Downward Spiral?

Downward Spiral?

I had a medication change about 5 days ago because I was feeling numb, flat, and empty. My psychiatrist said that he has seen this happen to people who reach a therapeutic level of Clozapine that are also taking Mirapex. We decided together to taper off the Mirapex. I will take my last dose of Mirapex on Wednesday, I’m currently taking half the dose.

I feel worse than I did a week ago. I’m hoping that this is just me adjusting to the medication change. I really hope that it’s not the beginning of another downward spiral. I took a nap this evening because I just couldn’t stand being awake anymore. When I woke up, I was hoping that at least a couple hours had passed, but instead, it had only been about 30 minutes. What a disappointment. It’s getting harder each day to fake being okay.

Fixing The Numbness

Fixing The Numbness

I told my psychiatrist that I’ve been feeling numb for the past few weeks; that nothing seems to matter to me anymore. He responded to me by telling me that he has seen some patients feel numb once they achieve a therapeutic level of Clozapine while they are also on Mirapex. He said that the Mirapex can act like an antidepressant and cause emotional flattening. He said that the technical term for it is alexithymia.

I’m going to cut my dose of Mirapex in half for the next week, and then I will go off of it completely. My doctor said that should help within about two weeks. If that doesn’t help, then he wants to reconsider ECT, which I really do not want to do. Fingers crossed for this medication change to help.

Physical and Mental Health

Physical and Mental Health

As if I didn’t have enough issues already, I went to my primary care doctor yesterday because my cholesterol is high. Now I have to add a new medication to my current large list of meds. I was told that one of my meds is most likely causing my cholesterol to rise, but no one told me which medication is causing this problem. I think it might be the Clozapine, but that’s just a guess.

It’s getting difficult managing both my mental health and my physical health at the same time. I have also developed some myoclonic jerks, most likely from the Lithium that I take. They’re manageable right now, as long as it doesn’t get worse.

So Many Meds

So Many Meds

Sometimes I feel like I take too much medication. I take Lithium, Tegretol, Clozapine, Cytomel, Mirapex, and Valium for my bipolar disorder and anxiety. I take Zofran, Cogentin, and Metformin because of side effects from my bipolar medication. I have to take hormone replacement therapy because of my hysterectomy. I also take Percocet and Elmiron for my bladder disorder. It’s a long list of medication.

One of the meds has to be taken on an empty stomach twice a day, but some of my other meds have to be taken with food. I take medication about 6 times a day, sometimes more, depending on when I eat. It feels like all I’m doing is taking medication. I hate the fact that so many of my medications are treating side effects of other meds, but I guess that’s how it goes.

I’ve been hoping that one day I won’t have to take medication, but realistically, I know that won’t happen. This is just something that I have to deal with. I think I wouldn’t care about it as much if the meds actually worked. My depression has improved, but my suicidal ideations are still there. In the end, I know that I’m a lot better off taking these meds than I am without them.

Psych Appointment

Psych Appointment

Yesterday was my appointment with my psychiatrist. It went really well. I brought a list of everything I wanted to talk to him about, so I wouldn’t forget anything. It was very helpful. He listened to everything I said as well as all of my requests.

I am now off Deplin, because I don’t feel that it has helped at all. He increased my Cogentin at night for the dystonia, just like I asked. He also said I could get off of the Inositol since it wasn’t working either.

I talked to him about the twitches I’m having in my hands that cause me to drop things. He said there was a name for it, but the only solution would be to go off some other meds, such as Lithium and Tegretol. I don’t want to do that at this time. I told him about the extreme nausea that’s been happening this past week, but we both agreed that it’s most likely from Elmiron, which I take for my bladder disorder. The Clozapine is causing the drowsiness during the day.

He is also going to check my thyroid level, Lithium level, Tegretol level, blood sugar level, and cholesterol. I’m very pleased with this appointment.

When I got home, I took a nap that lasted about 6 hours. I don’t know why that happened, but I couldn’t keep my eyes open. I feel better so far today.

Goodbye Cape Cod

Goodbye Cape Cod

I’m headed home now. I’ve had a great vacation, but it’s time to get back to reality. I’m purposely made sure not to schedule any doctors appointments for Monday, with the exception my weekly blood work. I’m trying to give myself a day to get back into the swing of things. Tomorrow, I will most likely spend running errands and doing laundry.

I have one doctor appointment on Tuesday, teo on Wednesday, and one on Friday. What a life! The appointment on Tuesday at with my psychiatrist. While I was away, I wrote down a long list of things I want to discuss with him. There’s some meds I want to get off of,some dosage changes, some side effects to report, and some lab work to get done other than my weekly blood work. I’m on thyroid medication, but we never check my thyroid level. That could be contributing to my weight gain.

Unable To Sleep

Unable To Sleep

Lately, my nighttime meds kick in within about 20 or 30 minutes and I’m asleep quickly and easily. Tonight is anything but quick and easy. I was just laying in bed waiting for the meds to start working. After an hour of laying in bed without the ability to fall asleep or even be the slightest bit tired, I gave up, took my pillow, and went out to the living room couch. Sometimes, just changing my scenery helps.

So far, no improvement. In fact, I’m a bit jumpy. I’ve seen some flashing lights racing by my house and a lot of dogs are barking (thank goodness my dog is completely silent). I get nervous when I’m alone. My husband is asleep, so I count this as being home alone. So maybe a change of scenery has been counterproductive this time; maybe I should go back to bed soon.

In the mean time, I’m trying to figure out why I can’t sleep. I recently had a couple of medication changes, which could be a big factor with my sleep problems. I’m exhausted during the days and awake at night. This may be something I should mention to my psychiatrist.

Tips for Medication Management

Tips for Medication Management

 

Medications are one of the more difficult things to manage that comes along with a bipolar diagnosis. The medications work together to help decrease the symptoms caused by bipolar disorder. Every person takes a different combination of medications to treat their individual symptoms and needs. I have been on multiple medications since my diagnosis, just like most individuals diagnosed with bipolar disorder.

I take a combination of anti-depressants, anti-psychotics, and anti-anxiety medications. My medications need to be taken three times a day, and it’s important to take them regularly. Some of the medications I take treat side effects caused by my bipolar medication, and some of my meds treat separate physical conditions. It’s a lot of medication to take and keep organized. It’s important to take the right medication at the right time. It’s also important to make sure I don’t run out of any of my medications.

Keeping our psychiatric medications organized is a difficult job to handle, but it is a vital task. Medications can do a lot to treat bipolar disorder, as well as other psychiatric disorders, as long as they are taken on a regular basis. Each medication has its own specific instructions that need to be followed. Keeping track of everything is not easy, but our psychiatrists prescribe these medications to us with detailed instructions for a good reason. I never make any changes to my medications without first clearing it with my psychiatrist.

At times, I have been unable to manage all of my medications properly, even when using a weekly pill organizer. In the past, I have used a free online service called MyMedSchedule.com. This website has helped me to keep track of all my medications, how often I taken each medication, it sends me reminders to take my meds, and it sends me reminders to refill my meds. I can also print off a list of my medications that is wallet size so I have it with me in case I ever need it; when my doctors asks me what medications I’m on, all I have to do is pull out my list and hand it to them. Hopefully, this website can help some people organize and manage their medications with greater ease.

Keeping track of side effects is also important to medication management. It is critical to report all side effects to your psychiatrist so he/she can properly treat them. Some side effects, such as nausea or drowsiness, can be easily treated.

The following suggestions helpful for people who take multiple medications:

  1. Use a pill organizer: I fill mine up weekly to make sure that I take my morning and evening medications.
  2. Count your meds: Every week, when I fill up my pill organizer, I count the pills I have left. I put the bottles away as long as I have at least one full week worth of medication left in the bottle after filling up the pill organizer.
  3. Refill meds as needed: If I have less than one full week in the pill bottle, then I leave it on the counter so I remember to refill that prescription that week. I have never run out of medication using this method.
  4. Use alarms: I also set an alarm on my phone, which goes off every afternoon, to remind me to take my afternoon medication.
  5. Keeping some meds on me at all times: Some of my medications only need to be taken “as needed”, such as anti-anxiety medication and those that treat specific side effects. I keep these medications in my purse so I have them with me at all times.
  6. Use the free online services: The website mymedschedule.com can be used to keep track of all your medications, when to take your meds, and when to refill them.
  7. Talk to your psychiatrist and pharmacist: You can ask your psychiatrist about side effects, but your pharmacist will generally know more about all medication side effects and medication interactions.
  8. Don’t change your meds on your own: Despite side effects, it’s still essential not to make changes to your medications without first speaking with your psychiatrist about it.

Medications must be taken as prescribed in order for them to work to the best of their ability. This means that it is necessary to keep track of when to take meds and when to refill meds. Keeping track of side effects also helps to treat any medical issues that arise. Communicating with your psychiatrist is very important for medication management, which helps to ensure the best outcome.

 

When Is It Enough?

When Is It Enough?

At this point, Clozapine is causing a few side effects such as weight gain, drooling (increased salivation), and dystonia. I have to figure out when enough is enough. There are medications that can help with these side effects, but I’m already taking enough meds. I’m currently on Lithium, Tegretol, Cytomel, Deplin, Mirapex, Clozapine, Inositol, Depo-Estradiol, and Depo-Testosterone regularly. I also take Zofran, Percocet, and Valium as needed. I’ll probably be adding Cogentin to this list after I talk to my doctor today about the dystonia.

How many more medications can I add to this list? Every medication has side effects, even the ones that I’m taking to fix side effects of other medicines. It’s a vicious cycle. I know I need to take something, I’m assuming Cogentin for the dystonia, because I can’t handle the pain and discomfort.

I’m trying to decide when enough is enough with a medication. I believe that the Clozapine is helping me; however, it is the cause of the three side effect weight gain, drooling, and dystonia. I just can’t figure out if I should stop the medication or not. I made a decision earlier that I would keep taking this medication through the next two months of dosage increases. I have been told that once I stop increasing the medication, my body may adjust to it and the side effects may lessen. It’s hard to make decisions like this. I’ve gone through a long list of meds that didn’t work. Now, I may have found a medication that actually helps, and it causes all sorts of other problems. I know that my other option is IV Ketamine, and I really don’t want to do that. I suppose I will put up with these side effects for as long as I can.

Clozapine Prescriptions

Clozapine Prescriptions

My psychiatrist mailed me two months worth of prescriptions. These scripts, for Clozapine, will get me from my 200mg dose up to my target 400mg dose. Each script is for one week worth of medications (because I still have to do the weekly blood work). He sent me everything that I would need to get through the next two months. The scripts are pre-dated, so I can’t fill them until Wednesday of each week.

I will be starting the increase soon, either Wednesday or Thursday of this week. I’m a little concerned about the possible side effects, but I mostly think it will all work out.I’m increasing my dose slowly to hopefully avoid side effects. I guess only time will tell.

I can still contact my psychiatrist any time I need, but hopefully everything with the dosage increase will go smoothly and I won’t have to. My next appointment with him is on August 25th. Until then, I can contact him via email or text if necessary. He will still get my weekly blood work results. If he sees a problem with my blood tests, then he will contact me.