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Xanax vs. Haldol for acute mania


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This may belong on one of the med boards, but since you bipolar people have the most experience with this I decided to post it here. Feel free to move it.

I've been experiences some quite intense manias the past few nights. It starts with me not being able to sleep and ends with my parents forcing me to take Xanax cause I'm running around the house talking about God. I would guess they qualify as manias rather than hypomanias.

The bad thing about Xanax is that I need to take at least 2 mg for it to work against mania. And that gives me a hangover from hell. But even that doesn't always do the trick. So was on the phone with pdoc and she's gonna prescribe me Haldol.

Any experiences with PRN use of Haldol?

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Um Haldol..yeah its an older anti-psychotic right? Well I was on that for a short time in the hospital and  Ihad a HORRIBLE night once of really bad bad side effects , they were thinking it was the celexa I was so not supposed to be on but then perhaps the haldol as well... ? I would try one of the newer ones..

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This may belong on one of the med boards, but since you bipolar people have the most experience with this I decided to post it here. Feel free to move it.

I've been experiences some quite intense manias the past few nights. It starts with me not being able to sleep and ends with my parents forcing me to take Xanax cause I'm running around the house talking about God. I would guess they qualify as manias rather than hypomanias.

The bad thing about Xanax is that I need to take at least 2 mg for it to work against mania. And that gives me a hangover from hell. But even that doesn't always do the trick. So was on the phone with pdoc and she's gonna prescribe me Haldol.

Any experiences with PRN use of Haldol?

<{POST_SNAPBACK}>

I tried both haldol and xanax.  Xanax calms you down rightaway and kicks ass for anxiety, really mellows you out.  Problem is that its addictive and that you develop a tolerance real fast.  Also, its half life is real short so for mania you have to keep popping pills.  Using a benzo for mania can only be a temporary solution.

Haldol calms you the hell down too, but I found the side effects sucked way too much at 10mg - muscle aches, stiffness, some akathisia, tremors, EPS etc...  It wasn't for me.  If you can handle haldol's side effects though, its a med that can work.  I think it would still be a better choice than a benzo for mania and its cheap.  You could consider zyprexa or risperdal for mania too.  I like my zyprexa a lot.

PBF

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Helena:

Wish I could give you some helpful info, but my only experience with it was in 1973 (I think) when a pdoc gave it to me in a weird combo of old fashioned tricyclics, barbituates, and yes Haldol. Wasn't a good combo for me.

Hope it helps, sweetie...or that you find something that does.

revlow

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Heya Helena,

You're right to wonder about the Xanax.

It's a good short-term anti-anxiety med or sedative, but isn't really stopping the mania.

Most docs following the current guidelines will pick one or another "antipsychotic" medication, at least in the short run to stabilize an acute mania.

Then, back to the usual regimen, until (hopefully, never) the next mania seems to be showing up.

Most docs will use one of the so-called "atypical antipsychotics" like risperidone, quetiapine, olanzapine, or some others I'm not familiar with b/c we don't have them in Canada.

"Typical antipsychotics" like Haldol work well, and in fact Haldol is supposed to work as well as valproic acid for bipolar mania.

But, the side effects are greater with the "typicals" than the "atypicals."

Ask your doc why the Haldol, and if it sounds reasonable it's okay for short-term use, like to bring down an acute mania over a few days.

--ncc--

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I just realized that my "manias" are more like mixed states since I'm very angry and sometimes depressed, yet have TONS of energy.

Anyways, I took Haldol for the first time yesterday. Two mg didn't work, so I took two more (I'm prescribed 2-4 mg) and that calmed me down a lot.

Hopefully I won't need Haldol when my Lithium levels are in the therapeutic range again. My levels are a bit low right now, and I guess that accounts for my latest hospitalization and these mixed states. We upped the dose, but I don't think that has kicked in yet.

The reason for choosing Haldol and not an atypical... Hmm. I think doctors here are comfortable using older ones, cause they know how they work. I've had pretty bad experiences with never APs too. And I don't seem that prone to having EP side effects.

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Gggaahhhh a new mixed state from hell. I.hate.this. This is worse than mania (hell, mania is even fun, before I go psychotic) and somehow worse than depression too. When I'm depressed at least I know I'm depressed, I don't have to guess how I'm gonna feel in five seconds. Oh the joys of rapid cycling...

I took Haldol a while ago and it seems to work cause I'm a lot calmer now. Obviously, since I can actually sit down and focus on writing.

It's funny, I wasn't aware of the term mixed state until when my pdoc hinted that I was not depressed in the standard sense, rather a mix of mania and depression. She didn't use the term mixed state, it's probably called something else in swedish.

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Heya Helena,

Interesting, and I'm glad the Haldol helps.

For short-term use, the risk of EPS is quite low anyway.

Sounds like you're mixed to me.  Wonder what it's called in Swedish?

Take care.

--ncc--

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