Jump to content
CrazyBoards.org

med change suggestions


Recommended Posts

Things aren't at 100%.  I've been dealing with the AH for two weeks and, barring yesterday, they have seemed to decrease.  It's definitely going in the right direction, but not gone yet.  We've increased my fanapt and zyprexa, which I hoped would eliminate them completely.  I'm looking for suggestions--predominantly related to what I currently take.  I had a mini-hypomanic episode in May (with hallucinations right after) and I had a mini-depressive eposide right before the AH started this go around..  So symptom prior is the AH--I'm currently quite stable mood-wise.

So- for those who can't read my signature:

Fanapt at 12 mg (I can't take a split dose because it gives me insomnia)

Zyprexa at 20 mg at night (has strangely not touched my psychosis, but maybe  higher dose or having something during the day would change that

Lithium at 750 mg (I went toxic before so I'm wary, but my blood level is still .6....but I' not sure there's a mood component right now

Lamictal at 275 mg (not sure it would do anything)

 

and then some random not likely to be uesful - klonopin (1mg), xanax (0.5mg total), and prazosin (2mg total).

 

Curious about impressions/suggestions etc.   I really don't want a drug change, but I'm not sure how much I have to play with.  I've also failed off most AAP with EPS (can't take cogentin because t causes blurry vision and can't take propanalol because iprazosin lowers blood pressure already.  The higher fanapt has been since Monday, so it's had a good amount of time to kick in and it definitely dose help...my brain feels clear and quiet.  On work days, I can make it to 4ish.  Yesterday was hell, probably because of a lack of need to use my brain.  Right now things are quiet also. 

Link to comment
Share on other sites

The max dose of Fanapt is up to 24 mg/day should you need to increase that. If you increase the dose of Fanapt even more, you may be able to do without the prazosin due to Fanapt's α1 antagonism.

I hope you find something that works.

Link to comment
Share on other sites

thank you both.  Yesterday went well enough (and today is going well so far) that I'm wondering if I screwed something up when putting my meds together for Saturday.  Probably not.  But it does make me wonder.

An AC could make sense.  Add it on to the rest of it or replace something with it?  I'm too terrified of depakote for that one, but I'm more open to others.

Edited by dancesintherain
Link to comment
Share on other sites

Thanks.  I remembered some drugs did that but not which.  I’m back at the not wanting a chance except possibly dosage change.  Because yesterday was fine and today has started out okay.  So six out of seven days being manageable isn’t awful.

still worth considering though

 

if increasing fanapt is on the table @mikl_pls, I might go for it because it’s been a really good drug and the last increase helped a lot.  But I appreciate the suggestions @argh.  I’ll have to see how my pdoc wants to see this one play out.

Edited by dancesintherain
Link to comment
Share on other sites

Thanks @Iceberg.  It does seem to be what helps the best with psychosis.  It’s consistently improved (barring the backlash on Saturday) each increase.  I know that Zyprexa should be working on it also, but that seems to be playing more of a sleep/mood role.

ill see what my pdoc thinks and what my insurance will pay for.  Hopefully those are the same thing.

Link to comment
Share on other sites

So we are trying with me taking a baby dose of fanapt in the evening to see if I can do it without insomnia because of a somewhat changed night time med cocktail.  She didn’t want a drastic change since things are largely moving in the right direction.  We will see how it goes.  I’m not optimistic but I willing to try.  I have permission to add to am instead ifbi have a handful of insomnia days.

i also have a new schizoaffective disorder diagnosis, which I have mixed feelings about.  It makes sense because I don’t feel like there’s a mood component anymore.

Link to comment
Share on other sites

9 hours ago, dancesintherain said:

So we are trying with me taking a baby dose of fanapt in the evening to see if I can do it without insomnia because of a somewhat changed night time med cocktail.  She didn’t want a drastic change since things are largely moving in the right direction.  We will see how it goes.  I’m not optimistic but I willing to try.  I have permission to add to am instead ifbi have a handful of insomnia days.

i also have a new schizoaffective disorder diagnosis, which I have mixed feelings about.  It makes sense because I don’t feel like there’s a mood component anymore.

Good luck keep us posted!

Link to comment
Share on other sites

I was getting ready to reply with a thank you to LL, But apparently the post is no more.

ive had three straight nights where I’ve been able to sleep regardless of the baby dose of fanapt and feeling less like I’m dealing with AH.  So tonight I do a slightly larger dose (3mg) to see if it helps.  I do three days of that and then switch to 4mg and stay, assuming no sleep problems.

it doesnt make sense to me that it’s helping because I’m taking it at night and I was having symptoms at 530/6.  But something is doing something and it’s he only change I’ve made.

Link to comment
Share on other sites

5 hours ago, dancesintherain said:

it doesnt make sense to me that it’s helping because I’m taking it at night and I was having symptoms at 530/6.  But something is doing something and it’s he only change I’ve made.

Once you take a medicine long enough (5 half-lives), it reaches steady state (homeostasis) in your blood, basically meaning (I hope I explain this correctly) that there are no profound peaks and valleys of the amount of medication in your blood. So even if you take your second dose at night and your AH occur usually around 5:30-6:00, you will still have high enough Fanapt blood levels to help with the AH.

That's my non-professionally educated guess anyway though. Anyone please feel free to jump to explain this, especially if I haven't correctly or adequately explained something.

I'm very happy that the Fanapt increase is helping you! :D 

Link to comment
Share on other sites

2 hours ago, dancesintherain said:

That makes sense.  My pdoc muttered something about steady state. This must be what she was meaning.  Does the fact that it’s 12mg in am and 3mg at night make a difference?

It might. Your steady state level may be lower than if you were taking evenly divided doses, but I could be very mistaken on that. I was going to say that if you reach 16 mg that they make 8 mg tablets that you could take two of in the morning.

Link to comment
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

 Share

×
×
  • Create New...