Stimulants to combat sedative effects of antipsychotics

[BriPolar]

Hello, I'm wondering if anyone could offer some insight on stimulants that an help with the sedative effects of prescribed a typical antispychotics. Currently I am taking seroquel 50mg. I have also tried Abilify, Saphris and Risperidol.
I cannot remain awake during the day, and by afternoon evening I am extremely irritable, exhausted and sick of being medicated. I've read that amphetamines are basically cancelled out by the antipsychotic.
Is there anything that can help? Or another antipsychotic that I can try? My Dr is pretty open to my preferences.
For reference I have Bipolar Disorder and Anxiety.

Thank you

 

[eye dew Things]

Hi BriPolar and a warm welcome to BL.... Have you thought about Kratom? I take Etizolam daily and when the tiredness sets in, I toss and wash a few grams and it perks me back up.

 

[d1nach]

If they have bipolar disorder I wouldn't recommend them having etizolam around because it is easy to overdose on and they'd have a large excess of it. I have unipolar depression and take meds to stabilize my depressive mood swings but I can tell you from experience every one of my self harms and suicide attempts involved benzos.

If you are on multiple antipsychotics I take it you have severe bipolar disorder correct?

Idk what saphris is so I have to look that up

But maybe your doctor could consider using modafinil it reducing day time chronic fatigue and sleepiness without effecting dopamine receptors that may play a role in bipolar disorder.

Another option is asking your doctor about a nicotine patch or gum if this would be safe and if they could monitor and help you try it out because you read it might help with some of the side effects of antipsychotics and you really want to keep taking your meds but the side effects are unbearable at times.

 

[d1nach]

If your exhausted due to

Extrapyramidal symptoms (EPS), also known as extrapyramidal side effects (EPSE), are drug-induced movement disorders that include acute and tardive symptoms. These symptoms include dystonia (continuous spasms and muscle contractions), akathisia (motor restlessness), parkinsonism (characteristic symptoms such as rigidity), bradykinesia (slowness of movement), and tremor, and tardive dyskinesia (irregular, jerky movements).[1] (wiki)

Another option is switching to a antipsychotic with anticholinergic effects or adding a anticholinergic. However this will likely just make you more tired atless your fatigue is due to extrapyridamal symptoms.

Basically dopamine is widely expressed in both areas involving mood and areas involving motor skills. Antipsychotics can sometimes interfere with the normal brain signaling involved in movement making simple tasks difficult. Anticholinergics act in these motorskill areas. One mechanism this might work is dopamine regulates muscarinic acetylcholine signaling in areas like the substancia nigra by inhibiting it. Antipsychotics by blocking dopamine receptors may allow the muscarinic receptors to now activate inappropriately and by blocking the muscarinic acetylcholine receptors in these motor skill areas it may help restore the balance between dopamine and acetylcholine making movement easier

 

[king kpin]

Hey Bripolar,

I have taken all of the antipsychotics you mentioned except for saphris, and IMO seroquel is the worst medication out of the ones listed. Also amphetamines most definately still work even if you are taking a high does of an AP, i speak from personal experience. I have recieved both diagnoses you list so my experiences should be very applicable to your situation.

depending on your insurance and financial situation, there are a few other options:

1. try a different AP (Anti Psychotic) - Latuda is new and has a low side effect profile, also consider Geodon. Note: Latuda is expensive if insurance wont cover it and may still be too expensive for you even with help from insurance. I take Latuda and it seems good, and I have minimal side effects. Geodon would be the preferred medication of choice and seeing that you are taking such a low does of seroquel you would likely respond well to geodon too.

2. if you like the seroquel, (I hate it and would advise switching) but if you like it, stay on it and try adding a mild stimulant. my recommendations are as follows: 1. Modafinil 200 mg daily 2. Ritalin/Concerta 54 mg daily 3. Adderall 40 mg daily 4. Caffiene
Caffeine is a prescription free route, but it is honestly a very dirty stimulant. makes you jittery and anxious, and as far as stimulation is not even comparable to Ritalin or Adderal in moderate doses.

3. Ofc the best option is to ditch the AP, 50mg of seroquel is very low, and it is likely not doing much for you other than giving side effects. Typical doses of seroquel for Psychosis is around 300mg daily going up to 800mg on the higher end of the spectrum.

If you are able to function without an AP it is best to do so. They have been linked with many concerning side effects, increased risk of death in elderly/ those with dementia and are also known to cause loss of brain volume when taken for extended periods of time.

let me know if you have any questions.

 

[d1nach]

I wouldnt consider 40 mg of Adderall as a moderate dose especially in someone with bipolar even though I take 55 mg. I believe the recommended theraputically range for ADHD is 5 - 30 mg per day.

If you want 200 mg modafinil for a reference point I would say

200 mg of modafinil is like 10 mg - 20 mg of Adderall in terms of ability to promote wakefulness defined as ability to focus, switch tasks, recall short term memory after total sleep deprivation. There is a paper I believe showing 20 mg Adderall 400 mg modafinil and 600 mg of caffeine being roughly effective.

Even with Adderall when I take 55 mg I notice the focus and other cognitive benefits well before all of it kicks in.

I think it may be important to use lower doses of Adderall rather then the higher end first because you want to focus on getting the cognition benefits without interfering with the antipsychotics in areas like the mesolimbic system

 

[ThatOneDude!]

Hi BriPolar and a warm welcome to BL.... Have you thought about Kratom? I take Etizolam daily and when the tiredness sets in, I toss and wash a few grams and it perks me back up.

Hey pardon me, this isn't relevant to this thread, eye dew Things, can you please clear a few messages from inbox? I am trying to message you but your inbox is full.