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Abilify as a rescue med?

  • Thread starter Backwoods Beast
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Ginger Kitten

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That won’t work. Antipsychotics are not
‘rescue’ drugs. Don’t try and treat them as such.

Sorry to play devil's advocate, but some pdoc's use antipsychotics in exactly that way, as 'rescue' drugs. I was pumped full of Quetiapine to bring me down from mania. It worked, I was far more 'level' in just 3 days. Trouble is, I've been left on it since and it's only recommended as a 'crisis' drug, so the community pdoc who left me on it for 5 years done me wrong, but them's the breaks. I now can't get off it because when his predecessor tried to titrate me down on Q and up on lithium, he and I both found I couldn't go lower than 200mg daily of Q or I shot up into mania. I do wish some of these psychiatrists wouldn't treat us like lab rats.
 
G

Ginger Kitten

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That won’t work. Antipsychotics are not
‘rescue’ drugs. Don’t try and treat them as such.
I just lost a long reply, goodness knows where. Basically, it said that some psychiatrists use antipsychotics as 'rescue' drugs. I was pumped full of Quetiapine years ago and left on it, when it is only really meant to be used in crisis. Now I can't come off it, because if I go lower than 200mg a night, I shoot straight up into mania, and agitated mania at that. I do wish some of these pdoc's wouldn't treat us like lab rats.
 
G

Ginger Kitten

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Yes, I agree Beastie. I once told my pdoc that if he and I coud figure out a way of harvesting the chemicals in the bipolar brain when hypomanic, and find a buyer, we could make a fortune! He didn't smile, but he did say, in his gently ironic way, "Well yes, but I think there might be something in my code of ethics that would forbid it!"
You're not boring, BB. I find you fascinating. How are you doing today? KR, Ginger. x
 
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BlueWater

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Ah, good old psychomotive agitation. One of my primary symptoms... Meds have greatly reduced irritability and anger for me. But, like you, elation has also plummeted. Being in the middle is safe, but makes me boring as hell in my opinion. Even in hypomania it's always a mixed state where I'll be depressed but bouncing off the walls. My mind runs a mental marathon sprint without stopping for two seconds to take in the sights. If only we all could figure out how to stay in pleasant hypomania one day, it'd be the best day of my life.
Ah, pleasant hypomania! Sounds glorious!
 
Backwoods Beast

Backwoods Beast

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Yes, I agree Beastie. I once told my pdoc that if he and I coud figure out a way of harvesting the chemicals in the bipolar brain when hypomanic, and find a buyer, we could make a fortune! He didn't smile, but he did say, in his gently ironic way, "Well yes, but I think there might be something in my code of ethics that would forbid it!"
You're not boring, BB. I find you fascinating. How are you doing today? KR, Ginger. x

Haha, that's funny. Gave me a smile. I wish my pdoc was like that. He's an oddball. Dresses like a homeless man, forgets/mixes up important things in my chart, and is generally nice but confusing to figure out at times. He gets really pensive, makes a concerned face, and closes his eyes or stares at me or the ceiling in apparent thought a lot. We often have long, awkward pauses.

Before him, I was seeing a lot of docs who were forcing me into things. When I met him I finally had someone who let me be in control and at first I was excited. But now I think he too often lets me be in control when maybe I shouldn't (of course when I desperately need meds because if mania I'm going to say, "No thanks, I'm good!" This last time was the exception, not the norm). In the past they asked lots of prying questions, and he only asks the basics. Not sure how I feel about all that. For example, when I felt like I could trust him, I briefly mentioned that I struggle with constant bad dreams/nightmares and have been, every night, for years. I had prepared myself for the questions but they never came. Not a single one. Instead he said, "Oh, that's terrible. I'm sorry. Thanks for telling me. It's obvious this stems from your past and you have PTSD. You should consider taking this drug, joining a support group, and maybe talking to this specialist I know."

I'm not saying I don't have PTSD, but how can you say that while not knowing the content of the dreams or really anything about me? After a lot of back and forth I decided to take the meds - which didn't work whatsoever. I even relented to seeing the specialist because things were that bad at the time. She did ask the prying questions. Immediately. Before I even began to know her. And was blatantly frustrated when I wouldn't bare all. WTF? I saw her a few times but she gave up on me because I wouldn't spill my guts and go into detail about how horrifying the dreams are... The mental health system is messed up. I feel like the majority of my meetings with my pdoc are an uncomfortable waste of time, so I avoid him as much as possible. Anyway, apologies for the rant.

I'm not excellent, to be honest. Maybe you can tell by my cynical tone. I feel like my mood is constantly shifting, far faster than usual. Not sure if it's the Abilify, or just a really weird episode. The way it has unfolded is that I ramped up to hypomanic for a few weeks, stayed hypomanic/mixed for a few more weeks, started to show some signs of manic and psychotic stuff for a couple weeks, got meds, and then immediately started to feel a bit better. But now I don't quite know how I feel. It's muted, but I have moments that lean depressed and moments that lean hypomanic. More often depressed... I had a fight with my spouse last night. Wrote about it in another thread. Feeling a bit like a loser right now.

Wow, that was long. Sorry. Enough about me. How are things going for you, Ginger? (And anyone else still following this thread.)
-Beast
 
K

keith74

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Sorry to play devil's advocate, but some pdoc's use antipsychotics in exactly that way, as 'rescue' drugs. I was pumped full of Quetiapine to bring me down from mania. It worked, I was far more 'level' in just 3 days. Trouble is, I've been left on it since and it's only recommended as a 'crisis' drug, so the community pdoc who left me on it for 5 years done me wrong, but them's the breaks. I now can't get off it because when his predecessor tried to titrate me down on Q and up on lithium, he and I both found I couldn't go lower than 200mg daily of Q or I shot up into mania. I do wish some of these psychiatrists wouldn't treat us like lab rats.

Quetiapine is a unique one. Because of its effective with both mania and depression, it is sometimes considered a "mood stabilizer" instead of just an antipsychotic. Hence it will be used as a long term maintenance med for people who want to be on just one med and don't want to be on lithium.
 
Backwoods Beast

Backwoods Beast

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So what are your thoughts on Lamotrigine, then?
 
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keith74

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So what are your thoughts on Lamotrigine, then?

From what I have read and heard, it is a good mood stabilizer for preventing depression. However, its effectiveness for mania is questionable. It is commonly prescribed with something that helps with mania like an antipsychotic or (less commonly) depakote.
 
G

Ginger Kitten

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Haha, that's funny. Gave me a smile. I wish my pdoc was like that. He's an oddball. Dresses like a homeless man, forgets/mixes up important things in my chart, and is generally nice but confusing to figure out at times. He gets really pensive, makes a concerned face, and closes his eyes or stares at me or the ceiling in apparent thought a lot. We often have long, awkward pauses.

Before him, I was seeing a lot of docs who were forcing me into things. When I met him I finally had someone who let me be in control and at first I was excited. But now I think he too often lets me be in control when maybe I shouldn't (of course when I desperately need meds because if mania I'm going to say, "No thanks, I'm good!" This last time was the exception, not the norm). In the past they asked lots of prying questions, and he only asks the basics. Not sure how I feel about all that. For example, when I felt like I could trust him, I briefly mentioned that I struggle with constant bad dreams/nightmares and have been, every night, for years. I had prepared myself for the questions but they never came. Not a single one. Instead he said, "Oh, that's terrible. I'm sorry. Thanks for telling me. It's obvious this stems from your past and you have PTSD. You should consider taking this drug, joining a support group, and maybe talking to this specialist I know."

I'm not saying I don't have PTSD, but how can you say that while not knowing the content of the dreams or really anything about me? After a lot of back and forth I decided to take the meds - which didn't work whatsoever. I even relented to seeing the specialist because things were that bad at the time. She did ask the prying questions. Immediately. Before I even began to know her. And was blatantly frustrated when I wouldn't bare all. WTF? I saw her a few times but she gave up on me because I wouldn't spill my guts and go into detail about how horrifying the dreams are... The mental health system is messed up. I feel like the majority of my meetings with my pdoc are an uncomfortable waste of time, so I avoid him as much as possible. Anyway, apologies for the rant.

I'm not excellent, to be honest. Maybe you can tell by my cynical tone. I feel like my mood is constantly shifting, far faster than usual. Not sure if it's the Abilify, or just a really weird episode. The way it has unfolded is that I ramped up to hypomanic for a few weeks, stayed hypomanic/mixed for a few more weeks, started to show some signs of manic and psychotic stuff for a couple weeks, got meds, and then immediately started to feel a bit better. But now I don't quite know how I feel. It's muted, but I have moments that lean depressed and moments that lean hypomanic. More often depressed... I had a fight with my spouse last night. Wrote about it in another thread. Feeling a bit like a loser right now.

Wow, that was long. Sorry. Enough about me. How are things going for you, Ginger? (And anyone else still following this thread.)
-Beast

Well, I'm feeling quite a lot better thanks to the Clonazepam (benzo) I've been taking at night for just over a week. I'm going to have to stop it soon though because you can only take it for 2-4 weeks before it becomes addictive, and it can be addictive in less time than that for some people. I rarely take it, so I wouldn't like to push my luck...

I really am a lot more 'normal' now though, not desperately depressed and angry and much, much calmer. I'm also doing a walking meditatin first thing too, at my pdoc's suggestion: he remembered that meditation is one of the tools that help me when episodic. I'm also trying to take some exercise every day, but it's been ice-cold over here in the UK apart from the past few days, which demotivates me from going outside to exercise.

Tomorrow I shall get my bike out and pedal for all I'm worth along a tow-path near me that runs along a river - it's a lovely ride.

Thanks for asking after me Beastie, and I'm sorry that you're not feeling so good. Could you talk to your pdoc and express your concerns? He at least sounds sympathetic and approachable. All the very best, Ginger.
 
Backwoods Beast

Backwoods Beast

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From what I have read and heard, it is a good mood stabilizer for preventing depression. However, its effectiveness for mania is questionable. It is commonly prescribed with something that helps with mania like an antipsychotic or (less commonly) depakote.

This is interesting to hear. I feel like I've read enough on my own, but I'm always confused by this stuff. In the beginning I went between being unmedicated and being on antidepressants (first Lexapro, then something else, and then Wellbutrin). The antidepressants made it worse, and that's why I went for periods without taking anything. While on Wellbutrin - and likely caused by it or made worse by it - I had that psychotic episode I've mentioned here a handful of times. I was given an ultimatum: do what they say and get treatment, or they would force me, and if I fought either, my life would be ruined. So, my doc/s prescribed Lamotrigine because I wouldn't do Lithium (didn't want to have more routine checkups). They tried to get me to take other things with it, but I refused and they actually compromised. Things finally got better on 400mg, which is quite high. Since then I've been asked to consider adding other meds, but have always said no until now.

For the record, It's not that I don't want to get better, it just freaks me the f out to have my mind examined. And I've had some trauma when it comes to the mental health system. Plus, when you're paranoid and they are trying to help, your mind (at least in my case) is telling you that they are plotting the opposite. PLUS, as previously discussed, some meds make things worse. So that's why I'm hesitant.
 
Backwoods Beast

Backwoods Beast

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Well, I'm feeling quite a lot better thanks to the Clonazepam (benzo) I've been taking at night for just over a week. I'm going to have to stop it soon though because you can only take it for 2-4 weeks before it becomes addictive, and it can be addictive in less time than that for some people. I rarely take it, so I wouldn't like to push my luck...

I really am a lot more 'normal' now though, not desperately depressed and angry and much, much calmer. I'm also doing a walking meditatin first thing too, at my pdoc's suggestion: he remembered that meditation is one of the tools that help me when episodic. I'm also trying to take some exercise every day, but it's been ice-cold over here in the UK apart from the past few days, which demotivates me from going outside to exercise.

Tomorrow I shall get my bike out and pedal for all I'm worth along a tow-path near me that runs along a river - it's a lovely ride.

Thanks for asking after me Beastie, and I'm sorry that you're not feeling so good. Could you talk to your pdoc and express your concerns? He at least sounds sympathetic and approachable. All the very best, Ginger.

Hey Ginger,

Glad you're doing better! Those are all great things.

Yeah, maybe. I'm just so tired of this.

Best,
Beast
 
K

Keesha

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Well, I'm feeling quite a lot better thanks to the Clonazepam (benzo) I've been taking at night for just over a week. I'm going to have to stop it soon though because you can only take it for 2-4 weeks before it becomes addictive, and it can be addictive in less time than that for some people. I rarely take it, so I wouldn't like to push my luck...

I really am a lot more 'normal' now though, not desperately depressed and angry and much, much calmer. I'm also doing a walking meditatin first thing too, at my pdoc's suggestion: he remembered that meditation is one of the tools that help me when episodic. I'm also trying to take some exercise every day, but it's been ice-cold over here in the UK apart from the past few days, which demotivates me from going outside to exercise.

Tomorrow I shall get my bike out and pedal for all I'm worth along a tow-path near me that runs along a river - it's a lovely ride.

Thanks for asking after me Beastie, and I'm sorry that you're not feeling so good. Could you talk to your pdoc and express your concerns? He at least sounds sympathetic and approachable. All the very best, Ginger.
I’ve got a lot of catching up to do since I somehow missed your posts. Normally clonazepam is a short term medication. Doctors would rather not prescribe drugs that have an addiction factor BUT most of them will agree that this drug can be used longer than 2 to 4 weeks for specific reasons. Yours is a specific reason. If it’s making you feel considerably better, could you not talk with your doctor snd ask if you can be on a low dose to keep you from doing manic?

A significant in law has been on lorazepam for over 15 years and is completely fine. Maybe you could take this indefinitely to help keep you stable from getting too high. ( manic )
 
K

Keesha

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Hey Ginger,

Glad you're doing better! Those are all great things.

Yeah, maybe. I'm just so tired of this.

Best,
Beast
I can’t blame you for being fed up if twice they gave you anti depressants knowing you are bipolar. That’s incompetence. This happened to me twice before while I was trusting my medical providers. After 5 days of no sleep I got prescribed anti depressants. It just about did me in. They should know better.

In fact most times that I trust medical staff, I am over medicated and am usually worse off than I was before. Not that I’m endorsing going unmedicated. I am just agreeing that trusting others with how your mind works is a scary thing.
 
K

Keesha

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Well, I'm feeling quite a lot better thanks to the Clonazepam (benzo) I've been taking at night for just over a week. I'm going to have to stop it soon though because you can only take it for 2-4 weeks before it becomes addictive, and it can be addictive in less time than that for some people. I rarely take it, so I wouldn't like to push my luck...

I really am a lot more 'normal' now though, not desperately depressed and angry and much, much calmer. I'm also doing a walking meditatin first thing too, at my pdoc's suggestion: he remembered that meditation is one of the tools that help me when episodic. I'm also trying to take some exercise every day, but it's been ice-cold over here in the UK apart from the past few days, which demotivates me from going outside to exercise.

Tomorrow I shall get my bike out and pedal for all I'm worth along a tow-path near me that runs along a river - it's a lovely ride.

Thanks for asking after me Beastie, and I'm sorry that you're not feeling so good. Could you talk to your pdoc and express your concerns? He at least sounds sympathetic and approachable. All the very best, Ginger.
It’s great that you are getting some exercise. It really does help get rid of excess energy and help calm the mind and body down. It’s good that you are adding alternative resources like meditation 🧘‍♀. This is really good. You seem less agitated . I’m glad you are doing better.
 
Backwoods Beast

Backwoods Beast

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I can’t blame you for being fed up if twice they gave you anti depressants knowing you are bipolar. That’s incompetence. This happened to me twice before while I was trusting my medical providers. After 5 days of no sleep I got prescribed anti depressants. It just about did me in. They should know better.

In fact most times that I trust medical staff, I am over medicated and am usually worse off than I was before. Not that I’m endorsing going unmedicated. I am just agreeing that trusting others with how your mind works is a scary thing.

Agreed. To be semi-fair, the first doc didn't figure out that I was Bipolar because I only saw him when I was suicidal, and he gave me the first two meds. The second doc was the first to diagnose Bipolar but I told him he was nuts. Only saw him once and I can't remember what he prescribed, but I don't think I took it. The third doc was a sports medicine doctor (same credentials as a GP but specializes in athletes) and he gave the Wellbutrin, but apparently he had no experience with mental health stuff.... Actually I feel a pang of irrational shame when I look back at that, because as athletes we're trained to be physically and mentally tough. I was generally thought to be the toughest of everyone I new. Going to the team doc was one of the most embarrassing moments of my life. The look on his face... The look on my coaches' faces when they found out... Wow, memories rushing back.
 

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