Which would you choose - mental chaos or problematic side effects

[PenelopeAnn]

I know my dr is going to suggest Lamictal when I go on the 10th. I don't like Lamictal but the drs like it for bipolar depression. I can't take antidepressants because they spur mixed and manic episodes and I'm already having those. I'm rapid cycling with serious depressions, possibly dangerous to myself depressions where my thought processes are about death and dying but my feelings are of a quiet euphoria, everything taking on a deeper meaning. This usually happens just before the crying jag depression, which is followed by the blank-brained, catatonic depression. The whole thing lasting only days - but severe.
Name a drug and I have been on it. I am side effect prone. The class of drugs that Lamictal is in gives double vision, poor coordination and sedation even at low doses. I can't drive safely. I can't read, watch tv, be on the computer unless I have one eye closed. I tend to fall down the stairs. Even at the lower doses.
The only reason I am able to take the drugs I am on - Lithium and Seroquel - is because they come in extended release and this cuts down on the side effects. I take them at night so I sleep through the initial sedation. And I do do my part. I exercise, I do yoga, I don't drink or use drugs, I go to therapy, I keep to my sleep schedule, I take my meds, I make my appts, I am educated on my disorder, I have insight into my cycles and monitor my moods.
I feel I am at a point where I have to decide between frequent (rapid cycling where a whole cycle lasts maybe a week with a few days of 'normal' in between, rinse and repeat) intermittent mental chaos and missing out on something due to sedation and being dependent on family because I can't drive seeing double. This in itself could cause depression and despair.
I will make my own decision, just curious what you all thought, input, experiences, etc.

[PenelopeAnn]

Your tremors are how I was when I take regular Lithium--spilling my drinks all over myself. Depakote messed with my hormones and I got a lot yeast infections then. Thanks for being brave and mentioning the embarrassing side effects. I don't mind the constant crying depression as much because I can still do stuff, just do it crying. When I get my catanic depressions I can't even think of the steps involved in brushing my teeth. I'm a blank mentally and physically. But it is the combination of mania and depression that is my most dangerous and which I have been having, but as I said in my last post, I feel things evening out, so maybe I'm in luck. We'll see!

[Yvette97]

I am a little in your boat with the sensitive nervous system and meds situation. I just weaned of depakote due to tremors big time after having been on it for 12 years. My head was bobbing and my hands couldn't hold a cup of coffee without burning my lap most of the time.So....doc said, "let's try something different". I took lamictal for 6 days and had to stop. Eyesight was my first downfall, I did the one eyed driving routine too. Then non stop yawning but insomnia at night which was followed by slow spiral into depression. this was all in 6 days. Here is the clincher..hopefully it will not be too gross for some members but my vagina was burning non stop as well as my mouth. So, I guess my mucus membranes were rebelling and I could not have a bowel movement to save my life. Then came the rash. Not the Stevens Johnson die from rash but a itchy, scratchty, rash that drove me nuts. So, I'm off the stuff and I cannot go back on depakote. My next move is to see the pdoc again and ask what else he has up his sleeve. Because even though the med changes and side effect issues can be a nightmare I will still seek out a med I can tolerate and one that keeps me on an even keel. I only have to think back to my pre medication days and remember my then 8 year old little girl climbing into my bed and wrapping her arms around me and sobbing! I asked her why she was crying and she said, "mommy, I'm afraid you are going to die because you are too sad all the time". I had been in bed on and off for 6 days and tears would just slide down my face no matter if I was peeling potatos or folding towels. I didn't even realize it. But she saw. That is the first time I went to get help and I got my dx. So, if you could at all stick it out and try to find a good mix even though it is hard I will be there with you doing it too. I don't look forward to finding out what the doc thinks might be a good next med but I am willing to try it. Good luck to you.

[PenelopeAnn]

Well, since I've made this first post, I've had another string of 'normal' days. I hoping this means the severe highs and lows every few days is easy up. I'm hoping I won't have to make this decision after all.

[shiverl]

I feel like I can understand some of what you're going through.  I have been on zyprexa for the past 6 months and have been taking many sick days from work because of brain fogginess, light headedness, and blurred vision.  

At times, I cannot read the words on my computer screen.  My doctor tried lowering my dosage 2 weeks ago and the depression hit, so he raised it back to the prior dosage and I'm still with the side effects.  

My husband always cringes when my meds change, but I've spoken with him and he knows that I've tried, but I just can't take the side effects anymore.  I have an appointment on Wednesday and I'm going to ask that I be taken off zyprexa for good, and pray that a bad episode won't follow.  

It's very difficult to have a bipolar episode, but it's equally difficult to live everyday sick due to the meds side effects.  I don't think that either is an easy solution.  I admire you for sticking it out and appearing to have such a positive attitude anyhow.

[horselover65]

You're between a rock and a hard place. Having had, and continuing to have, issues with finding words/losing vocabulary/comprehension, memory, and concentration, I still consider those losses more tolerable than physical coordination or vision problems. I'm having tremors now and it's a lot harder on me than the other things. That's just personal opinion. It would be hard to think about giving up the car, sedation is difficult and overall it sounds like a situation where you'd have to proceed with caution. I hope they start you on a low dose and can keep you on a low dose that doesn't cause any of the side effects you've had before. Best of luck to you.  

[PenelopeAnn]

I was excited when Abilify came along. My pdoc started me on it. She told me that many people with bipolar have discovered they only need this one med. Bring it on! Unfortunately, it caused really bad akathisia, and a jittery-I'm sleepy-but can't sleep feeling at the beginning doses.

I took Lamictal years ago during a crisis period when I was hospitalized and post hospitalization for awhile. As soon as I felt stable I explained to my pdoc that I had to get off the Lamictal as it was making my life miserable. Falling down the stairs, walking into walls, unable to see unless I had one eye closed due to double vision, so I couldn't drive. I had to have someone drive me everywhere. I couldn't read or watch tv or be on the computer. It was also very sedating and made me numb, much like Zyprexa and Risperidol made me feel. I was miserable. The day I'd had enough was the day I went down a small but steep hill to fetch a tennis ball for my dog. I couldn't get back up, nobody was home. I had to wait for help. If I remember correctly I was taking 150mg BID. The second time, years later, that I went on it was with a different dr and he felt that it was really what I needed. So I agreed to start at a low dose at bedtime. I decided I would look at it with fresh eyes and hope it wouldn't be the same. Then he pushed to increase it, then a dose in the am. Still, it was in total a low dose. It caused sedation and poor coordination. We started at 25mg and raised it by 25mg at a time. We didn't get far. I get the same side effects with Triletpal and Tegretol, which have been tried. I can't take Topomax either, word finding and short term memory problems. Depakote stopped my periods.
I take a low dose of Neurontin and zonisamide for trigeminal neuralgia, a nerve pain disorder. They cause the same symptoms at higher dosages, but I was able to communicate with my new neurologist that I needed to start at low doses in hopes a low dose helped or I'd end up with the same side effects I get with Lamictal. I know because I've on higher doses of Neurontin with the very same side effects.

[ILADVOCATE]

If you've had this side effect from Lamictal before that's one issue. If not you can't assume you will get it. Unless your psychiatrist or doctor has determined it will happen start it with a fresh perspective. There are certain side effects I'm very suspectable to and certain classes of medication I can't take. However, my friend finds Klonopin to be sedating and I have no problem with it. Everyone reacts differently. Generally the side effect profile of Lamictal is a lot more tolerable than Lithium. And it has a strong anti-depressent effect. Abilify does generally have less side effects than Seroquel but its less of a mood stabilizer. If you go on Lamictal you'll have to raise it by 25 mg. a week by FDA regulation so it will take two months or so to build up to a full dose. You'll feel a bit slogged at first as I did and once its completed your psychiatrist can see whether the lithium you are on can be lowered or discontinued. Lamictal is an adjunct mood stabilizer for some but for a good number of people including myself it was a primary (stand alone) mood stabilizer (with an antipsychotic) and it is FDA approved as a first line mood stabilizer.

[ohanamama]

Wow, you are in a tough position.  I've been blessed with a liver that can take anything you put its way, so side effects for me are limited to digestive issues and headaches.  I can say that after years of mixing-matching-trying-changing I'm thrilled with the results of my current combination of meds, side-effects be damned!  The ability to live life on an even keel, to stop the crazy ups and downs that practically break your neck, to find a place where you can make relationships again because you're not bouncing off of walls -- for me it was worth trying and trying again.  Whether those changes are in dosing, time of day you take the med, or changing the med itself, riding it out until you find the right mix is well worth it!  You've got two meds working for you, you just need one more to boost up the depression.  Patience.  You're talking about a life-time of relief.  You said you've taken them all, does that include Abilify?  It's one of the newest that seems to work for a lot of people.  And if it has to be Lamictal - smaller doses more times a day?  With food?  Without food?  Keep trying, but do what is best for you, always.  And only you know that.  Good Luck!  We'll be thinking about you on the 10th.

[bernie40]

Hi,  I've asked myself this question many times and sometimes it's one and sometimes it's the other.  When I'm cycling I want the the stability with side effects.  When I'm experiencing side effects I'd rather have the cycling.  

Like you say it is a very personal decision as it is you that has to live with what is going on.

Luckily I have now found a med that doesn't give me bad side effects and has calmed my mood swings.  I know that a lot of people aren't so fortunate.  As to what I would do had I tried every option, I don't think I can honestly answer that one.

You must do what is right for you.

Thinking of you xx