Mental Health new ins, new Dr. .. switching med(s)?

[SilverFeniks]

No doubt BL is sick of my posts but finally.have something new going on.

Met with a new Psych this week (private practice instead of HMO). I've been hella stressed and my life has been falling apart this year (due to.my own stupid choices) but she seems nice and I was able to talk to her.

Under my HMO since being diagnosed bipolar (a few years too late ) I'd been on lamotragine, Risperidone, and trazodone for a few years (allergic to depakote and seroquel) plus various one-timers I never took consistently

My doses have been upped but over time the effects have faded.

So new Psych asks if I've ever tried Lithium (no) and seems keen to put me on it.

I know the basics but naturally I'm.nervous. I'm a "less is more" type so I'd love to reduce the # of.chemicals I'm ingesting.
Have been very thankfully side-effect free with Lamotrigine/Risperidone aside from maybe some weight gain. Hope I get to keep.the trazodone!

So I am concerned with some of the common side effects; is it true they tend to fade over time?
I've had specific problems with 3 prior meds that lead to quick discontinuation.

Obviously more concerning is the toxicity issues. I am physically healthy and other than my Swiss- cheese brain and damage from too much alcohol/cannabis use over the last 12 years so this stuff sounds scary.

How often do you have to have blood tests taken?
I work in a different county from where I live/physicians are, just lost my license due to a hospital visit .. the hospital by my work charged me $854 to walk in for 3 minutes for a work release letter so I can't afford to go there much unless insurance helps.me.out on this.

I've gone thru wicked withdrawals when trying to quit Lamotrigine & Risperidone in the past (despite Drs saying there is no w/ds).

Is Lithium a lifetime med or just a year or two and then I'll.be cut free?

Thnx for any advice!

 

[UncookMyBrain]

Its a life time med if you really do have bipolar rather than the other disorders it gets confused with.
If you want to try get off it after a while I suggest you take fish oil, NAC and start exercising, go low carb quit any alcohol and caffeine use.

keep us updated how you go.

 

[engineercchad]

Every 6 to 12 months, after ever couple of weeks to establish your baseline response. People tend to view lithium as so much more toxic but if you were willing to attempt the depakote only to find out you're allergic then I wouldn't think of lithium as so much worse. It can mess up your kidneys and your heart (being a salt) but if the level is good then you should be okay. Valproate, on the other hand, can cause sudden toxicity of the liver and shut it down completely and fatally even after several years with no bad response and with good levels. Back in the many years I took it, those levels can fluctuate even after a good baseline is established a lot and get out of control. I think they had me going ever 4-12 weeks over every bit of the 15 years that they had me convinced I needed that crap. Your mileage will vary, as always.

 

[cj]

Why does he want to change up your meds? Are your symptoms being adequately controlled? Switching around the meds of a stable patient for no reason seems very suspect to me. I would seek a second opinion.

 

[SixBuckets]

A lot of side effects happen in the first three months and then fade, but this isn't the case for everyone (or every side effect). You'd have to be specific about side effects for us to give our opinions on whether they're likely to be permanent or temporary.

It's really common for tolerance and plateau to happen with a lot of drugs, but I was under the impression this wasn't really a thing with lamotrigine. Can you tell us a bit more about what's happened there?

Are you having symptoms, or are you stable? I agree with crimsonjunk that switching your meds if you're not having symptoms is weird and possibly uncalled for.

 

[sirfoxey]

I really can't comment on the medications and your condition as I don't have any experience with it. I do completely agree with the less is more approach and when I had to start medications for my mental health issues I did not want to take anything more than I needed. I actively fought my treating medical professionals on this which ended up being worse for me. My Psych and I discussed this and he asked me to trust him and lets just do what ever it takes to get me stable and functioning in life as a happy and successful person. Once we get this right then we can look at making minor changes over time to reduce what I am taking and test out what the very minimum amount of drugs I require are. Once we set off on this path everything started falling in place and over time we have removed some medications and reduced others. Some we tried reducing but were required to go back to the original dose but we worked together and got the best result with the minimum medication in the end.

 

[SilverFeniks]

I can't say I've really been 'stable' the last year or two. I almost was (should have been) hospitalized last year during a week.of abject suicidal despair accompanied by extreme.physical symptoms. I still get suicidal/homicidal thoughts and panic quite often. I do feel much better than when I have gone completely unmedicated but over time I fail to notice a difference.

I was unaware of much about Depakote. I was rushed into it upon almost being fired after some manic behavior when I was on Prozac. Only took it a couple weeks, it quickly gave me a bad headache. Around that time I was diagnosed as bipolar which I'd suspected for years.

I wonder how much the Risperidone wears me down. Most people seem to have a lot more.side effects than I think I have.
If.anything if on Lithium alone I'd reduce my caffeine.&alcohol intake.further (work in progress) as I see caffeine reduces Lithium's concentration and combined.toxicity with alcohol would really worry me.

I find it impossible.to make.Most decisions on my own (and when I do it's always the wrong one) so.I guess I.should just express my reservations to the psych and do what's recommended. But if I get a lot of initial side effects I'm likely to discontinue quickly, I can't let a mediciation interfere with my employment.

 

[SilverFeniks]

Well that's it for.me.
Psych changed her mind,.wanted me.to take more Risperidone. Not.gonna do.that.

Hospital didn't have any of.my.refill info.

Billing dept is still.deciding to.f**k me.over for my non-visit.

So I'm gonna taper on.what's left on my meds,.and not go.back.to.another hospital or psych. Never should have changed.my insurance.

 

[cj]

Well that's it for.me.
Psych changed her mind,.wanted me.to take more Risperidone. Not.gonna do.that.

Hospital didn't have any of.my.refill info.

Billing dept is still.deciding to.f**k me.over for my non-visit.

So I'm gonna taper on.what's left on my meds,.and not go.back.to.another hospital or psych. Never should have changed.my insurance.

That sounds like a terrible idea man.i know your frustrated but you just got to hang in there and work the game a little more.

 

[SilverFeniks]

Been at 25% meds (except trazodone, Still 50-100% doses since I have a decent amount) for a couple weeks now.

I've had a Non-stop.headache but none of the usual anxiety/suicidal thoughts/ mania i've experienced in previous tapers.
Have also been experiencing extreme anger/rage all day every day. Not unusual for me but hard to tell if it's amplified by the lack of drugs or merely.a symptom of my current battles with the DMV and the medical establishment, and related loss of freedom & social life. Going to be a long, drawn-out war and I've been at breaking point for weeks so not sure this will end well.
Insurance is covering a decent amount.of.my hospital.bills.but apparently.very little.of.my.two mental health visits, so definately not going back until I can change.my insurance next year. But by then I should.be either stable, locked up or dead. Time shall tell.