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One manic episode per year...Abilify or Lithium? Alternatives?


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I have been dealing with one manic episode per year for since November 2010 that results in hospitalization.  I'd refuse medication, but after this most recent episode I'm confused I need to be on something.  Right now it is abilify in the morning and lithium at night.  I am currently taking myself off lithium and have a meeting with the psychiatrist next week. 

 

The more I read about abilify, the more concerned I become.  It does not read like a drug that you want to be on long term, especially in my case where I go almost the entire year without a problem.  I wanted abilify because Lithium has stupid side effects and abilify feels entirely lighter.  Am I wrong in this interpretation?  I suppose it's different for everyone.

 

Does anyone have any Chinese herbs or another solid alternative to take for long-term maintenance to prevent a manic episode?

 

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Some people use zyprexa PRN (as needed) for mania. It has a bunch of potential side effects that would probably scare you, but if you only take it once in a while it shouldn't be a problem. There might be other AAPs that you could take PRN for mania as well.m seroquel? What are the side effects of abilify that scare you? That's a tame one from what I've read. I use both, BTW: 15mg abilify daily and 10mg zyprexa PRN. I sincerely doubt there are any efficacious herbal remedies. If you want something natural, stick with the lithium.

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Crazyboards is a pro-med, pro-psychiatry board. We don't believe you can treat mental illness with Chinese herbs, although some people take their medication along with herbs and other supplements.

 

Instead of taking yourself off the lithium, and telling your pdoc (psychiatrist) after the fact, please take it until the appt. Then you can discuss with your pdoc a plan for whether or not you want to still take the lithium. Why do you want to stop the lithium? Please stay on it for now, stopping it abruptly can cause rebound mania.

 

You may only have one manic episode a year now, but BP illness can turn on a dime, and tends to worsen over time. That is why people have to be on meds long-term. You may experience a mixed episode or a depressive episode in the future, or more than one mania a year. I was actually first diagnosed with BP II over 25 years ago, then just 5 years ago started having manic episodes, which changed my diagnosis to BP 1.

 

All medications have side effects. You have to decide what you can tolerate, but you can't choose a med based on what *might* happen. You have to try it for yourself. Everyone is different, and experiences different side effects.

 

I am on a different atypical anti-psychotic (AAP) than you, Latuda, which has all the same caveats, but I have zero side effects. Geodon made me so agitated I had to come off of it immediately. Risperdal helped, but was too sedating. Abilify made me manic. All four of those meds are from the same class of meds (AAPs).

 

The first time I took lithium, I became toxic, but I tried it at a much lower dose the second time, and now I really like it. I have side effects from the lithium that I choose not to treat, but could treat if I wanted to.

 

If anything, I would say lithium has a shorter list of side effects than abilify, so I'm wondering what makes you want to stop it more than the abilify?

 

I agree with Flash that there are prn AAPs for mania, but I wonder at what point you notice you are manic, since you have ended up hospitalized, indicating you have repeatedly passed the point of no return. You have to be really self-aware to use AAPs prn for Mania, and unfortunately, one of the symptoms of BP illness is "lack of insight," which means some people don't notice anything is wrong until it is too late, or maybe not even then.

Edited by crtclms
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The more I read about abilify, the more concerned I become.  It does not read like a drug that you want to be on long term, especially in my case where I go almost the entire year without a problem.  I wanted abilify because Lithium has stupid side effects and abilify feels entirely lighter.  Am I wrong in this interpretation?  I suppose it's different for everyone.

 

 

 

I've been on Abilify for over 10 years without any problems, and the only side effect I have is that it makes me a little tired.  Everyone is different re: side effects.  What might happen to one might not happen to another.

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I've been on Lithium and Seroquel for almost four years after my first (and so far only) hospitalization for mania.  I've had some close calls since then, but my meds helped me manage them. Lithium has caused some problems for me, including hypothyroidism, but that, to me, is preferable to being in the hospital ever again.  I definitely agree that you should discuss the side effects you're having with your pdoc before going off any medication.  There may be mood stabilizers that work better for you.  Abilify won't replace Lithium, as it's a completely different class of meds.  Also note that not every side effect listed will happen to you and others get better with time.

 

Being hospitalized every year does not sound like a fun time.  With meds, I find that I am better able to notice the symptoms and get treatment (changing my dose, increased therapy) BEFORE I would need to go to the hospital.   

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I was taking all my meds on time including lithium, invega, etc and I still had an episode. It happens every 3-4 years I believe.

I'm scared of getting more frequent episodes as I get into my 40's then 50's then 60's.

 

With meds I found my episodes were less severe though.

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I've been on Lithium and Seroquel for almost four years after my first (and so far only) hospitalization for mania. I've had some close calls since then, but my meds helped me manage them. Lithium has caused some problems for me, including hypothyroidism, but that, to me, is preferable to being in the hospital ever again. I definitely agree that you should discuss the side effects you're having with your pdoc before going off any medication. There may be mood stabilizers that work better for you. Abilify won't replace Lithium, as it's a completely different class of meds. Also note that not every side effect listed will happen to you and others get better with time.

Being hospitalized every year does not sound like a fun time. With meds, I find that I am better able to notice the symptoms and get treatment (changing my dose, increased therapy) BEFORE I would need to go to the hospital.

Some pdocs use Abilify in place of a mood stabilizer such a lithium. This is exactly what mine did. Edited by Flash
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I don't understand how you can be so manic that you are hospitalized yearly, which does damage to your brain, but you are worried about med side effects? I would be more worried about the disruption to my life that a manic episode obviously causes. So, either way you look at it, your brain is being effected. I personally, like taking my meds at keeping the crazy at bay. I have been taking my meds for 3 years now (the ones that we found work) and I have no side effects from them. I think the mental illness did more damage to my brain than the meds ever have.

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I was hesitant to be on meds too for the longest time... one of the reasons it took me so long to get help. I was afraid of side effects and stuff. I even thought, for a while, that psych meds were the doctors' way of controlling us not the illness, but us, like zombies (because of all the crazy things and side effects I had read about). I admit, I was wrong. I have only been on Abilify for a little over a year, and we're still zeroing in on an appropriate dose, but so far it has helped me tremendously. The only side effects I got from it were lethargy and weight gain (a result of the lethargy), which I blame on being on too high a dose in the beginning that it zonked me out quite a bit. I take Ablify as a mood stabilizer, though I believe the reason for my dose being so high for so long is my history with psychosis. I think my pdoc was being precautious about that, but given I haven't had a psychotic break in a long time, we are bringing the dose down to mood stabilizer only levels.

 

I agree with waiting on your pdoc as far as the Lithium goes. I only hear bad things about stopping meds without proper supervision. I mean, I've never done it, but I wouldn't want anything bad to happen to you as a result of it.

 

Good luck with everything! I hope you get it figured out sooner rather than later.

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  • 3 weeks later...

I have been dealing with one manic episode per year for since November 2010 that results in hospitalization. I'd refuse medication, but after this most recent episode I'm confused I need to be on something. Right now it is abilify in the morning and lithium at night. I am currently taking myself off lithium and have a meeting with the psychiatrist next week.

The more I read about abilify, the more concerned I become. It does not read like a drug that you want to be on long term, especially in my case where I go almost the entire year without a problem. I wanted abilify because Lithium has stupid side effects and abilify feels entirely lighter. Am I wrong in this interpretation? I suppose it's different for everyone.

Does anyone have any Chinese herbs or another solid alternative to take for long-term maintenance to prevent a manic episode?

Unfortunately it's not a case or either/or. Lithium and Abilify have different therapeutic profiles and work in combination in some people to maintain stability. Follow your doctors advice.

Side effect profiles are also different (not better or worse just different).

I've been on lithium monotherapy for 6 years and then lithium+Abilify for 3. Five hositalisations prior to the Abilify. Lithium alone was not enough.

Perhaps the combination will work for you. Perhaps not. Perhaps you won't even give it a shot.

There are no "solid" alternatives to mania prevention other than modern medicine,

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There are no "solid" alternatives to mania prevention other than modern medicine,

 

Getting enough sleep and (trying to) limit stress, would be other alternatives.

 

It wouldn't completely get rid of mania, but those are 2 things that are key for mania prevention, at least in most people, IMO.

Edited by melissaw72
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