of stuck and wish I was starting from where I am on no meds to transitioning to 1st line treatment for bipolar.
Any thoughts? Anyone start out on meds for MDD and anxiety transition well to meds for bipolar? Med changes are never fun in my experience.
I have had doctors consider bipolar type II for me on and off but they never really seemed to be firm with the diagnosis. Conversely, I have had doctors say I don't have bipolar, but MDD. I recently decided to have a few short sessions with a very good psychiatrist and this is what he told me; People with bipolar type II often tend to have hypomania in their late teens to early 20's before having a depressive episode. He said people with bipolar II tend to experience more depression and less clear hypomania as they get older.
When I was 22 I remember feeling on top of the world. I talked and joked constantly; I had magical thinking and thought I was psychic; And then something bad happened and it just seemed like I couldn't deal with life much and then things went downhill with a big crash at the end.
I'd rebound super quickly after a bought of meds and then I would be euthymic to dysthymic and that's where I would stay. Life would then get good and would start to have a magical quality again; I'd make some bad choices- caused maybe by my mindstate and/or a combination of poor coping mechanisms and then things would start to go downhill. The next episode went downhill slowly until I dug up some traumas, and then I was suddenly suicidal. I clawed my way out of that depression- barely. I began experiencing dysthymia with a heavy slice of anxiety. That bought of depression and anxiety seemed brought on because I felt so disconnected and like everything wasn't making sense anymore. I felt agitated and terrified of going out in public. I started experiencing panic attacks in public.
I tried antidepressants which worked in the beginning but I felt like I was clinging to sanity with a thread on them in the end. I felt kind of numb but mostly strange and anxious.
I went off them and anxiety would get worse; I went from being very anxious to majorly anxious. Then I would sort of half recover but never fully. I was often very socially phobic to being set off into an anxiety attack when having to do something like ordering coffee.
I was tried on topomax which worked like a charm at first but it was a little hard on the insides. I was not always med compliant because it seemed like no one was sure of what was happening with me; their diagnosis seemed to change dramatically from doctor to doctor which made it hard for me to manage consistent treatment. It seemed like everyone had a different opinion on how I should be treated.
I am doing ok. The new psych suggested aggressive treatment of my symptoms; he said the current drugs I am on are ok for now but maybe switching to atypical antipsychotics and a drug like Lamictal might be better for me in the long run. Unfortunately this doctor is not my permanent doctor as I felt he gave me useful advice on getting treatment. He is transferring his diagnostic info to my family doctor with med suggestions. My family doctor has managed patients with bipolar so I think I this has put me on track to consistent treatment.