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Best med(s) for Bipolar-Hypermania Disorder
If I'm on an early 'string', please let me know. I am still new to a forum. I'd like to know what medication is
best for Bi-:Polar/Mania/Severe (and it's rapid cycling)? I hope someone sees and can answer this
question. Thanks in advance, Christine (7-23-13)
best for Bi-:Polar/Mania/Severe (and it's rapid cycling)? I hope someone sees and can answer this
question. Thanks in advance, Christine (7-23-13)
Best Answer
Oh yeah, Anonymouse nailed it. "An important componant of therapy is education." CBT helps with opiates and bipolar, I think that has helped more than anything.
Yeah, don't play super hero with the Hydros. You want to go as slow as you can. You should feel stable, then drop again. Opiates cause our receptors to shrink, they shrivel up into the surface of the brain. It may feel like you don't need the opiates, but it's hard to stabilize once the withdrawal symptoms hit. You shouldn't feel like you need it, that's the point of a taper. Wean down to 0mgs. Getting in a hurry is the most dangerous thing you can do. Though opiate detox alone will not kill you, that's a holllywood legend, but being BP, who knows what will happen. It's better to go slow. After you get of the Hydros, then you will have a base YOU to build upon. Don't over think it. It's easy to psyche yourself into an intense episode. Opiates are no small deal, no matter how small a dose. I was 120 days clean when I had the worst cycle of all. Until you are off opiates for a few weeks or months, you can blame a lot if your instability on detox. Your spirit will come to life in a totally new way. Try to give yourself a break. I know, easier said than done, but the mind is a powerful thing. You will be able to see yourself more clearly once the opiates aren't playing with your mind.
What instructions did she give you for the taper? Rather than just space pills out as much as you can bear (which seems to be not working very well), you might be able to cut some pills in half, provided they aren't extended release, or even do a cross taper to another opiate that comes in smaller doses, so that you can more easily slowly lower your level over time. You might ask for a referral to an addiction specialist to help you taper properly.
By the way, if you have certain pain issues, especially nerve related ones, some of the anticonvulsants used as mood stabilizers can also help with the pain. Oh, and you need to stay the hell away from any SSRI antidepressants (like prozac, paxil, zoloft, luvox, etc.), at least until you're on a mood stabilizer and your mood isn't fluctuating. SSRIs can cause mania in people with bipolar.
You should also get therapy. An important component of therapy for bipolar is education, learning things about the disease and its management. This can cover different med options, reasons why you should take your meds as directed, and strategies to help with episodes, like learning what the warning signs are for you or having a trusted person take over your credit cards when things get bad. CBT (cognitive behavioral therapy) can also help teach you to restructure your problematic thinking patterns and learn to use certain behavioral techniques to control episodes.
I'm glad I could help, and please continue asking questions for as long as you need.
By the way, if you have certain pain issues, especially nerve related ones, some of the anticonvulsants used as mood stabilizers can also help with the pain. Oh, and you need to stay the hell away from any SSRI antidepressants (like prozac, paxil, zoloft, luvox, etc.), at least until you're on a mood stabilizer and your mood isn't fluctuating. SSRIs can cause mania in people with bipolar.
You should also get therapy. An important component of therapy for bipolar is education, learning things about the disease and its management. This can cover different med options, reasons why you should take your meds as directed, and strategies to help with episodes, like learning what the warning signs are for you or having a trusted person take over your credit cards when things get bad. CBT (cognitive behavioral therapy) can also help teach you to restructure your problematic thinking patterns and learn to use certain behavioral techniques to control episodes.
I'm glad I could help, and please continue asking questions for as long as you need.
Good grief - what a manic message! Forgive the redundancy and lack
of chronology. I have a feeling that you 'got' it, regardless. :)
of chronology. I have a feeling that you 'got' it, regardless. :)
Unipolar it is - I'll present it to my psychiatrist on 8/7. I actually made it an
'emergency' appt.. I called my primary doctor and told her what was happening two days before reading your much needed posts today.
I was just excited to being able to taper so quicky-- not making the realizing the correlation between the BP repercussions. She did give me
to much leeway to choose for myself but have, since reading the info so
started a regimen of a much taper today. I just thought 'why take a pill if I don't need it?' So would wait the longest I could, pushing the 'craving' as long as I could bear the discomfort and craving. I was SO proud of myself and didn't make the correlation between the BP intensity and the addiction.
I needed the 'aha' moment you've given me after just two weeks in.
Thank you!
'emergency' appt.. I called my primary doctor and told her what was happening two days before reading your much needed posts today.
I was just excited to being able to taper so quicky-- not making the realizing the correlation between the BP repercussions. She did give me
to much leeway to choose for myself but have, since reading the info so
started a regimen of a much taper today. I just thought 'why take a pill if I don't need it?' So would wait the longest I could, pushing the 'craving' as long as I could bear the discomfort and craving. I was SO proud of myself and didn't make the correlation between the BP intensity and the addiction.
I needed the 'aha' moment you've given me after just two weeks in.
Thank you!
I'm on quitiapine and it has worked brilliant for me.i was in 300 mgs and wanted to wean off again,got down to 150 but mania started coming back again so for back upto 250 and things have settled down so far.i find quitiapine great for calming down mood x
Thank you, Tony. I did so and made it for 8-7. Appreciate the insight as to
why I've been on such a SEVERE roller coaster for the last week+. Hands shaking so badly today; I was hardly able to compose these last two posts.
why I've been on such a SEVERE roller coaster for the last week+. Hands shaking so badly today; I was hardly able to compose these last two posts.
I couldn't remember the acronym 'NOS' you mentioned, when composing that last comment and don't know what it stands for?
Yes, indeed in I am and have been diagnosed as such. Everything you
spoke of as far as reactions to the weaning are what I am experiencing.
I'm tapering much faster than prescribed from my primary care doctor.
After reading your comment, I called and made an 'emergency' appt. with
my psychiatrist.Thanks SO much--your advice was exactly what I needed
today. I'm shaking so badly, I can hardly function. Again, I'm going
through all that you described. At least I know that they are not 'unique'
reactions when dealing with a dual diagnosis.
spoke of as far as reactions to the weaning are what I am experiencing.
I'm tapering much faster than prescribed from my primary care doctor.
After reading your comment, I called and made an 'emergency' appt. with
my psychiatrist.Thanks SO much--your advice was exactly what I needed
today. I'm shaking so badly, I can hardly function. Again, I'm going
through all that you described. At least I know that they are not 'unique'
reactions when dealing with a dual diagnosis.
Yeah, opiate detox would make everything worse. It might even be worth it to wait a little longer to get stable before completing the detox, depending on what your doctor's willing to do.
Are you sure it isn't hypomania? Hypermania isn't an official condition as far as I know, and cyclothymia is mild to moderate depression + hypomania. If you're that severe, I'm wondering if your diagnosis needs an upgrade (although given the length of the episodes, NOS might be what actually fits, if you interpret the DSM strictly).
The crazymeds site is here: http://www.crazymeds.us/pmwiki/pmwiki.php/Main/HomePage
Are you sure it isn't hypomania? Hypermania isn't an official condition as far as I know, and cyclothymia is mild to moderate depression + hypomania. If you're that severe, I'm wondering if your diagnosis needs an upgrade (although given the length of the episodes, NOS might be what actually fits, if you interpret the DSM strictly).
The crazymeds site is here: http://www.crazymeds.us/pmwiki/pmwiki.php/Main/HomePage
The thing about opiate detox, it makes everyone a bit bipolar. The first cycle hit me hard after getting clean. Opiates block the emotional center of the brain, so it felt like a flood of thoughts and feelings, then the bipolar kicked in. I rode it out, I kinda lost it for a few days, but I made it. I'm glad you're tapering, I think that will help. I would definitely get into the doctor sooner than 8/12, when will you be off the hydros completely?
Thank you for your post. The last sentence was 'spot on'. Yes, I'm a rapid
cycler and do have a psychiatrist. Today, was quite a roller-coaster. I'm
also 12 days into detoxing from 10-15 years of a 'therapeutic' addiction
to hydrocodone. It seems to have kicked the BP into overdrive or just
making me more 'aware' of it. Scary; I'll try change my 8/12 appt. with
doc to sooner. Have 'crashed' from today's mania much quicker.
I'll ask him about the meds you wrote of. I am cyclothymic and diagnosed with hypermania/severe and am on a very low dose of the Lamictal, but
have found it the best so far. Thank you for your thoughts. They were
needed just at the right time.
cycler and do have a psychiatrist. Today, was quite a roller-coaster. I'm
also 12 days into detoxing from 10-15 years of a 'therapeutic' addiction
to hydrocodone. It seems to have kicked the BP into overdrive or just
making me more 'aware' of it. Scary; I'll try change my 8/12 appt. with
doc to sooner. Have 'crashed' from today's mania much quicker.
I'll ask him about the meds you wrote of. I am cyclothymic and diagnosed with hypermania/severe and am on a very low dose of the Lamictal, but
have found it the best so far. Thank you for your thoughts. They were
needed just at the right time.
Well, lithium is the gold standard for bipolar I. That being said, depakote outperformed it in clinical trials when it came to controlling mania. Zyprexa (olanzapine) is an atypical antipsychotic that has a reputation for stopping even the worst manias in their tracks, but it comes with one of the largest weight gain risks out of the BP meds.
I suggest you check out the crazymeds pages, both the wiki and the forums. The wiki has information on a large proportion of meds used for BP, both on and off label, and the forums are full of people who have been on multiple medications (it selects for people who have more issues), and can give their personal experiences. Just remember that the internet, and especially forums for people having these issues, will over-estimate negative effects, because people who have good experiences don't tend to go post about them on the internet.
What does your psychiatrist say? If you have severe rapid cycling bipolar, I'm assuming you have a psychiatrist. If not, you really need one.
I suggest you check out the crazymeds pages, both the wiki and the forums. The wiki has information on a large proportion of meds used for BP, both on and off label, and the forums are full of people who have been on multiple medications (it selects for people who have more issues), and can give their personal experiences. Just remember that the internet, and especially forums for people having these issues, will over-estimate negative effects, because people who have good experiences don't tend to go post about them on the internet.
What does your psychiatrist say? If you have severe rapid cycling bipolar, I'm assuming you have a psychiatrist. If not, you really need one.
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NOS stands for "not otherwise specified", which means that you're clearly bipolar, but don't fit into the officially defined categories. For instance, with extreme rapid cycling, you could have clear hypomania, but if you've never had an episode that lasted at least 4 days, it doesn't officially "count". Another example would be having unipolar hypomania: multiple official hypomanic episodes, but no depressions.
Ask your psychiatrist for an even earlier date if possible, and if they absolutely can't, ask to be put on the list if people cancel. It could lead to you having very little notice before the appointment, but it could get you in sooner.
If you're having serious, emergency level problems, like horrible physical distress, or you think you're going to hurt yourself or someone else, or just feel like you're going batshit insane, go to the ER (911 if necessary), and voluntarily commit yourself to inpatient. Things go better for you if you go in voluntarily, and you have the right to take yourself back out. Make sure you read the description of your rights carefully before signing, though. In inpatient, they can help you with the detox symptoms, and can also possibly adjust meds more quickly, since they can better monitor side effects.