So, this is more exploratory than anything. I accept that, as someone with bipolar disorder, taking an antipsychotic might be a necessary part of my maintenance treatment, and lately that has become more evident. I had been taking Rexulti (brexpiprazole) in varying doses since 2017 when I started it with Depakote ER (divalproex, 24-hour) and Trintellix (vortioxetine). Still taking the Depakote (now up to 1500mg), but Trintellix and Rexulti have worked their way out of the equation, as of late.
My medication regimen has taken a more classical turn due to a breakthrough hypomanic episode in Dec./Jan., and I am currently taking a combo of Depakote ER at night along with 0.5mg of Risperdal (risperidone). Because of persistent issues with depression and anxiety, I am also now taking 50mg of Pristiq (desvenlafaxine) each morning along with 50mg of Vyvanse (lisdexamfetamine) for ADHD that I have been taking for some time.
This combo seems to be working fairly well for me. When I started the Risperdal at 0.25mg/day at bedtime, I didn't really notice much difference at all during the day, but I suppose it was nice as a sleep aid. I increased to 0.5mg on Day 4 and I've parked here to try it out for a bit before deciding to increase further. The Risperdal is really to deal with those breakthrough hypomanic/mixed symptoms such as irritability and agitation, which have always been tough for me. In the beginning of my treatment (2014), antipsychotics were used as monotherapy for mood stabilization, but I could never tolerate the doses necessary to calm those symptoms, because I was easily susceptible to EPS like akathisia. Fast-forward a few years, and we've found that using an anticonvulsant as the primary mood stabilizer with the antipsychotic as a secondary has generally served me well without too much incidence of akathisia.
I started Risperdal on June 8th and increased to 0.5mg a few days afterward. So it's been almost 3 weeks at this dose. My experience so far tells me to keep increasing. I'm curious to know people's experiences on Risperdal, particularly in combination with another established mood stabilizing agent like lithium or valproate. I recognize that I take Depakote and that a combo of lithium+Risperdal may not be the same, but the mood stabilizing effects of lithium and valproate are generally regarded with equal respect in most literature for the time being.
Any thoughts on lower dose Risperdal?....particularly in concert with another mood stabilizer?
Forgot to take Lamictal yesterday (I took my other meds). Holy Hell, I took my dose today (on schedule) and I STILL feel awful!! I've only been on 100mg....I thought Lamictal had a super-long half-life? Yesterday went like this:
10am - up, had breakfast
11am – slight Brain “swishes” started (was out the entire day)
12pm – Stronger Brain zaps start
1:30pm – Lunch (meat, salad/veg)
2:30pm – Sudden extreme exhaustion
4pm - more brain zaps => ZAP ZAP ZAP! 🤯
7pm - Irritability starts
11pm – Tea, bedtime, could not fall asleep (I haven't had insomnia in 2+ years)
...Night sweats…Restless legs.....
12am – Ruminations, feel weepy
..Insomnia ensues…(Toss & turn, sweaty/achey all night)
It's now 12pm,and I am STILL having brain zaps! I worry I’ll never be able ever taper, switch from, or withdraw from this med. You probably think well, with MI, WHY would you ever go off it? For me, longterm, these meds are band-aids. There is always a price. Ok, maybe great at preventing acute/severe depression, but as a result, they rob me of any spark, joy, elation, happiness, libido, sexual sensation/response, feelings of reward, love.... This disturbs me. I used to know what positive emotions felt like…
So I’m stable, existing.....but still lacking will or any interest in living....
I'm currently on a cocktail of Seroquel XR at 600 mg and Lamictal at 150 mg. My Seroquel dose got this high because of a mixed episode, so as of now, thats likely where I'll stay for a while to keep things stable. I was at 400 mg which not only lacked the sedation of lower doses, but also came with a lessened appetite. But that all came back when I bumped up to 600 mg.
I've put on 10-ish pounds or so in a month, and I'm not thrilled. I asked my doctor for a Metformin Rx to help with the metabolic side effects. She was hesitant, but agreed I may need something and actually leaned more towards Topamax instead. She wants me to try 1 more month of dieting and exercise to see if I can manage without adding another med.
Now I'm leaning towards Topamax, since maybe it could have mood stabilizing properties to it, in addition to curbing appetite and helping me lose weight. I'm not overweight by any means, but I'm definitely hyper-vigilant about my body and tend to...obsess.
Has anyone taken Topamax and found that it (1) helped with appetite or weight control and (2) had positive effects on their illness?
Hello all, I'm looking for some med experience/anecdotes!
I am bipolar and also have anxiety, ADHD, and PTSD. Currently I'm taking Lamictal (400mg/day), Geodon (80mg/day), and Adderall (25mg/day). I'm looking to change it up because I am seriously struggling with the side effects. Since starting Geodon I am tired all the time (it doesn't help that I'm in the midst of a depressive episode) and I've gained 20+ pounds in two months. I think it's helping with the manic side (or maybe that's just because of the depressive episode I'm in?) but I can't deal with these side effects. The Adderall works great for my ADHD but I think it's making me too edgy/irritable for my liking. On top of it I have been having terrible anxiety lately.
I'm meeting with a new PMHNP next week and I like to research my med options ahead of time so that I feel more informed and can advocate for myself. I'm interested in Wellbutrin because it doesn't have weight gain associated with it, it helps with binge eating and supposedly helps you quit smoking (both current concerns of mine), and can work for both depression and ADHD. I'm also interested in Buspar as a possible anxiety med? I like that it also isn't associated with weight gain and that it isn't supposed to be sedating.
I've also taken Abilify in the past (before I took Geodon) and didn't experience any terrible side effects other than it making me sleepy but maybe combined with the right thing that wouldn't be as much of an issue?
Anyone have experience with this combo or a similar one? Any and all feedback appreciated! The med game is so overwhelming.