Mental Health My experience with Bipolar disorder, psychosis, medication and substance abuse.

[jskeez]

I'm really looking for relatable stories, and input on the direction i should take.



I'll start off with some background information, just so you can be on the same wave-length as me.

I am(or was diagnosed) with Bipolar type 1, with psychotic traits. Over the past 4 years of my life i have come a long way. My friends, family, coworkers and the medical professionals i have seen in the past(both voluntarily and in-voluntarily) would say the same.

I have been on the following medications in chronological order:
Cipralex 10mg
Olanzapine 10mg - varying dosages, starting with the 5mg, up to 10mg, then back down to 7.5.
Lamotrigine - back and forth between 100mg-200mg
Clonazepam - .5mg PRN(as needed)
Abilify 10mg - reduced to 5mg

I currently take, and have taken steadily for the past 1-2 years:

Abilify 5mg daily
Lamotrigine 100mg daily
Clonazepam .5mg very VERY rarely. i still have 3 tabs in a 8month old bottle of 30 tabs.


I was diagnosed with depression and anxiety(the most 'cookie-cutter' diagnosis in my opinion) in 2011. The family doctor i was seeing at the time hardly batted an eye and prescribed me 10mg cipralex. being young and naive, i didnt do much research on what i was taking. ill touch on that later.

fast forward to my grad year(2012), i started experimenting. I really stuck to the basics, marijuana and alcohol. My grades dropped significantly, my motivation was almost non existent and i was becoming more ill.

long story short, i ended up becoming hypomanic, which eventually turned into full blown mania.

In tandem with extreme anxiety, things went south very fast for me. I lost my lame pizza delivery job and a lot of my friends. both of which were big things to me when i was 18. The abuse continued and got a lot worse until i was very rarely sober. This combined with my prescribed medication and a family history of bipolar, i had an acute psychosis and was taken to the hospital. I had a fairly short visit of 32 days.

I was released fairly early with a new prescription, 10mg Olanzapine daily. It turned me into a zombie.

As the bipolar story goes, you can probably forsee the next chapter of my life. I came down from my mania with the help of medication, and fell back into depression. i spent a good 3 months sitting on my ass.


Fast forward a couple more things. I got another part time job, attended a trades school, bounced through a few more medications and dosages.



I am now 22, stable, working out of town on industrial jobs as an electrician. I drink more than i probably should, but i haven't abused any illicit substances in 4 years, but that's beside the point.


Now that you know my story, this is my current situation:

I don't feel depressed. I don't feel happy. I feel nothing.

Why? I think its the abilify. I'm ready to go through a doctor and stop taking it, over time of course.

When i forget to take my meds for around 40 hours, i start to get mildly delusional. It's more persecutory than anything. I dont think im being controlled, or im a reincarnation of christ or something like that. It's more paranoia about what people think or know about me.

Personally, i think its the abilify, again. I could be wrong, maybe without it i won't function as a normal human being.

What route do you guys/girls think i should take? I want to hear people's stories regarding abilify and bipolar.

 

[paranoid android]

Are those all the Anti-Psychotics and Mood stabilizers you have tried? 2 Anti-Psychotics and 1 Mood stabilizer is not alot of the med go around that is Bipolar and i am surprised you have not been prescribed more to try. Abilify is one drug that seems to be getting a bad rep for causing certain side effects such as Akathisia and i honestly don't know anyone who has tried it without atleast getting a mild case of it such as restless leg syndrome that is not too bad. Others i know had no choice but to give it up because of Akathisia and movement disorders and i think Abilify is perhaps one of the worst Atypical Anti-Psychotic's for causing those types of side effects. I don't know how bad Abilify is for causing Anhedonia but this side effect is most often associated with high potency D2 Antagonists such as Risperidone, Paliperidone and older Typical Anti-Psychotics such as Haldol and Fluphenazine. Abilify is only a partial agonist at the D2 receptor but no 2 people are the same when it comes to how they react to meds.

How well do you find Lamotrigine at controlling your symptoms? I am on 200mg's a day of it and i have been on it since maybe 2008 now i guess. I find it to work wonders in stabilizing my moods and stopping the rapid cycling, it has greatly reduced the mixed states i used to get on a regular basis and it also helps alot with the Depression as well as Mania. However i really didn't notice much of a difference until i hit about 100mg's a day and i didn't see a drastic improvement until i hit 200mg's a day. Have you tried any other Anti-Psychotics besides Abilify and Olanzapine? If you think Abilify is causing the problem then trying a different Anti-Psychotic may not be a bad idea. Too bad the Olanzapine didn't seem to agree with you as it was literally a lifesaver for me. Quetiapine may be a option and it rarely causes Anhedonia due to the fact that it is a pretty weak D2 receptor antagonist and may also rapidly dissociate from that receptor. It is very sedating at first for most people but this generally does away after a week or 2. There are also lot's of other options out there such as Geodon/Zeldox, Risperidone, etc.

I am also diagnosed as having Bipolar 1 disorder with some Psychotic features. Usually i only got Psychosis during really bad Mixed states and Manic episodes when i had not slept but i also occasionally got them when i was severely Depressed. Right now my psych med regimen is:

- Lamotrigine 200mg's a day

- Quetiapine 300-400mg's a day

- Clonazepam at about 5mg's a day.

I also take Bupropion aka Wellbutrin aka Zyban 300mg's a day when the Lamotrigine and Seroquel aren't doing the trick for the Depression side of things. Usually i only have to take Wellbutrin during the winter as i get Seasonal Affective Disorder which makes the Bipolar Depression that much worse. I have never tried Abilify but i have tried Quetiapine, Risperidone, Olanzapine, Chlorpromazine (brand names Thorazine and Largactil), Methotrimeprazine aka Levomepromazine (brand name Nozinan) and also Prochlorperazine (brand names Compazine, Stemetil, etc). As for Mood Stabilizers the only true one i have taken is Lamotrigine as i have not tried Lithium. I have also taken the Anti-Manic drugs Carbamazepine and Divalproex aka Depakote aka Epival. The Anti-Depressants i have tried are Effexor (one of if not the most awful drug i have taken), Amitriptyline, Bupropion, Mirtazapine and Trimipramine which is a Tricyclic Anti-Depressant that has some Atypical Anti-Psychotic effects. So yup i have been on the med merry go round . It took me a good 2-3 years to find a combo that worked and i am pretty sure it was the addition of the Lamotrigine that did the trick.

Noone here can tell you what you should do as we are not doctors nor do we know your medical history. But we can give suggestions and mine would be to discuss alternative treatments to Abilify if you think that's the problem.

 

[Mmp85]

I also really like lamictal.
I think depakote has made the biggest difference for me.
Seroquel just wasn't for me and knocked me on my ass and made it very hard to get out of bed. The doctor would ask if it was helping and I told him I wasn't awake long enough to know!
I take prozac for depression and have a klonipon prescription I use mostly for sleep.

 

[whatamI]

i was given the option for abilify many times, i turned them down because i generally look at antipsychotics as unhealthy and not useful(not to mention side effects).
I'm going to be honest my opinion is that klonopin and other benzodiazepines have great antimanic properties. lamictal is good but i really hate memory loss and eye pain with insomnia that come with the drug. k pins are great for bipolar with almost no side effects, if you really want to treat depression id look into ketamine if thats popular in your area. that form of treatment is something i might look into until then I'm low dosing dxm with klonopin and it seems to be working while making me feel like my past self.

 

[cr33py]

With some people, just getting the mood swings under control is enough to keep the hypomania and anxiety from turning into psychosis. While AAPs are used as mood stabilizers I personally wouldnt take them for the long term unless I had to. There are a lot of metabolic effects that take place, for one. If you absolutely need to be on them I would make sure you watch your weight and blood sugar very carefully.
I have seen some people in that spectrum that had good relief from symptoms on just lithium. Benzos are AEDs and mood stabilizers but they shouldnt be used for mood maintenance. Maybe an acute episode.

 

[jskeez]

my goal is to be off of antipsychotics entirely. im just not sure what would be a good replacement.
as for side effects, ocassional restless leg, memory loss.. i do still find that if something bothers me, it really REALLY bothers me for about an hour before i realize its not worth worrying about. doesnt happen that often but i get pretty pissed at work at things i shouldnt be upset about.

 

[whatamI]

in my experience klonopin makes a psychosis much more manageable (did more than antipsychotics). lamictal has some side effects but i want to like it because it has some upsides, but vision problems, memory loss, and insomnia are what i got from it. ps i would never recommend an antipsychotic for any illness

and lowing stress is the best way to prevent mania so watch out for causes and find what works for your stress

 

[jskeez]

update: weening from 5mg to 2mg over 6 weeks. hope to drop it completely.

 

[Ligaturd]

Abilify being a partial agonist tends to cause the least anhedonia from my experience and what I have read, Akesthesia is quite prominent right now but I really want it to work. I have been prescribed clonazepam with it temporarily to combat this, next I will try propranolol if it doesn't calm down. It has the best side effect profile for me and works quite well for me. Weight gain and gynecomastia are side effects that pushed me towards Abilify. Abilify tends to increase sex drive too which is a plus.

Hopefully you can manage your symptoms without Abilify, if not as paranoid android has said, there are quite a few other AP's to try which might work better for you. It's too bad about olanzapine as I found that quite tolerable except for prolactin increase and weight gain as far as its impact on my mental state.

 

[strity1994]

Abilify being a partial agonist tends to cause the least anhedonia from my experience and what I have read, Akesthesia is quite prominent right now but I really want it to work. I have been prescribed clonazepam with it temporarily to combat this, next I will try propranolol if it doesn't calm down. It has the best side effect profile for me and works quite well for me. Weight gain and gynecomastia are side effects that pushed me towards Abilify. Abilify tends to increase sex drive too which is a plus.

Hopefully you can manage your symptoms without Abilify, if not as paranoid android has said, there are quite a few other AP's to try which might work better for you. It's too bad about olanzapine as I found that quite tolerable except for prolactin increase and weight gain as far as its impact on my mental state.

My doc prescribed me Abilify and took me off my Adderall (speed) after I saw him at the end of a meth binge. but I never told him about the meth, just that I was seeing shadow people. Never took Abilify after a quick Google search. Weight gain is a common side effect.

And it is an anti psychotic medication, I would never take something reduces dopamine (pleasure chemical). Why would I take something that decreases my pleasure in life? my doctors a fucking idiot lol...

Did it increase your sex drive? If if acts as a partial dopamine agonist at low doses, it would reduce prolactin no? Therefore one would experience weight loss and increased sex drive and INCREASED DOPAMINE! WOO

 

[jskeez]

update part 2: everything is much more clear. i have more energy. although if i miss a dose/ take it late i start to get extremely disoriented. this happened on 5mg after about 40h of no meds. it happened today after about 20h. the delusions that i used to get years ago, have shown briefly during times of extreme stress. but i haven't had an issue with that so far, which was my main concern. i still have slight persecutory delusions.. ie; people dont like me and they talk about me behind my back.. however i've always had that. i just kind of deal with it. years ago i was under the impression that my mind was on the big screen to the whole world. as if everyone could always check up on me to see what i do, say, or think.

I just hope i stay around this general mood/state of mind. I like it, and i don't feel hyped up or manic-y.
I'll try to keep somewhat regular updates going. getting close to the next 1mg reduction.