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Relapse after finding working meds?

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I went inpatient back in June and the doctor there added depakote er 1000mg to my regimen along with rexulti 2mg to go with the zoloft 100mg, and topamax 100mg twice a day that I was taking. It was working wonders. I was finally stable. I was also very sleepy. My original pdoc said if depakote er at 1000mg made me too sleepy then to try it at 500mg or one tablet at bedtime. I have been scared to do that because it was working so well! But, I was sleeping all day and all night also.

This week, i decided to take my pdoc suggestion and try it at 500mg at bedtime. I am a little  more awake but I still need a caffeine jolt in the mornings or I am down. What I have noticed is that I am quickly pushed into mania (I get so much housework done!!!!) And I stay wired until I take my ambien at night to go to sleep. I have done this since probably Tuesday or Wednesday when I started. 

Now today was different. Today, was more complicated as it was .... more on the depressed side. My husband asked me what was wrong and I said nothing and everything! The slightest thing could go wrong and wreck my entire world and I started bawling. I haven't felt like that since I started taking my new regimen. 

I am fixing to go back to the way I was taking it before, it's just overwhelming thait feels like I have to choose between stability and the ability to function!

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On top of the sleepiness, I'm more or less apathetic. My husband accused me of having an "I don't give a shit attitude" here a while back. And I honestly didn't. He said that, and I just laid back down and went back to sleep. I couldn't have cared less. About anything. Cooking for our kids, for him, cleaning house. I have been trying to do better and it has been a struggle to fight through all of the fog while on the 1000mg. So long and I worked intensely and did not stop even for a moment I usually get through it, but the first moment I take a break, it's over and I'm done. I'm dreaming before my eyes even close.

I don't know what the best course of action would be. Should I talk to my pdoc about adjusting the depakote differently to a different mg that is in between 500 and 1000? I was perfectly stable at 1000 just apathetic and had EDS. At 500 I'm manic. Or do you think there will be need to consider changing meds again? another nightmare? Med changes alway make me feel like i need to be behind wrought iron bars and chained up. That image is viscious.

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Clozapine also makes me highly sedated and it is very difficult waking up early. My pdoc added some adderral and that has helped somewhat. Maybe suggest a stimulant or a drug like provigil. Honestly though, the best method is having someone physically wake me up.

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The issue is, sometimes they can't wake me up. There are times when I am in such a deep sleep that I am paralyzed and cannot move at all. I might be able to hear them trying wake me up, but I cannot always respond to it. It isn't all of the time, but it hjas happened several times.

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I think you should try what your DR said in the first case, then give your body time to get used to it.  That side effect (feeling sedated) may go away. in time. 

9 hours ago, Rabidtears said:

it's just overwhelming thait feels like I have to choose between stability and the ability to function!

^^Sometimes this is the case, choosing stability vs the ability to function.  It sucks to have to do that though. 

Edited by melissaw72

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The not being able to move but being alert thing might be a serious side effect.  I don't know if this is worth anything but I took ambien CR for... ever.  And a while ago I had to do without it for a weekend (Forgot my luggage) and I've been sleeping without it.  I honestly thought I was going to be taking that forever so things can change.  And while I totally understand fears of changing meds and having to deal with different side effects or poor results I would say you could do a lot better and it would be worth some fussing around with them.   If nothing else I think its really important to let the doctor know whats going on so she/he can assess things.

And I'll end by saying I am not an expert anything so this valuable advice is actually just my 2 cents worth. 

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You said you were "worried you'd go back to the way you were before"?  What was that?  Were you hypo, suicidal, manic, mixed, whatever?  I have found that with my bipolar, stability breeds stability.   When I've been manic, I go to suicidal for quite some time, before I get stable again.  Also, since lithium about eight years ago, stable as the grave.

I understand and sympathize about the Depakote.  I only ever took it when hypo because stable, it was *depressing as fuck" and gave me unfortunate side effects.  If you've been mixed, however, you really might need it for a time.

You're on a fair amount of meds; it really would be important to talk to your doc.  There have been times in my BP that my husband would certainly have to carry me out in a fire, I slept so soundly, always saw that as a GOOD thing, however.  No sleep= psychosis for me.  You need to talk to your doc about this; he's the prescriber he needs to know what's happening and your sx.  Anna

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