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1039200 tn?1314912008

New to bipolar! confused about medications

After years of feeling that things were 'speeding up' and an episode this spring which resulted in me losing my job, savings, driving license and 11 year relationship I was finally diagnosed as bipolar.
I started on 600mg tegretol which made me feel better but the dose crept up to1400mg and was still not enough to stop the agitation, hallucinations and delusions. Then 100mg seroquel was added which initially reduced the hallucinations paranoia etc at first, but some symptoms have started to come back, again.
Is it normal for medication which work for a while to lose their effectiveness, and what do you do when this happens? Is it better to change the medication or persevere with the same one in higher doses? Which is safer? Also does this mean my condition is getting worse? I am new to all this and would welcome any opinions.
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Avatar universal
thanks for reply
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574118 tn?1305135284
yes you always do, it will take time since the body adjusts itself in a matter of 2-3 weeks . this applies to AP's in general whether the typical or atypical. just make sure you take your time
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Avatar universal
Hi adel did you get withdrawl symptoms while stopping risperidone?.Just wanted know as i am getting a bit edgy when I tapered the dose to 0.5mg a bit more than when I was 1.5mg.
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574118 tn?1305135284
hi

i never objected to tegretol on the contrary being an old drug all it side effects are well tabulated and known how to handle them.

only if the pt doesn't benefit from it that one has to search for other alternatives. tegretol is effective in mania mainly but seroquel is more effective and for lesser dose. for tegretol to work it needs time while an antipsychotic works much faster that is my point. as to the patient remarks that it worked then doesn't continue to function later, that's because an MS usually pdocs know the dose by monitoring the pt asking him how it works and based upon a slight improvement they increase the dose. i.e. the mechanism of all psyc drugs is that as soon as you take them you notice the improvement but then it declines meaning you need further dose adjustment.  
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Avatar universal
actually tegretol is a vry good and effective medication unless it causes decrease in white cell count.It causes minimal physical side effects unlike other medications and is generally well tolerated.
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574118 tn?1305135284
hi

yes tegretol is quite common to be used in britain because the british pdocs are in general conservative docs so they use what is written in their health guide: tegretol, valproex and lithium. These 3 drugs i claim they are better for mania and not depression because bipolars are supposedly dangerous people in early history. only when their illness is understood and the name manic-depressive is substituted by the more decent word bipolars and even more decent mood swings, they concluded that the bipolar pt must be cured from his depression too. so came the atypical antipsychotics like seroquel and lately abilify, or the AC lamictal widely used in the USA. Many pdocs worldwide gave up tegretol due to its interactivity with other drugs and replaced by trileptal though weaker.

If depression is your issue then either lamictal (AC) or abilify (AP) is a choice. If mania / hypomania or mixed states is a concern then seroquel is best for this. Each of seroquel and abilify has its advantages/drawbacks, the 1st is very sedating and its therapeutic dose starts from 300 and very small doses which i take myself 25mg helps me sleep only but is very subtherapeutic it is good for depression and can be used as monotherapy but less stronger than the activating abilify in this context, again abilify dose is much under so much tolerated whereas seroquel you have to go up to function properly, however will be sedating. so whereas with seroquel you will not turn depressed as an AP, nevertheless a high dose makes you lethargic, so i would discuss abilify with your pdoc especially that i know in britain they advise it alot according to a friend of mine who was there this summer.  

as to bipolarity worsening or meds start not functionning, they do often but not so quickly. my guess it's the dose which needs readjustment.
Helpful - 0
1039200 tn?1314912008
Thank you for your reassurance, it seems that the medication I am on does need adjusting. For starters I would rather be on a therapeutic level of seroquel than an sub clinical level (for obvious resaons) and so will need to talk to my psychiatrist about this. It's also interesting how varied the effects of medication have on different people, I was naiive enough to think that I would be put on one medication and that would be it. It seems that tegretol is not particularly effective for me or I have just developed a tolerance, but as this is not uncommon I won't worry about it. I guess that getting the balance right takes time and depends on each individual person, and I could count myself lucky compared to some.
Helpful - 0
585414 tn?1288941302
No needn't worry. What is available now should be able to help you. There are an increasing number of FDA approved options and I started a forum to make people aware of them to discuss them with their psychiatrist. Research does have a steady but slow pace but new treatments will be available within a reasonable amount of time that I am personally aware of that will have a more favorable recovery rate. In the meantime you could ask your psychiatrist about adjusting what you are on so that you can more fully benefit from it.
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Avatar universal
Sorry, it was DBSA.org not DBSD.
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Avatar universal
When starting out, it takes awhile for your psychiatrist to find the correct medications and their doses.  When turning in the prescriptions, ALWAYS have a consult with the pharmacist...head pharm.  Then when you take them, journal.  Also foods sometimes interact with meds.  Don't drink on bp meds or take cold meds with decongenstints or alcohol.. Drink lots of water, excercise and keep an open line to your psych.
Bp's are smart, deep, intuitive and we are thinkers.  Try to read about the disorder, join a local DBSD.com chapter and know your brain is not the end all say all of who you are. It has a disorder that needs meds to level it out, don't fight it.  Try relaxation/meditation, another purpose besides work and get a Talk doc, mine is Christian but they are out there so you can keep open about what is going on in your life.
Good Luck
Helpful - 0
Avatar universal
Some medications don't work as effectively as others for each person even though the ones of the same classes pretty much work in the same ways.  One medication might be a miracle drug for one person while it might ruin the life of another.  I think one day with all these advancements in studying things at the molecular level that doctors might somehow be able to tell in the future with some kind of crazy advanced technology how a medication will affect each person with probabilities but that day is probably a long ways off.  A person can also build up a tolerance to psych meds.  I know some people like one person for example who has to go in the psych ward every few months to have her medication adjusted because she builds up a tolerance and I guess it's not safe for her to be out while her body isn't adjusted to a therapeutic dose of medication.
Helpful - 0
585414 tn?1288941302
I doubt it means the bipolar is worsening. I did not find Tegretol particularly effective and also I've been on many mood stabilizers that lost their effectiveness. That is not uncommon. Its just a matter of speaking to your psychiatrist about it and changing to another medication under their direction. Personally I found Lamictal a lot more effective and easier to tolerate but each person reacts differently. Seroquel is an antipsychotic used as a mood stabilizer as well so it has the typical side effect profile of an antipsychotic but 100 mg. is a subclinical dose. For me when I was on Seroquel it didn't become effective until 300 mg. Don't make any changes but you could speak to your psychiatrist about all this and here is full information on mood stabilizers in general:
http://www.psycheducation.org/depression/meds/moodstabilizers.htm
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