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Medications for Bipolar Disorder (slight trigger warning?)


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What medications have you tried for your Bipolar? What's worked? What's not worked?

My boyfriend is going to be finally going back to a doctor - to confirm his Bipolar diagnosis since it's been so long and get the medication he needs. I know Latuda is one that people have tried, but I've tried it for my BPD and my mom has for her Bipolar. It put her in the hospital for suicidal ideations and gave me suicidal ideations and just made me feel like a lump. He's tried Abilify before it did nothing for him. His main worry is losing his creativity. We both write fanfiction in our spare time; is what that is in regards to. I'm on meds and on meds I feel no difference in my creativity. Everyone gets writer's block.

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Antidepressants basically don't work for my BP depression. I've tried Effexor, Prozac, Zoloft, Celexa, Lexapro, Cymbalta, Remeron and Edronax without much success. They help a tiny bit. 

The one AD that really worked for me was Wellbutrin. It was very stimulating, I found it hard to relax but it didn't matter because I got stuff done and felt good, I had a headache a lot. I couldn't sleep much, only 4 hours each night, and felt like shit on waking but was fine after morning dose of WB kicked in. It worked quick too. Like, the first or second day. 

I tried Zyprexa at a low dose briefly. I felt calm but emotions were very dulled and I was extremely hungry and gaining a lot of weight. I took this pre diagnosis for social phobia.

when I was dxd, I started on Lamictal, I felt great but seemed to have a hypomania so had to take Seroquel alone side it. Those meds worked very well for me for a year or two. I went from rotting in bed to being independant and functional. I had some nausea, indigestion and drowsiness but eventually all that passed. Seroquel was very sedating at first but i developed a tolerance to that eventually.

Lithium I've found is great at treating and preventing the highs, but not so much the lows. It did reduce the urge to commit suicide when I was very depressed and I think it boosted the effect of the AD I take. I have no side effects from lithium.

i tried saphris but got akathisia so quit it.

Based on my experiences  I think Lamictal is great for the lows, lithium great for the highs and Seroquel a good adjunct treatment for all kinds of episodes.

Ive just started Abilify so can't say whether it works yet, but I feel like it is going to work. I've had a good few days since starting it. No hypersomnia, more motivated and positive. 

I am much more creative on effective meds. I don't do anything creative during an episode. usually when I get hypo I pace around compulsively muttering under my breath. I don't write or paint or do anything requiring focus or sitting still.

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I'm mostly medicated for my mania right now since that was my problem when I was diagnosed, but my current combo seems to have also helped the depressive symptoms from the mixed episodes I had when I added the AAP to the mix. But I've only been diagnosed since late November-early December, and I've only tried a couple things.

First one is depakote. I'm on a really low dose of this, but it's helped me pull myself down toward my baseline. I'm looking for increasing my dosage for this, and if I had started with a higher dose it likely would have helped more. 

I've also tried trazodone, mostly for sleeping but also to help stabilize me. I took it for one night and the next day, one of the side effects (lowering blood pressure; mine is already low) I almost passed out in a store. Needless to say, I didn't take it again.

The third med and the second one I still currently take is risperdal, and frankly it's been the best med I've tried. I'm only on 0.5 mg, but since starting it I've felt more awake and alive, slept easier, felt more stable, been able to concentrate better, and I actually want to have a job. I'm actually currently looking. Honestly, I've got nothing but good things to say about this drug.

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You can look at my signature to see what I've tried for my bipolar. Some were outright fails. Some worked for a wile, then either stopped, or my symptoms changed and I needed new meds. I've never been on only one med at a time.

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2 hours ago, Gearhead said:

Some worked for a wile, then either stopped, or my symptoms changed and I needed new meds. I've never been on only one med at a time.

Same with me.  It has always been a combination of meds. 

(bold) Unfortunately it is, for me at least and I'm sure others, a rollercoaster ride of moods with the med-go round until I found meds that worked. 

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5 hours ago, Iceberg said:

Start slow one med at a time . Lithium is the "gold standard" I would try mood stabilizers before adding aps 

I agree with this. Lithium has the more evidence to support its use than any other BP med. it has the most evidence for being neuroregenerative and improving your condition over the long term. I've found it to be very mild and gentle in terms of side effects. Many of us need additional meds but you might get lucky and need only one.

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  • 2 weeks later...

Everything I've tried is in my signature. I have had good luck with Saphris and Vraylar but the side effects necessitated a switch. The former was weight gain and the latter was EPS that seemed to spill over to any other AP that wasn't a partial dopamine agonist. That is how I wound up back on Rexulti. I had good luck with Zyprexa for the highs, but not the lows. Zyprexa oddly didn't help me with sleep. Lithium seems to take care of the highs for me right now (900 mg ER, 0.9 mEq/L). Trileptal used to be somewhat good but it made my hair fall out. I take Seroquel exclusively for sleep and as an emergency PRN for mania. The only side effect I got from lithium is tremor, and it was easily treated with propranolol. If I could, I would consider switching over from Rexulti back to Saphris. 

I can't take antidepressants anymore because they all induce mania, mixed states, or rapid cycling. But I did have great luck with Emsam and Parnate. Now if I am in need of some sort of quick and fast intervention I will do ECT again. Finding meds to treat the depressive side that aren't antidepressants  has proven somewhat difficult, though its been easier since doing ECT. Lamictal didn't help me but I metabolize it quickly. Gabapentin seems to help a little. Rexulti definitely helped with depressive symptoms. Zonegran has helped in the past so I am titrating on that before I taper off gabapentin. 

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On 5/4/2017 at 1:23 PM, Gearhead said:

You can look at my signature to see what I've tried for my bipolar. Some were outright fails. Some worked for a wile, then either stopped, or my symptoms changed and I needed new meds. I've never been on only one med at a time.

That's pretty much the same for me. Zyprexa is the one drug that has never let me down. Stims (Ritalin or adderall) help me from sliding off the depression cliff. Deplin has definitely helped, but only partially. Cymbalta helps a bit. Doxepin used to work fantastically, but no longer. And none of my sleep meds work for shit anymore, either. 

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5 hours ago, Flash said:

Doxepin used to work fantastically, but no longer. And none of my sleep meds work for shit anymore, either. 

Are you still taking 50 mg of doxepin? I think I was taking 100-150 mg of it. When it wasn't working that great on its own, we combined it with a tiny bit of Seroquel or Ativan and that seemed to help. It's possible to build a tolerance to it with time. I try to rotate between Seroquel and temazepam occassionally so that I don't get too accustomed to it. 

Have you tried Saphris? That one had me sleeping like a baby but didn't leave me comatose into the next day like full-dose Seroquel. 

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5 hours ago, ByePolarCoordinates said:

Are you still taking 50 mg of doxepin? I think I was taking 100-150 mg of it. When it wasn't working that great on its own, we combined it with a tiny bit of Seroquel or Ativan and that seemed to help. It's possible to build a tolerance to it with time. I try to rotate between Seroquel and temazepam occassionally so that I don't get too accustomed to it. 

Have you tried Saphris? That one had me sleeping like a baby but didn't leave me comatose into the next day like full-dose Seroquel. 

I was on 300 mg doxepin until I switched to Cymbalta. The 50 mg is just a sleep dose, but it doesn't work well. I can't take seroquel (and it doesn't help anyway), and temazepam doesn't work either. I haven't tried saphris, but I think it was on the 'not recommended' list when I had the genetic testing done.

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17 hours ago, Flash said:

I was on 300 mg doxepin until I switched to Cymbalta. The 50 mg is just a sleep dose, but it doesn't work well. I can't take seroquel (and it doesn't help anyway), and temazepam doesn't work either. I haven't tried saphris, but I think it was on the 'not recommended' list when I had the genetic testing done.

Ah, yes. Doxepin and trazodone were both surprisingly disappointing for me. Saphris is actually on my not recommended list either because I am an ultra-rapid metabolizer of one of the minor enzymes that is involved in its metabolism. But it still worked fine for me the first time around. Stopped it because of significant weight gain unfortunately, but otherwise it was probably the first "miracle" drug I stumbled upon. I'd love to make it work again and get rid of the Rexulti and Seroquel and jus take that. But last time I tried using it again it gave me terrible RLS and re-activated the EPS that Vraylar kindled. Might still ask to try it again in interest of simplifying my meds.

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1 hour ago, ByePolarCoordinates said:

Ah, yes. Doxepin and trazodone were both surprisingly disappointing for me. Saphris is actually on my not recommended list either because I am an ultra-rapid metabolizer of one of the minor enzymes that is involved in its metabolism. But it still worked fine for me the first time around. Stopped it because of significant weight gain unfortunately, but otherwise it was probably the first "miracle" drug I stumbled upon. I'd love to make it work again and get rid of the Rexulti and Seroquel and jus take that. But last time I tried using it again it gave me terrible RLS and re-activated the EPS that Vraylar kindled. Might still ask to try it again in interest of simplifying my meds.

It really sucks when meds don't work like they used to, or cause different side effects. Unfortunately, you usually have to learn that the hard way.

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5 hours ago, Iceberg said:

I've tried basically all the AAPS but not saphris...now am on Vraylar....do you think it's worth the switch? The Vraylars effectiveness is questionable and it doesn't help me sleep 

If sleep is an ongoing issue, Saphris could be significantly helpful. I slept like a baby on it and it seemed to help me with both mania and depression. I'd ask your pdoc. Not sure what else you are on but sometimes they don't like combining AAPs that don't include at least one partial dopamine agonist like Abilify, Rexulti, or Vraylar. It tends to lower the chance of some side effects including movement disorders. If you do end up trying it - ask for the black cherry flavor. 

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Rexulti has been the clear winner for me. It's stopped my depression and most of my anxiety. Trileptal has been helpful in smoothing things out and making the mood swings less prevalent, but I could be OK without it. Xanax has been the best anxiolytic and an awesome PRN med. I don't need high doses for good efficacy. For sleep, it's a toss-up. Stuff works for a while, then quits, so I rotate meds every few months. I have no real strong positive feelings for any sleep med, although Lunesta is doing the job right now.

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