Atypical Antipsychotics

[Paz]

 I have been doing a lot of research and asking Docs about the use of atypical antipsychotics in people who suffer from Bipolar 2.
 
 What I found out is kind of disturbing......

 Atypical Antipsychotics are only supposed to be used for people who suffer from Bipolar 1 mania [or schizophrenia]. They do NOT help people with Bipolar2! So if you have BP2 you are taking an unnecessary & dangerous mind altering drug! Read any leaflet [the really fine print] that comes with these drugs, and you will see that it says this, go to any website like NIMH, etc, or even a drug website and you will see that these drugs are for symptoms of BP1 mania & psychosis.

 If any of you are BP2 and are on any drug like this [seroquel, abilify, geodon, zyprexa] your Doc should be slapped. They are prescribing it unneccessarily to you. I would question any Pdoc who thinks that a BP2 needs these strong drugs. They should have their License to practice medicine investigated.
 
 I don't want to scare anyone, but you should really check it out, why take something that has horrible side effects [long term health problems, weight gain, etc] and is potentially harming your brain and possibly altering your brains way of thinking......if you do not get mania or psychosis, you do not need these meds!!!

 FYI, I have asked 4 different Pdocs about this, and they all told me the same thing, and I've visited many drug websites and mental health websites, so I'm not just talking out of my ass. And I have always paid top dollar for my mental health care, so I trust what the Docs & therapists have told me. They know how I feel about meds, they say since I am a BP1 maniac that I am someone who needs these types of drugs, but I won't take them unless I am in a major freakout, and when I do, it's for short term use. If you are not manic, you should not be taking these meds everyday, it's not necessary, and it is harmful to your health!


 

[Phyllis]

So then, what are some meds we should be asking our docs about to take care of  racing thoughts? I will be honest with you, I only take my Seroquel once a day (at night) and it is rx'd for me to take 3 times a day. It was given to me in the very beginning to cut down the racing thoughts and emptiness in my head along with my rage (In the beginning i was on 600mg of it!). I'm off of the Abilify, but it did help me quite a bit. (They are now marketing the Abilify as an add on for depression treatment)

I have been quite proud of myself though. I have been having some serious bouts of rage lately and my mind tells me to take a Seroquel because I know that will calm me down better than Ativan (of course it will! It's a lot stronger!) I have even been steering clear of the Ativan. And I am very happy that I had another med knocked off my cocktail more or less (the Lunesta) so I am only down to taking 3 meds for my BP now. 4 if you count the Ativan. I found some old medicine bottles from 2007... I was on 200mg of Trileptal 3x a day! YIKES!

But back to the antipsychotics....

I think I am probably addicted to the Seroquel in all honesty. And not for the high (that doesn't happen on the extended release -- at least not to me). But more out of habit and fear of if I stop taking it the racing thoughts are going to come back. But, I'm working on it....

[Paz]

 Antipsychotics are not for racing thoughts, that is what your mood stabilizer is for! If your mood stabilizer isn't cutting it, then the dosage needs to be increased, or perhaps you need to try a different one. Antipsychotics are for stopping psychosis and mania, not for racing thoughts. Sometimes people need 2 mood stabilizers,[I used to take 2, lithium & depakote at the same time] and that helped immensely. If your current mood stabilizer seems ineffective, then ask for a dosage increase, if that doesn't work, maybe you could take something else. I know that you don't get mania, and I hate to think of you harming your body from taking a med that's not necessary.....and Ativan is a good drug, why not ask for the larger dose of that so you don't need to take seroquel?

 Seroquel is not addictive, check this out:
" Technically, no, seroquel does not have addictive properties. However, you can become psychologically addicted to the benefits it may offer you...decreased anxiety, better sleeping, etc. Thus, if you were to stop taking it, you may feel "withdrawal" ie increased anxiety, due to lack of the drug. Always taper seroquel when discontinuing to avoid these symptoms.
 
 Atypical antipsychotics are not addictive.


 Lithium is the gold standard for Bipolar and racing thoughts, have you ever been on it? It really works, it's just that for me the side effects were intolerable[same with depakote, unfortunately I am very med sensitive, and crazy as a loon! a very bad combo being a BP1 maniac  ]

[Phyllis]

guess I should sue for malpractice then. 

prior to my diagnosis, I did have mania. that is one of the things that prompted me to get help. Going days at a time with no sleep isn't good for ya, as you know. I had other symptoms of mania as well, but I'm not going to get into a long tirade and I'm not trying to justify myself here.

Seriously, you should probably look into go going to school for psychology or psychiatry. You have the means to go to school, you have the smarts, obviously. And it would do you some good to get out once in a while. You know, they say it's never too late to go back to school.

[Phyllis]

meant to edit the above post again, but it wouldn't let me (something about not being able to verify something... it happened earlier to me today as well...)

Anyhow... No, I have never been on Lithium. Yes, I know it is gold standard. But, there are a lot of people that have never been on it, I think it just depends on the doctor and if they feel that it is worth it. I'm glad I'm not on it though. As it is, I hate going to get labs done every 6 months, let alone 3 months, and 500 bucks a pop for lab work coming out of my pocket??? Nope. Now, I don't know how much lab work would cost being on the lithium. I just know my lab work for my cholesterol and lupus stuff runs that high. I have a pending bill right now that I have to get paid by next month or else I can't get my labs done for my cholesterol meds.

And as for much information you give on the subject of the dangers of atypicals, I can retort with just as much information that states the opposite. Many months ago (maybe even a year or more) I started a post about both sides of atypical's. And of course for one reason or another the post didn't go through and I had to start all over again so I just said fuck it and didn't start over....

It is a very "hot topic". So, I'm not saying you are right. I'm not saying I am right. All I am saying is that there are many schools of thought on this topic and I don't think anyone will ever get to the bottom of the actual "answer", "truth" or whatever you wanna call it. With that being said, I will humbly agree to disagree with you on this one. 

[Dreamline]

The lithium serum is pretty cheap compared to most lab work.  I don't know how much it is because I don't have to pay for mine.  I don't know why you haven't tried it.  Its worth a shot...I'm glad I did, and it works on the mania and depression.

Were you DX'd as manic by a pdoc?  Why did they not DX you as BP1 but 2?  Not sleeping for a few days is no good but what makes somebody manic vs hypo is their functioning (and duration)...the symptoms are the same.

There's no doubt a-typicals are dangerous esp the higher the dose.  Therefore its best to take a mood stabilizer or two than one of those.  And adding them to antidepressants is a new trend even though augmenting them with mood stabilizers could be tried first.  Its one thing if a person's depression is psychotic then ok yeah.  Anyway what I'm saying is it should be a holistic approach not just smack it with the hardest drug for it, even against the labeling.  I don't know why anybody would want to do that?  That would be like my p/doc prescribing me haldol on my 1st appointment instead of lithium.

[Paz]

 All I can say is what I've heard from Pdocs......and the ones in the Seattle are really very well versed in the med thing......Seattle was the proving ground for the benefits of Prozac for depression all those years ago. I think that they are pretty good at figuring out what meds are helpful.

 Didn't your Doc lose her license to practice awhile back? If that is true, I would get a second opinion on your med regimen, you still feel rage, you still can't sleep, and you still feel badly on all of the meds that they want you to take. Pills don't solve everything, and if your body is so used to them that they don't seem to work any more, well, maybe it's time for a different med regimen and therapy to help you cope with living.

  Just my opinion, and we all know opinions are like assholes.....everyone has them!       Love ya Miz Coffee!
 

[spongebobfan]

All very interesting thoughts. I agree that docs should try less harmful meds before bringing out the more hard core ones. However I try to keep in mind that every situation is different and some medications do have off label uses. Just because the primary use for these meds is treatment of psychosis and mania doesn't mean they are not also useful for many other things. If the patient and doctor have thoroughly discussed the risk vs benefit of the med in relation to the situation then there shouldn't be a problem. Now don't get me wrong I don't think doctors know everything. Lithium has extreme side effects and many pts are not compliant enough to do follow up labs which just increases there risk. In my mind the possible effects from lithium toxicity and the effects from atypical antipsychotics are on the same level. I've seen severe lithium toxicity twice and it is very scary as I'm sure you know.scary enough that I never want to take it!
Thanks for sharing. Just curious, do you have a medical background or have you just researched a lot of psych stuff?

[Phyllis]

I was diagnosed with having Bipolar by a psychiatrist who then recommended 2 pdocs. The psychiatrist is the one who told me I had mania (days awake, feeling like I was the be all and end all and nothing could stop me or hurt me, hyper then depressed then back up etc etc etc... Living with me was no fun. I was evil evil evil....) I was diagnosed by Pdoc with bp2 after I took some tests and we talked for a long while and with my previous history of depression and the "mania" not lasting long, from what I understand that was the reasoning for the bp2 diagnosis.

I find no reason to change my medication at the moment. My cocktail of anti-depressant, mood stabilizer, and anti-psychotic seem to do the trick right now. I know you all don't agree, but it's what works for me. I have tried some herbal remedies in the past for depression, sleep, and relaxation and they didn't work for me. But that is me. We are all different... none of us with this bullcrap is the exact same as another person with it. If that were the case, we could all drink from the well and be cured forever....  

[Phyllis]

she didn't lose her license to practice, she was put on suspension for 6 months because one of her patience o.d. at least that is what the records from the hearing with the medical board I found said... Yeah, it freaked me out when I found that information out, but I look at things differently than most people. And I have looked around here and there are not many pdoc's. Not English speaking ones anyway. 

[spongebobfan]

Phyllis I hope you didn't think my post was saying u should switch things up. I meant the opposite. That if those meds work for you and you and your Poc feel the benefit is greater than risk then you are probably doing the right thing :-)
I'm happy to hear you are doing well! Have a fabulous weekend!

[Phyllis]

no worries spongebob 

[Paz]

 Miz Coffee, I worry about you alot, I know that your Doc didn't tell you to get bloodwork done for 5 years, & then when she did, you found out all sorts of news of ill health. I don't want you [or anyone else] to die from effects of drugs that are supposed to be helping you. I think that most docs are too quick to heavily medicate people like us because they don't want to deal with us. Pills only help so much, we all have to live with this thing and therapy is really important if we want to have the skills to keep on living.
 What language do the other Docs near you speak? Spanish? I would imagine that the Doc would have to be bilingual to be able to practice in Ohio?

 I am thinking of trying to get more info from Johns Hopkins about meds.....that is where Kay Redfield Jamison was a professor of Psychiatry. Johns Hopkins was voted best overall hospital in the USA, and their psych dept. I have much respect for.

 I am not smart enough to go into medicine, though my mom seems to think so. She's an OB/GYN, but that is SO the opposite of Psychiatry! I thank you for the compliment though. I loves ya, Phyllis and I want you to grow old so we can bitch about being bipolar when we are grey haired old ladies.
 And that applies to the rest of you ladies here as well!

[Phyllis]

I know you do my friend. 

And I didn't mean it literally that the other doctors don't speak English.... but English is their second language. 90% of them are from India. And while I am fascinated with India and their people, I have had bad experiences with Indian doctors. I know that sounds horrible and it makes me sound like a racist, but it is what it is. I dunno if it is the cultural differences but the ones I have come across have a bedside manner that is horrible at best.  So, I'm not going to put myself in a potentially uncomfortable situation, ya know?

[Paz]

  We BP's feel freaky enough going to the Doc, you don't want to put yourself in an uncomfortable situation on top of it. Good bedside manner is key for people with any sort of MI.
 
  Just out of curiosity, do the other Docs have good reviews from patients? Sometimes you can find reviews online. It would be good to know, in case of an emergency, ya know?