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Bipolar Disorder Community
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2010625 tn?1329375656

medication sensitivities?

Is it common to have a bad reaction or get bad side effects at the lowest doses of almost every psychotropic medication tried? I have tried 6 different antipsychotics, I had bad side effects at the lowest dose, and can't take them. 4 SSRI antidepressants, bad side effects at lowest dose, can't take them. I also can't take Welbutrin, Depokote, Effexor, vistaril, This can't be normal right? I can tolerate a few medications at small or regular doses, but do not control my BP or anxiety symptoms these include buspar (did absolutely nothing that i noticed), lamictal could take 200mg, but not 300mg when tried an increase. Trazodone did ok on 150mg at night. Xanax, and Ativan, did ok on and has been the only thing to help my anxiety without bad side effects, and I have only taken them at lower doses. Is this a common occurrence or experience other people have had? I am starting to wonder if I just have problems metabolizing them or something???? I also can't take some pain medications tramadol not at all, and can only take one half to one lortab 5 and no more, I can't tolerate alcohol either it just makes me feel sick, not enjoyable to me at all. So what do you guys think normal or not?
34 Responses
2010625 tn?1329375656
I am only on gabapentin now, and I think it is making me feel stupid. I am having memory problems, trouble thinking, and concentrating, I am going to give it a bit longer as I have not been on it very long ( 2 weeks 3 days), but I don't think this one is going to work out either......sigh.....
1551327 tn?1514049467
COMMUNITY LEADER
It is very common to have side effect in the beginning when you start a new medicine.  That is one of the reasons thay start you out on a low dose although they know it will take a little while to reach a therapeutic level.  I will say that I have taken a lot of different combinations of meds but your experience does seem a little odd.  I am surprised that you had so many horrible side effects.  
I do know that if you are currently taking pain medicine it will definitely effect the therapeutic effect of many (perhaps most) bipolar meds.  Also alcohol is one of the worst things you can consume while taking these meds so if you have to drink don't drink too much in any given day and try not to drink very often.
If most of your problems with the meds are that they make you feel less intelligent or they make you feel "not like yourself" then don't be afraid of the medicines.  At first I thought that mine took away my creativity and my personality.  In a sense that is what they are supposed to do.  No matter the meds you take you are going to feel different...that is there job.  We are not able to control our moods cognitively.  At first the meds can make you feel the way you describe but please give the meds you are on know a chance.
No matter what I say most of us go on and off our meds because when we do a lot of times we get a euphoric feeling but the high is not worth the low.  It took me a long time to accept my lack of euphoria.  Also when you get the cycles under control you may be like me and find that there are also some other disorders or problems that present themselves like ADD and OCD.  These are things that although you can take medicine for, you have to learn how to control them.
This is just general information based on what I have read in your post.  everyone is different but I hope you got something from it.  Let us know how the medicines are working.  This will get better but unfortunately it takes a while.  You can't give up because in my experience this disorder can worsen over time.  Don't learn the hard way like I did.  You are young and you have a better chance of getting stable than I did and I am not even that stable right now.
Avatar universal
You may be unable to metabolize drugs efficiently.  Since women are often not included in clinical trials determining dosage, even the "normal" dose can be too large for even the average woman.  A recent example is the recommendation for the standard Ambien dosage to now be 5 mg for women and 10 mg for men (when it used to be 10 mg for everyone).  If you're particularly thin, this could also play a role in what the appropriate dose is for you.  A mg/kg approach, the way they determine medications in pediatric patients, might help if this is the case.

Or you could have inefficient enzymes.  Maybe you should get your liver checked?  That's what does the filtering in the majority of medications (and alcohol).  Have you tried lithium?  I think it's controlled by the kidneys, so if it is a liver enzyme issue, that one might work for you.  You could retry the antipsychotics at even lower doses if they're in a form that's splittable, or maybe try one of the anticonvulsants approved in children, since those will come in smaller forms.  Since you can tolerate Lamictal fairly well, using it plus something else at a really low dose might be the thing that works.  And antidepressants, especially SSRIs, are generally a no-no for bipolar, especially if you don't have a mood stabilizer on board already.  You should definitely talk to your doctor about this, and bring up your concerns about metabolism.
2010625 tn?1329375656
I had reactions like make me feel dizzy, like I was going to pass out/faint, vision problems = abilify, seroquel. Extreme body aches = geodon. Extreme body aches, akatishia, neausia = Latuda. Slightly elevated blood sugar, and as the nurse said the highest prolactin level she has ever seen = risperdal. Complete zombie = Invega. Flatline emotions, couldn't get sad, or happy, no opionon or care about anything = Zoloft. Had no effect at lowest dose, so raised dose falling asleep at work = Paxil. Made my thighs tingle, and numb, excessive vagina secretions (like when aroused) = Celexa. They told me to take it in the morning because it would give me energy so I did and two hours later I was falling asleep, so had to take at night, gave me a headache the entire time I was on it = Lexapro. Had a headache the entire time I was on it = Welbutrin. Made me fall asleep, then I would wake up super grumpy and yell at everyone = Vistaril. I was on the combo of depakote and effexor so not sure which one it was, but I was only awake 4-6 hours a day and slept the rest of the time. Did not control my symptoms when raised from 200mg to 300mg gave me migraine headaches = Lamictal. I can take 150mg if I take more gives me headaches = Trazodone. Had no effect therapeutic, nor side effect even when dose was raised = buspar. At least 85% of these side effects I had at the lowest doses, and sometimes but not always I would try these medications for 1 + months and the side effects never went away. Taking these medications has never controlled my symptoms, and really has just made me more sick instead of better. I don't normally drink alcohol anyways maybe once every 6 months for the last 3 years on average, and part of the reason why is that it just makes me feel sick, and has given me this effect even when I was on no medication. I don't always take pain medication, I have back problems, and actually have had most of these side effects from the psychotropic medications when I was on no pain medication. I don't get that euphoric and when I do it is really not that great, and totally unrealistic anyways. I do find that they do hinder my creativity but oh well. I really wish these medications did work for me, because I really don't want that ECT crap it takes out huge chunks of memory. I have also gotten sick from taking birth controll. I am tired of trying pills with hopes of them making me better, and only ending up with bad results.
1551327 tn?1514049467
COMMUNITY LEADER
I don't blame you about the ECT.  It has been offered to me when I stay manic too long.  I have talked to some people that said it worked well but I am afraid to do it and I would have to be in really bad shape...I'm talking manic for months will loads of self harm and perhaps several suicide attempts to even consider it.  I know a lot about bipolar, medications for it, and how to fight the depression that comes along with it but I wish I could offer you something.  
I don't know if you hve tried Lithium but you have likely had the option before if not but it does have some side effects and I don't blame you if you don't want to try it.
There are a few out there that you haven't tried.  What confuses me is I have read a lot about the BP meds and I have heard of all of them having side effects but never some serious ones with all of them.
All I have left to offer is to say that you likely know but depression causes a lot of concentration problems and sometimes some CBT can help in pulling you out of depression.
What is your creative outlet?  How long has it been since you have done it?  I have taken a lot of BP meds as well.  Most of what you said and some more that you didn't.  I finally found the combination that works for me after 2 years and over 160 days in treatment.  I know you are tired of being a guinea pig but don't give up.  I don't know how depressed you are but it sounds pretty bad.  If you cannot take the meds, then your only option is to use what you do have control over and try to find ways to keep your mood under control.  Whatever you can do.  I wrote some of my theories on fighting depression on someone's post on the depression forum.  The question was "Giving Up On Life.  When you get time or just want to read something you can check it out and see if any of it at all could help or at least show you how crazy I think>>>:P
2010625 tn?1329375656
I haven't tried Lithium, and honestly after all my bad experience with medications I am stating to get anxiety attacks when I try a new one, but it is not like my reaction is unrealistic or unwarranted in my case. I was really thinking about trying more natural methods. I don't really feel that depressed, frustrated would be a better definition of how I feel. I guess I really should talk this over with my psychiatrist, but don't have an appointment until May 9th. He may just tell me I need to go to the medical doctor, and see what they think too. I really wish I could get a therapist, but I can't until my medical insurance kicks in, in July. I know it is weird I have these kinds of reactions to medications, I really do wonder if I don't metabolize them right or something. Do you think having IBS (irritable bowel syndrome) could cause me to have problems with metabolizing medications, because I do have that. Sigh I don't know....
1551327 tn?1514049467
COMMUNITY LEADER
I have known a few people with IBS and if I had to just guess I would say that since some medicines are excreted through urine and some through number 2.  I am not sure which ones but I think it may be possible, don't know.  Your psych dr may send you to med dr and that would actually be smart.  Psychiatrist are amazing with their understanding of how the mind works and the medicines for it...all of them but the ones I have met.  Tha medical dr can likely tell you why you are having so many problems with the meds and then if that can be treated you night be able to try some mood stabilizers again.
I hope this works out well for you and let me know how it goes.
Avatar universal
I just looked up most of the drugs you mentioned in your original post, and they're all metabolized in the liver (to be fair, most drugs are).  Ask your doctor about getting liver function tests and whatever other studies you would need to see if your liver is working properly.  Poor liver circulation can be problematic, but you might have defective enzymes (or something).  Lithium is actually excreted unchanged, and it processed through the kidneys, so I think it might be your best shot if your liver is the issue.  Poor metabolism would cause drugs to build up very quickly to toxic levels, because you wouldn't be getting rid of them as fast as they were coming in.  Then again, I'm not sure how Lamictal fits in, since you tolerate it at higher doses than other things, but I've heard of some people taking 800 mg of Lamictal before (even though that's above recommended levels).

It's just a theory, but I think it's worth getting your liver checked out and giving lithium a try.  And maybe retrying other things that come in tiny doses or can be split to see if those work.

Did the Lamictal help at all when you were on 200 mg?  Lots of people end up needing med combos, so that one *might* be a good starting point, if it does something but not enough at the dose you can tolerate.

If anything, I would guess that IBS would reduce absorption of medications, but that's just a guess.  Don't quote me on that one.
1985196 tn?1402193698
HI , I haven't had many issue's with med's myself but my mother is the same as you , i didn't read all the effect's different med's had on you but i do know that my mum she can hardly take anything including most pain medication anti depressant's , mood stabilizer's aswell as anti psychotics , nothing agree's with her and she's not a real big woman either .
2010625 tn?1329375656
I am not that small in size 5'8" 200lbs. I gained weight unfortunately as the bipolar and anxiety and back problems got worse. I actually got my liver function tested before when they figured out I had IBS they tested just about everything that had to do with the digestion process actually, and everything was fine. That is part of how they come to a diagnosis of IBS they rule everything else out. I guess I could always get it checked again, and the doctor may have a few more idea about what to test. I don't know if the Lamictal actually helped or not. I still had a rapid cycling w/mixed episodes, and some bad anxiety when I was on it in combo with the trazodone. I really wonder if those Antipsychotics fried my brain or something. I am really sick, and I don't know what is wrong with me, and without insurance I can just go to clinics. I am sick of being sick. :-( Part of the reason they put me on Gabapentin specifically is because I am having body aches for no apparent reason. I thought these body aches were because of the Latuda, and actually when I went off of it the body aches went away within two days. I was fine for two months then boom rapid cycling, extreme anxiety, horrid body aches, amongst a bunch of other weird symptoms and I was only on Lamictal and Trazodone. urgh, sigh, urgh, sigh, sigh...........
Avatar universal
It is difficult when your on 2 or more meds at the same time to know which one is causing what. For some people just have one works, it's when you put it in a mix that changes things. It's best to try one at a time if you can.

A thought, I have heard many people have side effects months lasting up to a year from a drug. I know yours temp went away but I'm wondering if the ones you tried before and stopped could be causing your body aches. It could just be one of them out of the mix. I too am very very sensitive to meds and take very low doses. Have tried many and had to stop.

Have they ruled out Cronic Fatigue Syndrome or Fibromyalgia? Have you thought about getting a detox cleanse at the health food store?
Avatar universal
One more thing. My psyc dr prescribed Deplin for me  which is L-Methylfolate (a breakdown of folic acid). Don't worry it's not medication. You need a rx and Deplin has a coupon on line. Research it, you might want to try it. Over the counter has fillers and is not high quality.
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