Wednesday, November 15, 2006

Meds: What a pain!!

Sarah asked about what kind of a cocktail I'm taking. And it appears my cocktail is changing - with me not happy and arguing with the doctor. He's increasing both my mood stabilizer and anti-psychotic.

I don't usually like talking about meds for three reasons: I don't understand them, I'm not really interested (as long as they work, I'm happy), and I know they work differently for everyone. I would be worried that - if I 'm taking something that works, others would want to ask their doctors for the same thing.

But I'll talk about it now, since it came up. My mood stabilizer is tegretol (or carbamazepine) and I take two anti-psychotics: fluanxol (flupenthixol) and loxapine. I know the fluanxol is a weird one that hardly anyone takes, but I like it because it helps me get up early and I've come to love the long quiet time I can have before the day gets started. Loxapine takes the edge off the fluanxol, which causes a bit of hyper-ness.

BUT now my pdoc wants to increase the tegretol and loxapine. I increased the tegretol several days ago and have been feeling very tired. It's difficult to tell the difference between this tiredness and depression. I don't like this.

AND he wants to increase the loxapine from 10mg to 25mg. I start that today. I'm not happy. How will this affect my functioning? Will this mean less quiet time in the morning?

The REASON for him doing this?
  1. My anger (all reasonable and something that's been around for a long time. It's what has been making me write - for years.)
  2. My frustration (isn't it normal to feel that about things that are not right?)
  3. My impatience (when you see so much pain, isn't that understandable?)
  4. My sense of being overwhelmed (normal when one is small and trying to do a big job)
  5. Brief periods of depression.
  6. Two car accidents within 6 weeks (my fault) and another close one.
I think he's over-reacting. I know it's because he cares, but I don't think I need all this. And is the extra medication that makes me feel so tired going to help me drive better? Don't think so.
How much of what I've been going through has simply been because I care about social justice? And wouldn't anyone who cares about such things or who works on the kind of stuff I've been working on get passionate about it once in a while? I'm a passionate person, no matter where my mood is at.

Is my doctor increasing my meds simply because I've expressed passion?

But I respect the guy and will have to comply - at least give it a try. But I'm not happy.


Anonymous said...

Hi Marja,

mmmm. frustrating.

since i am not around you, i can't really comment about your level of anger, etc.

your husband, and closest friends would be a good barometer for feedback re: are the levels changing up and down, more intense recently?

i do think that you (as i am) are a deep thinker and a passionate person. (probably a lot of people with bipolar are...because we often feel so deeply).

thus, your observations and the products of those observations (ie. articles re: educating the church on mental illness) are SO Beneficial.

there is nothing wrong with that, and i don't see that, alone, being a reason to change meds.

i do know that seasonal changes are a huge trigger for moods to swing (i was just writing about that myself on my blog).

so, it might be that with the shorter daylight hours, your neurotransmitters are not firing at the rate they are supposed to.

my question...(i work in healthcare, so for 10 years i have been surrounded by patients and meds)...i was wondering if you had tried lithium, lithabid, or some form of lith in addition to the antiseziure (tegretol).

i take lithium + topomax. i was on a lot of topomax for years (to treat migraines) and i still escalated myself right on into type I bipolar with psychotic features.

i take lithium carbonate (just 600 mg at night)---it does not take away my spark or creativity. and 250 mg of topomax. i also take 1.5 mg of clonopin a day for anxiety.

and that is working really well for me.

another mood stabilizer that is supposed to help a lot of people is depakote (but it did not work w/ me).

anyway, i would check into maybe adding something to that tegratol, rather than increasing it, if you do make changes.

just my 2 cents.

Anonymous said...

i dont even know what to say butu i can definately say theres a VERY HIGH probability you're tired because of tegretol, it makes me sooooooooooo tired. and in a very weird way klonopin makes me less tired? go fire, meds are as crazy as we are:)

i know its frustrating but maybe your doctor isnt upping your dosages because of what has happened but because he fear what MIGHT happen. maybe its just a precaution you know

and remember for writers, feelings are absolutely essencial so get to the core of whatever you're feeling now and put in on paper, notebook, computer, palm pilot, whatever it is.

i know you'll be ok:)

bipolar_girl said...

Hi Marja! Maybe your dr saw symptoms you're not aware of that's why he's upping your medication. That's the way it's supposed to be,isn't it? Anyways, hang in there and you'll be okay.take care and God bless!

chalexa said...

Marja, you have a definate right to your frustration and anger- to an extent. God wants us to live lives of joy and freedom though! I firstly encourage you to seek out those things, in Him, in your Bible. This week.

You have such a loving and passionate heart, aspiring to be and do things that are probably realistic over the long term.

However, being overwhelmed right now to the extent you are might be a result of percieving the work ahead to be "too big" and "all yours"... i do know about your passions well, and i believe that God has gifted you with them for a reason.

I would encourage you to step back and let God take the steering wheel and relax for a few minutes while you contemplate it. We can't change all things, nor the whole world but we can change what is within our grasp at that moment they are there. You seem to be picturing the present *as well as* future and all the works that come involved with it! Let go, and let God... remember that solid foundation we talked about?

As for your medication? Trust your psychiatrist. He knows you well. The loxapine can sedating, especially at first increase but he knows how much you can tolerate because of your history. Take it at dinner so it wears off by morning until you get used to it. I do agree that living on anger is not the best answer and maybe your quality of life will go up with the changes your doctor has made.

Be encouraged and hang in there sweetie. I'm here for you!!!

Anonymous said...

can you find a happy medium he doesnt say increase your dose and stays in more contact for a while to see how you are stabilising or something like that ?

Bleeding Heart said...

In my personal opinion - the doctor only knows so much...he is doctor who is an expert in medication and the mind and that is it!

He cannot make you do anything or take anything. Do what you feel is right and only take what you feel comfortable with.

Be careful wit Tegretol. That is how my friend got Stephens Johnson Syndrome - from that very same medication.

Hope all is well!

Anonymous said...

Well- I understand your frustrations. I have known my pdoc for a long time and usually trust her opinion when it comes to medications. I would just try and take them as he suggests, and then report what happens honestly to him. He has an outsider's view of what is going on. And if you think things aren't working out- then you'll just have to tell him. Keep a daily journal about how things are going with the medication change and bring it with you to your next appointment. If you have a good pdoc I'm sure that he will listen to you, and value your contribution to your treatment.

Anonymous said...

Hey Marja,

Just checking in...i have been thinking of you and praying for guidance re: your meds decision.

marja said...

Hi Everyone, I was going to write a follow-up post on this topic, but just won't have time for a few days.

I want you all to know that I am very grateful for all your responses. Thank God for bloggers! You've been wonderful friends and have made a big difference in my whole attitude on this med thing. You helped me see that - though I was functioning fine, and normal in mood on the outside - stuff was happening on the inside that were not good.

You have helped me see that my doctor is really quite a smart guy and that I do need this extra medication. I took my first dose of extra loxapine last night and, though it was sedating, I felt wonderfully at peace.

I can see I've been fighting too much inside. And Chalexa, you're absolutely right in everything you said.

I don't know what I would have done without you all. You helped me come to terms with things. You helped me see that things were really not as they should be with me.

Thank you so much for the prayers.

Love, marja

marja said...

Must add this:

Sarah: I've been taking 800mg of tegretol for years now, and it didn't make me tired until I just added this extra 200mg. My pharmacist told me the tiredness will wear off once your body adjusts.
Amateur dancer: Thank you for your prayers and for checking in on me. I feel taken care of.

shebee said...

I'm sorry you're so frustrated...I would be too. Like myself, apart from being bipolar, you have a sanguine personality...high highs and low lows, which makes you a very passionate person...that doesn't necessarily mean you need to change your meds!!! But hey, I think you're doing the right thing by at least giving it a try. Hang in're in my thoughts and prayers.
Love Shebee

Anonymous said...

Hi Marja,

I just wanted you to know that I read your post on Chalexa's Blog. Your words did not go unnoticed.

I know that is a lonely call. You are a very strong woman, to go through all of this...because it is a spiritual journey, our spirit is a huge part of our "being" (have you read "The Road Less Traveled")

I will be praying for your situation. And, keep believing that Romans 8:28 for ALLLLLLLLL circumstances...

Lots of Love,