Bi polar 1 here with rapid cycling.. at least that's what they tell me. I'm finally starting to believe it after a couple of decades of extreme highs and lows and "self medicating" with everything and everything as a kid, but mostly opiates since really discovering their allure to control my mood especially combined with a benzo.
Anyways, after a particularly nasty nasty run on fent i decided to seek out a shrink who could give me subs and treat my mood. Aside from requiring what people here seem to think is a ridiculous dose of subs, 8mg TID as BID wasn't cutting it, I was restarted on the last med combo i had been stabilized on and actually worked until i decided it was all bullshit and went off and stopped treatment... Topamax 50mg BID, Celexa 20mg QD, Valium 10mg BID and 30mg Restoril Q HS. The Topamax, Celexa and Valium doses were cut in half from prior doses to be titrated up as needed. I can already tell it's time to up the topamax as I'm getting 2-3 hours sleep a night MAXIMUM this last week along with some other classic manic symptoms.
Anyways, i'm not trying to write a novel, but i mentioned to him the lethargy and inability to focus or get anything done after a manic episode and questioned the bipolar DX, being desperate to have a less stigmatized DX. I had been reading about ADD/ADHD being misdiagnosed as bipolar and asked if thought that was a possibility. I was honest and told him i had used 30mg adderall all through college as a study aid for focus and energy. He said "no" and he truly thinks i am bipolar.
He mentioned to me that some of his patients required Vyvanse, a prodrug to adderall, and we could talk about adding that next visit in a month if i wanted to. This was my second visit, a week after my first and he didn't want to start me on so many meds all so quickly.
I think i'm going to go for it and give it a try. I think that the possible benefits outweigh the risks and it's worth a try. My caffeine intake is insane, 4-5 quad shot drinks a day. On the way to work, on the way to a meeting, at lunch, one in the afternoon, on the way home from work, running errands in the evening..
Topamax already carries increased risk of kidney stones, further increased with dehydration from something like over consumption of coffee. The thought of kidney stones on subs without adequate pain control terrifies me. I saw what they were like for my dad and grandfather WITH great pain control... and unfortunately after mania always comes the crash.
He might sound like some sort of a pill mill doc but i swear he isn't. He is really empathetic, listens, I never feel rushed and he is part of a large catholic hospital system that accepts insurance AND does charity work based on ability to pay.
