Tuesday, July 28, 2009

Meds - Pt 1

These are the medications on which I rely to manage Bipolar Disorder. (The generic name for each medication is given in parentheses.) Because the disorder varies in intensity from one person to another, and because each person's biochemistry is unique, what works for me would not necessarily work for someone else.

Main line of defense: Lamictal. Has anti-manic and anti-depressant properties. Basic tool for combating the disorder.

Close support: Klonopin. Mood stabilizer. Comes in handy for mitigating serious depressions and anxiety attacks. Also has some sedative properties.

Reserve support: Ambien. Used occasionally when it seems likely I will not otherwise get enough sleep.

Discontinued: Depakote. Along with lithium, the standard prophylactic against mania. But even at low doses usually results in weight gain -- in my case as much as thirty pounds -- and given the history of heart disease in my family and the conscientious way in which I have addressed the disorder, my psychiatrist and I decided two years ago to rely exclusively on Lamictal coupled with good sleep hygiene. Has worked well: no hypomanic episodes during that period.

Part 1 - Part 2

3 comments:

Anonymous said...

I have been off Depakote for 4 years now. I had gained 50 lbs and my liver started to fail. They cycled me off in one horrible summer and onto Topamax. Before I had also used Klonopin as a rescue for breakthroughs. After the transition, I have been stable and very happy on this routine:

morning:
80 mg Prozac (fluoxotine) morning as anti-depressant
100 mg Topamax (Topiramate) anti-manic and mood stabilizer without making you a zombie.

evening:
200 mg Topamax (Topiramate) anti-manic and mood stabilizer.

I have the clonazepam but haven't used it in years and also sleep well without aid. My liver is doing much better and I have lost about 30 pounds.

There were some funny tasting things at first with the Topomax but I saw it as an opportunity to lose weight. I have felt more alert and don't have the word aphasia I had on Depakote.
I also am eating less fast food and more fresh vegetables.

Anonymous said...

Isn't it funny that most of us who utilize psychotropic meds in order to participate fully in our lives; have experienced side effects that could potentially end them? The past several years I have asked one simple question: "how will this aid in my recovery?". As it was said before, Bipolar Disorder is complex and chonic. Therefore, my approach towards wellness must follow the same suit. Meds are but one line of defense. I also use nutritional wellness, physical wellness, spiritual wellness, social wellness... Afterall, I am a whole person. And the 'mind/body connection' is much more than the neck.

Mark Grimsley said...

I wholly concur. The most problematic aspect of this approach -- and I recognize it does not seem to be a path you have taken -- is to dispense with medications altogether. I've noticed in the bipolar blogosphere a few instances where this has been advocated.

I can understand why some persons with bipolar disorder would wish to do this, and I'm willing to believe that some have been successful. But the efficacy of this approach depends upon the severity of the disorder, which, as I say, varies widely from person to person. I doubt, for instance, that it would be wise for me to dispense with medications altogether. As you indicate, though, it is only a single tool, and by bringing other tools to bear, I have found it possible to reduce reliance on the pharmaceutical tool.

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