Advice about Bipolar meds needed

[brunette]

Hi all, I am sorry that I don't want to post about the details of this publicly, but I just posted a very long-winded story about my mum being Bipolar over on my hair journal in the Private boards here.

She's very scared as she reacts badly to drugs and just had one such bad reaction to an antidepressant. Tomorrow she might get given a different type of drug and is so frightened, I fear for her - she doesn't know how she can go on and while deep down I know she would never do anything stupid (she told me she would never once before) when she is in this state of mind who's to say what she might do? She's also scared of being on mood stabilizing drugs in the long term, specially if they have these weird side effects she tends to get.

Please, any advice is welcomed wholeheartedly. I'm sorry if anyone feels left out because they don't have enough posts to view my journal, I just feel a bit nervous about sharing the whole story but you should get the gist of it.

Please help!

[nastasska]

I understand your Mothers fear of drugs as I have just had my own bad experience with SSRI type anti depressants maybe the older style ones such as Tofranil would help her more I had very heightened anxiety with the SSRIs
Maybe more natural remedies might help this book might also help

http://www.amazon.com/Dealing-Depres...6312142&sr=8-1

I know how it feels to be terrified of what these drugs might do to you tell your Mother she is not the only one who feels that way reading about it might help her feel more in control of her own situation there are a stack of books out there

[Madam Librarian]

From the other side of the fence:

My dad and brother are both bipolar, so if you need an ear, PM anytime! I absolutely mean it!

I know my dad had a few problems getting stabilized but once he did, the difference in him is night and day. It is very much worth it to soldier through all the medication trials and adjustments, even though side effects can sometimes be no fun at all.

My brother seems to have had a much easier time finding the right medications. So in my experience, it can be a relatively short and easy task, or it could take longer with some discomfort along the way. Each body is different after all!

The best thing you can do is to keep an eye on your mom while she adjusts or tries new medicine. For a while, the combination of my dad + his new medicines + his truck = ditch magnet! He took more than one side trip through a ditch before putting two and two together to realize that his medicines just might be affecting his motor skills (and he is a really smart and safety conscious man, so those drugs can do some powerful things to the mind!). Effects might not be evident to your mom, so just keep an extra eye out for her. If you can't visit, phone her. If she has other people living in the household with her, have them keep tabs on her.

Maybe her doctor could focus on one symptom at a time, if it is agreeable for your mother. Perhaps get the lithium where it should be first, then try to treat depressive symptoms, then treat the manic symptoms (I am totally pulling these out of my butt here, I have not read your journal to know what your mom's particular troubles are). If that is appropriate for her case, it could be less scary and confusing than trying several different things at once.

I hope things work out for your mother. I know the standard 'keep up the fight' advice is probably not what you or she wants to hear, but it's all I've got! It is very much worth it in the end.

[Tabitha]

There are new medications out now that are meant to be better in their side-effect profile than Lithium Carbonate, but UK doctors are often reluctant to prescribe them as they cost more

If she is not being treated by a psychiatrist but merely a GP, it might be worth pushing for a specialist referral as they might be more up to date with meds.

[soobie]

I don't have experience with bipolar, but my husband has had problems with anxiety disorder for years. He's finally on Paxil, which works great for him and he's stable now, but it was pretty scary for a while until they found a med that worked for him.

I'd suggest that someone go with your mom to her doctor's appointments. If she's in a heightened state of anxiety, she's probably not thinking completely clearly. Having someone else there to hear what the doctor says and present her symptoms helps a lot. Assuming she's amenable to the company, of course. Writing symptoms and questions down beforehand is a great idea as well. And take notes on what the doc says.

I suggest this because it worked for me and my husband. YMMV. Good luck, and best wishes to your family on getting this straightened out.

[brunette]

Thanks nastasska your post was reassuring, I have made a note of what you said, I'm going to email my dad any notes I make before her appointment as he will probably sit in on it. Heightened anxiety is so scary, even for the onlooker and what kills me is the turmoil she is going through, I am sorry that you have suffered this too. If you found what works for you that is wonderful and means hope for my mum.

I find Wikipedia invaluable in looking up everything and that in turn leads me to all kinds of other websites, I'll type in Tofranil and SSRIs to find out more as well.

That's also really helpful what you said Madam Librarian, the doc wants to treat depression first then focus on the mood stabilizing and adjusting it according to mania/depression symptoms as far as I can tell from what dad tells me. Thank goodness there is always someone there unless dad has to go out, my brother tries to keep me filled in too when he spends the day at home. Today she said to me "there's no way I could cope if I was on my own" and I tried to keep her positive by saying that she'd gather the strength from somewhere, make sure she fed herself etc. I know that she is feeling a lot of pain from memories about the hypomania, lots of things she said that she regrets now and can see that something needs to be done. Thanks for the support anyway, I will most likely take you up on that!

Hi Tabitha - yep, doctors can be so swayed by costs and all that. Another thing I find in our area is sometimes a medication is in high profile one month, and the doctor seems to dish it out to everyone like he's on special perks from the drug company.. hmm. Yes this doctor is from the local hospital, he's the top doctor in a team of mental health experts, but I don't know how open to suggestion he is going to be. In some ways I wish I could be there but the best I can do is arm dad with a few notes.

Mum asked about hypnotism last time and he poo-pooed it and said results don't last. I'm thinking of phoning a woman in a town nearby who is an hypnotist and EFT practitioner, and I know some doctors who believe in complementary medicine will refer people to her. If someone like her can help mum cope with everything it will be a plus I reckon.

Thanks to you too, soobie! Thankfully she won't be alone, good idea about writing down what the doc says, I will pass that on as well. Sorry your husband went through the whole anxiety and drug trials as well, it must be horrible to have drugs make it even worse for a while when they are trying to find the right one. And how is a person to know whether it's just a teething period and to stick the drug out till it's started working or not? I know I wasn't happy about mum carrying on longer than the 5 days she took the Cypralex. I'm so glad you found the right meds for your husband, and thanks for the good wishes.

Thanks to all your replies I knew this place would not let me down! I'm off to bed now but I will check for more replies in the morning when I email my dad these notes. Here's what I have so far, what do you all reckon? I hope no one minds if I quote small bits directly (by the way she is vegetarian, another new thing brought about during the 'good days' following the hypomania - I'm veggie too and she admires how I'm doing):
*edit - she's now started eating meat as she is scared she's missing out on proteins and here is the revised notes I sent my dad in case they help anyone else:

One friend whose father and brother are both Bipolar said

"I know my dad had a few problems getting stabilized but once he did, the difference in him is night and day. It is very much worth it to soldier through all the medication trials and adjustments, even though side effects can sometimes be no fun at all."

another said it took her husband 2-3 weeks of unpleasant symptoms to get used to one particular drug (for high anxiety) and that the doctor was able to give him another fast acting drug to get him over the 'hump'

Recommendation to write down any questions, symptoms etc before the appointment (I suggested this to mum yesterday) and also for you to write down anything the doctor says so that you don't get mixed up or forget - he should be understanding enough to allow you to make notes.

book recommendation:

Dealing with Depression Naturally: Alternative and Complementary Therapies for Restoring Emotional Health
by Syd Baumel


Cypralex is an SSRI type anti-depressant - SSRI means Selective Serotonin Reuptake Inhibitor. Seratonin is the neurotransmitter that many believe if low is the cause of depression in most cases and so SSRIs are used to keep it in the right place. SSRIs are described as 'selective' because they affect only the reuptake pumps responsible for serotonin, as opposed to earlier antidepressants, which affect other 'monoamine neurotransmitters' as well. One person said she could not get on with SSRI type anti-depressants and had to take the older type.

Tryptophan -"Biosynthetically serotonin is made from tryptophan, an amino acid (found naturally in certain foods and also available in supplement form). If depression is caused by lack of serotonin, rather than insensitivity to it, SSRIs alone will not work well, whereas supplementing with tryptophan will. L-Tryptophan is available by prescription (US)"

5-HTP, a metabolite of tryptophan, readily crosses the blood brain barrier, aiding in the treatment of depression. It is marketed in Europe for this purpose under brand names like Cincofarm and Tript-OH.

Dietary sources - Tryptophan, found as a component of dietary protein, is particularly plentiful in chocolate, oats, bananas, dried dates, milk, yogurt, cottage cheese, red meat, eggs, fish, poultry, sesame seeds, chickpeas, sunflower seeds, pumpkin seeds,spirulina and peanuts.

Omega 3 fatty acids (found in Flax Seed Oil for vegetarians - available in capsule form) - a double blind placebo study showed that Bipolar patients improved greatly compared to a group taking olive oil placebos.

Vitamin B Complex as well if mum not already taking it.

Sleep - An inconsistent sleep schedule can destabilize the illness. Too much sleep (possibly caused by medication) can lead to depression, while too little sleep can lead to mixed states or mania.

[soobie]

I had another thought, regarding the duration of the adjustment period for new meds. It varies. Some of the SSRI anxiety prescriptions have an adjustment period of WEEKS.

If my husband had quit the Paxil after five days, he would probably still be looking for something that worked. I seem to remember that it was ~2-3 weeks of pretty bad adjusting, both physically and emotionally, then the Paxil started working. They gave him a second prescription (faster acting, but not to be taken long-term) to take with the Paxil at first, to help smooth out the transition. So maybe talk to the doctor about something like that to help "get over the hump," so to speak, for whatever they end up prescribing.

[Tabitha]

Hi Brunette

A few odd comments based on my own experience, not with bipolar but after a severe nervous breakdown 9 years ago:

I am in the process of coming off an SSRI which is proving to be a bit testing, and I read here that lecithin is helpful to give the brain choline - I had lecithing capsules that I'd used to help emulsify my OCM mix and started taking the maximum dose and it seems to be helping. I already take a multivit with B complex.

Just because the doctor is head of the team, he might not be the best person to treat your mother. I have tended to get on better with women doctors, because to be a woman in today's society is a complicated thing and I am not sure that men totally understand, however empathetic they can be in other ways. I was recently re-referred to the psychiatric team that first reated me and I had the confidence this time to refuse to be referred to the team leader (consultant psych), as she (yes she was female - the gender rule is not infallible) had become latterly part of the problem, not part of the solution. She had been cold and judgemental, overly directive and had me on 4 meds at a time which gave me dreadful side effects. This time around I've seen a couple of younger female staff grade doctors, who, although they have less experience, have been kinder and more empathetic and I felt supported by them rather than judged. Anything they don't feel they have the experience to deal with would be brought up at their team meeting, for the consultant's input but I don't have to see the old bag (she once criticised me for always wearing trousers - WTF?).

As for hypnosis, at that time we were so desperate that I tried everything I could think of, including Reiki and metamorphic technique (hmmm ... soothing but I'm not sure what else it did apart from that to justify the cost). The hypnosis I had didn't put me in a trance but just into a more receptive state so that instead of my conscious mind fighting ideas, they sunk in more. I did in fact find it helpful but I would advise caution in finding a reputable practitioner. This man (yes the gender rule is not infallible!) was based in a GP's surgery although working privately, which gave me some reassurance that he wasn't a total quack.

I hated the time when I was on Lithium (this consultant used the "scattergun" approach including 12 sessions of ECT - all THAT did was damage my memory permanently) because of the blood tests to determine levels - I am needle phobic.

Feel free to PM if I can say anything that might be of help or support.

[Silver Strands]

I just heard on the news yesterday that they have done studies and found that anti-depressants don't seem to have any benefit for people with Bi-Polar disease.

I would say a visit to the Dr. is in order and some medication changes need to be made.

I have a friend and a sister-in-law with this. They have both had problems with anti-depressants.

[akurah]

I definately recomend http://www.crazymeds.org as a source of research on meds--its incredibly exhaustive.

You're going to have side effects with almost every med you take, though some will be so mild you may not notice them whereas others may make it impossible to take the med. Don't be afraid to try meds, but if a side effect that you (or in this case, your mother) manifests that she cannot live with, it might not be worth it to wait the side effect out to see if it will go away, and it might be better simply to just move on and try another med.

On the weird side, you may find a medicine that works like frickin' magic but has a nasty side effect too. I'm currently dealing with this problem personally.

[Shiin]

Originally Posted by akurah

I definately recomend http://www.crazymeds.org as a source of research on meds--its incredibly exhaustive.

You're going to have side effects with almost every med you take, though some will be so mild you may not notice them whereas others may make it impossible to take the med. Don't be afraid to try meds, but if a side effect that you (or in this case, your mother) manifests that she cannot live with, it might not be worth it to wait the side effect out to see if it will go away, and it might be better simply to just move on and try another med.

On the weird side, you may find a medicine that works like frickin' magic but has a nasty side effect too. I'm currently dealing with this problem personally.

I agree with everything that Akurah said. It took nearly 2 years for me to finally get on my right cocktail for BP meds and I am so happy that I am finally on the stuff that works for me. Best wishes for your mother I'll be thinking about her and feel free to PM me anytime if you need to vent or ask questions.

I read constantly when I was being treated and always asked my doctor questions one of the meds I'm on I asked him about because I'd done some reading and he decided to give it a shot and it worked like magic for me with very little side-effects.

*big hug*

[cullofinniel]

I'm Schizoaffective but on the same sort of meds as someone with Bipolar, now that I've found the right combination I'm doing okay, but I had some really bad meds in the past.
Newer mood stabilizers have been good for me, as well as an anti psychotic and an antidepressant; most of my friends at the daycentre are on various of these and find them good.
I think it is cool if you can control things using natural substances but personally I'm much better with the drugs even though I don't like taking them.
Anyone who wants to, feel free to IM me about this, if you want to know more about specific meds or just fancy a chat :0)

My Meds are:-
Seroquel
Citalopram
Depakote
and Diazepam.

[breezefaerie]

I am Bipolar, diagnosed about 5 years ago after suffering from depression for much of my life.
My chemical cocktail consists of the following:
Welbuterin
Lexapro
Topamax
Seroquel

Both the Welbuterin and the Lexapro act as anti-depressants for me. There were years worth of trial and error to find these two and they work beautifully for me. The topamax I take for several reasons, the main one being that it works as my mood stabilizer. It also acts to prevent my migraines, another bonus for me. The last is Seroquel. This med is an anti-psychotic.

I went through years of trying to find the *right* anti-depressant, not knowing that my issues were not all depression. I went through lots of trial and error finding meds that DID work for me, and now that I have, I've found that the person I am now is the person I was struggling to be all those years. I just needed help getting there.

I would really recommend that you seek the help of a Psychiatrist though. They are better able, in my opinion, to deal with the subtle things that lead up to a manic or depressive episode whereas a regular MD might not think to ask those specific questions.
I wish you and your Mom all the very best and you will be in my thoughts and prayers.

If anyone would like to PM me, please feel free as I am very open about this part of my life.

[WindowDressing]

I applaud your courage here. As a family member of those with such disorders and the struggles with them, I've met many dear folks with similar concerns.

Please do know that fear of the unknown for patients is just as real to them as any other fear the rest of us might have.

My hubby describes it as "fiddling with the tinkertoys" of the brain chemistry. The best treatment does come with a combination of a board-certified psychiatrist and in most cases an internist who can cope with side--effects and other mood-altering effects (like drug-interactions, hormones, blood-sugar, etc.)

Hang in there, dear brunette, I am new here so I can't view many places. I've viewed many places in life itself, so I did want to offer my support for your mom and your concerns for her and your family.

Love and Hugs!
WD

[brunette]

Hi soobie thanks for the extra tidbit - I added that into my notes before I sent it to dad that morning. He said he found the notes really helpful and especially the experience of others I quoted.

The latest news I heard was Thursday evening, dad told me the doctor (I'm certain he is a psych cos he's from a special department of the hospital) had been very helpful and spent well over an hour and a quarter with them, he'd prescribed what he described as a "first line drug" called Fluvoxamine, 50mg for 7 nights, within a week she should apparently be sleeping better, and within 3 weeks they expect to see improvement in anxiety levels. He said that if she gets any side effects that really are not bearable that she should stop them.

Dad said she'd been a little better, was well enough to have lunch in a café after the appointment, went to Tesco and picked up a few items of shopping with dad, followed by a nice walk.

I looked it up and and Fluvoxamine (Luvox) sounded really good at first - of course that was until I saw the known side- effects, one of which was mania! I'm keeping my fingers crossed that it doesn't have that effect on mum but really this drug is to tide her over until they give her mood stabilizers. They might even take her off it I'm guessing. Another thing that struck me was the link to one of the Columbine shooters - and the fact it was withdrawn from the US market. There is no proven evidence that it was the cause though apart from the known ability to induce mania (in 4% of youths apparently - less than Prozac's 6% of youths).

Tabitha thanks for sharing stuff about your personal experiences, and that site you linked to is useful. I read all that they say there about Luvox in the middle of typing this post That woman you used to see sounds awful, mum had a woman doctor at this place before, she had seen her before when she suffered anxiety and was the one who whipped her off Venlafaxine when she realised it was raising mum's blood pressure. She didn't like it when mum was hypomanic and speaking her mind - she told mum "go and sit over there and be quiet while I talk to your husband"! Like a naughty child. Mum won't see her again, she didn't seem a very sympathetic person.

Hmm so hypnotism could be beneficial at least in helping to control anxiety and self doubts etc. I've seen a self help CD in Waterstones I am considering getting her, it uses hypnotic suggestions to increase positivity. I hope your SSRI withdrawal continues to go well and you can put that part of your life behind you

Thanks Silver Strands that's interesting and also worrying, and just goes to show that this drug she's just started may not work out for her. I will do some research on that report if I can. If this tablet doesn't work I'll tell dad he should bring up that point with the Psych/doc.

Thanks for the link and advice akurah - that site is very interesting, I won't show dad because I don't think he'd cope with the writing style! An article about side effects made me realise how whiney it sounds when I moan about them (well, I only whine cos mum feels that way) - I can see now that all the anti-depressants drugs have similar side effects, some worse than others - it almost makes you lose hope. I am feeling very positive now though, and I hope to see mum in a day or two.

Hi Shiin - thanks for sharing, and for the good wishes for mum, your experience with finding your own drug and asking the doc is very hopeful, that's what I imagined I'd be able to do, find one that sounded hopeful with the way mum is but it seems the doctor is doing quite well on his own *fingers crossed*

Cullofinniel I'm glad to hear you found some drugs that work for you, there's a lot of positivity in this thread and that is just what the doctor ordered!

Hi breezefaerie - that's what happened to mum - she was suffering from depression and anxiety years ago but always had these phases of going over the top (happy though, not angry like she was recently) and buying lots of stuff she didn't really need - usually at Christmas which most would say was just a normal festive spirit. I can see that now but at the time it was just seen as normal and "thank goodness she isn't depressed or anxious". It wasn't till she withdrew the Venlafaxine that they had used to treat the anxiety that the hypomania started.
What you said about finding the person you are now is the person you were trying to be all those years is hopeful too, I think that would bring mum comfort. She's been through so much in her life and when she has self doubts it's hard to reassure her of things like who she is and what she's capable of - really she is a strong, capable woman with a lot of love to give. Thankfully we are a close family and can tell eachother one another "I love you".
Yep, the doc is some kind of psychiatrist - I don't know his official title, it's almost as if no one will say because of the perceived stigma. I agree - our family GP is quite useless when it comes to specialised stuff. Even her Hypothyroidism mum had to tell the GP that she thought she should be tested, and it took further tests from a specialist (that she had to ask to see!) to find that indeed her levels were low.
Actually that reminds me, when she first found out she had hypothyroidism it was blamed for all the anxiety problems and for a while it seemed to have sorted it once she started the drugs. The doc even started giving her Thyronine as well last year because the symptoms of anxiety returned and a test showed thyronine was low. When she went back after the Hypomania started at first one doc said she'd gone Hyper-thyroid and a specialist said she should never have been put on Thyronine but that wasn't the answer after all

Thanks Windowdressing your input is valuable, I agree fear of the unkown is a very real fear - it's so hard to reassure someone when they are afraid at the best of times isn't it but even more so when they are in a very negative frame of mind generally and especially when they are gripped with the fear. I agree with the "fiddling with the tinkertoys" of the brain chemistry that's just how I picture it lol. The first drugs they tried to get her on sounded so harsh thank goodness she never took them - Risperidone and Procyclidine -one was anti-psychotic and the other was to deal with the side effects, no wonder the very idea of taking them freaked her out - it did me as well! Maybe, just maybe they would have worked for her and prevented this low - but at the time they didn't seem a good idea at all. I think that woman psych overreacted to mum's behaviour and mum did change the way she acted after that run-in.
Thanks for the good thoughts and I hope you loved ones are getting on well too

Thanks so much to everyone who has responded to this thread, I am so sorry I took so long in replying - I actually typed this in notepad cos yesterday the boards wouldn't let me post when I tried! Since I began to type this I have spoken to Mum and Dad and she says while 'she doesn't feel quite right' I'm sure if she had to put it on a scale of 0 to 10 she would rate much higher than last Sunday. She's been able to function as a human being, rather than stay in bed for days. I will keep in touch with them and visit possibly tomorrow. I'm not sure if she's up to seeing the kids yet but maybe they'd do her good. It can't be healthy to avoid things and dwell on oneself when a person is feeling this way. Anyway yesterday they went to Dartmoor and had a picnic for 2 hours, lots of walking and when they got back she "didn't know what to do with herself" so went to bed. She had a nice time while out though and said she's been getting some headaches. I told her I had read that these should pass - it seemed best to stay positive and give these tablets a good chance. I told her to avoid caffeine, alcohol and grapefruit juice (from what I have read on Fluvoxamine these should be avoided) and she said actually she has found that her decaff coffee makes her feel funny on these meds. So I expect she will avoid decaff too now.
Thanks again all, your input is really valuable in helping me and what I pass on has comforted mum and dad greatly .