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Hesitating about adding mood stabilizer


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Ok so heres the thing im currently on geodon and zoloft to treat bipolar 1 + severe ocd the problem is my sleep pattern sucks i barely sleep 4 hours my mood is erratic and im feeling unstable... will adding a mood syabilizer can improve sleep because right now im very irritated and angry about not being stable.. plz help me guys how can i improve my sleep with the least side effects thanks ..

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So you're on Geodon 80 mg in the AM, 40 mg in the PM? One thing that might help stabilize your moods and possibly help your sleep patterns is if your Geodon dose were to be increased to 80 mg twice a day (total of 160 mg/day). Also, make sure you're consuming at least 500 calories each time you take your Geodon so that it gets absorbed, otherwise you'll be effectively taking less Geodon.

Adding a mood stabilizer definitely has the potential to improve your sleep and stabilize you, and in fact, I'm surprised you're not on one in addition to your AAP being bipolar I. Depakote comes to mind first of all since it can be rapidly titrated to therapeutic benefit. It does come with some side effects, weight gain being one of them, but it will get you stabilized in a hurry, and if you want, and your pdoc agrees, later on down the road, you can gradually transition to a more weight-friendly, less side effect-prone mood stabilizer. The priority right now is to get you stabilized. Depakote ER, in particular, is dosed by body weight, and you will need to occasionally have blood tests to check for blood concentrations to make sure they're within therapeutic range and not too low/too high.

Lithium is another that comes to mind. It has quite a few side effects too in the higher doses, and also requires periodic blood tests to check for therapeutic levels, but again, the objective here is to get you stabilized.

Tegretol is one that could either be started now or started later on down the road that could help. Its closely related "sister medicine," Trileptal, can also be used with less side effects, but is said to be less effective anecdotally than Tegretol. 

Keppra is yet another that could be used, but that'd probably be for later on down the road once you're stabilized. It'd be a more weight-friendly alternative, and would probably have less side effects.

Lamictal I hear is less effective at helping mania than it is with depression, but it's on the table too.

Meanwhile, a benzodiazepine may also be worth considering... perhaps a short-to-mid half-life one like Ativan taken as needed, or maybe even a longer half-life one like Klonopin or Valium taken regularly.

Those are just some of my ideas, I hope they help. Good luck and I hope you get the help you need soon!

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12 hours ago, bigbangaz said:

Ok so heres the thing im currently on geodon and zoloft to treat bipolar 1 + severe ocd the problem is my sleep pattern sucks i barely sleep 4 hours my mood is erratic and im feeling unstable... will adding a mood syabilizer can improve sleep because right now im very irritated and angry about not being stable.. plz help me guys how can i improve my sleep with the least side effects thanks ..

Does it have to be a mood stabilizer?  Or are you looking specifically for mood stabilizers?

This isn't a mood stabilizer, but depakote wiped me out and it definitely put me to sleep.  That is the main one that I can remember because of the sleepiness.

 

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