• Share. Be Supported. Recover.

    We are a friendly, safe community supporting each other's mental health. We are open 24 hours a day, 365 days a year.

Hypomanic help - Med choices

B

BlueWater

Well-known member
Joined
Jul 29, 2021
Messages
594
Location
Earth
25% is indeed a non-trivial number. However, I thought that number is with the first generation (typical) APs while the number is much lower with the second generation (atypical) APs. I'mnot sure however.
I think much lower with SGAs.
 
K

keith74

Well-known member
Joined
Sep 14, 2020
Messages
650
Location
Canada
I take Depakote, which works for my hypo side pretty well. I won’t take APs for exactly the reasons you list. Depakote has a long list of potential side effects, but the bad ones are rare.
What do you take to help with the depression? My wife also takes depakote - she's been on it for decades. Most of the time she has only been on depakote (monotherapy). However, she has been placed on quetiapine at times to pull her out of severe depressive episodes. She then slowly weans off it after a long period of stabilization. She currently is on it now but is planning on reducing her dose as it has been several months since her depressive episode ended (May). But I always wondered if she needed some other med permanently to help keep the depression at bay since depakote is typically an anti-manic med...
 
B

BlueWater

Well-known member
Joined
Jul 29, 2021
Messages
594
Location
Earth
That's not a bad idea, but I don't believe Lamotrigine can just be stopped safely for any long length of time. Withdrawal would be a factor.

I like the idea of taking something on an as needed basis. There's is a specific benzodiazepine out there that I really wish my doc would prescribe because it's very highly rated for insomnia by many people.

I don't really want to go asking for benzodiazepines though because that may appear as though I'm a drug addict.
It shouldn't appear as though you are a drug addict but how will they prevent hypomanic episodes? Seems like I talked with you months ago about something else. Do you have OCD?
 
K

keith74

Well-known member
Joined
Sep 14, 2020
Messages
650
Location
Canada
The idea with benzos is that due to the heavy sedative effect, it can help a lot with with hyper energy, racing thoughts, aggression, and especially lack of sleep that comes with a manic episode. Benzos are often given to patients with acute mania to help calm them down. However, benzos on their own is not considered a viable treatment or maintenance for (hypo)mania. It is almost always given in conjunction with a medication to treat the mania directly (like depakote or an antipsychotic)
 
M

MrMuscles

Well-known member
Joined
Jul 29, 2021
Messages
61
Location
Oregon
I take Klonopin every night, sometimes .25mg, sometimes .5mg. It can cause depression.

For anxiety, I also take Propranolol 10mg most nights. My anxiety tends to occur in the afternoon or at bedtime.

The 25% TD rate is for SGAs or APs in general?
Actually it's a 20-22% prevalence rate among SGA's. When taking FGA's, your odds rise to 30%. I've also read literature that your overall risk of TD is about 25% on average across all antipsychotics.

Not worth all of the sleep in the world. I wouldn't take antipsychotics even if it meant I could trade places with Rip-Van-Winkle himself. :)
 
M

MrMuscles

Well-known member
Joined
Jul 29, 2021
Messages
61
Location
Oregon
It shouldn't appear as though you are a drug addict but how will they prevent hypomanic episodes? Seems like I talked with you months ago about something else. Do you have OCD?
I'm hoping I won't look like a drug addict because I genuinely need a medication that will help me and I've tried most drug classes at this point.
I kind of lost track of my thoughts as I wrote that, I'm seeking a med for hypomania but only because hypomania causes me to sleep 2-4 hours nightly. A benzo won't treat my hypomania but it may help me with sleep during those times, as well as during depressive episodes.
I actually enjoy hypomania most of the time, but lack of sleep is brutal.

I do have OCD, Bipolar & ADHD. We may have discussed these awhile ago, or we talked about my sleep difficulties.
 
B

BlueWater

Well-known member
Joined
Jul 29, 2021
Messages
594
Location
Earth
Actually it's a 20-22% prevalence rate among SGA's. When taking FGA's, your odds rise to 30%. I've also read literature that your overall risk of TD is about 25% on average across all antipsychotics.

Not worth all of the sleep in the world. I wouldn't take antipsychotics even if it meant I could trade places with Rip-Van-Winkle himself. :)
Outside of the other mood stabilizers, then what options do you have?
 
B

BlueWater

Well-known member
Joined
Jul 29, 2021
Messages
594
Location
Earth
I'm hoping I won't look like a drug addict because I genuinely need a medication that will help me and I've tried most drug classes at this point.
I kind of lost track of my thoughts as I wrote that, I'm seeking a med for hypomania but only because hypomania causes me to sleep 2-4 hours nightly. A benzo won't treat my hypomania but it may help me with sleep during those times, as well as during depressive episodes.
I actually enjoy hypomania most of the time, but lack of sleep is brutal.

I do have OCD, Bipolar & ADHD. We may have discussed these awhile ago, or we talked about my sleep difficulties.
We talked more about your OCD and sleep. Klonopin helps me. Trazodone helps me, too. Even when you're not hypomanic are you sleeping only 2-4 hours?
 
B

BlueWater

Well-known member
Joined
Jul 29, 2021
Messages
594
Location
Earth
There's also Mirtazapine. It is an anti-depressant that at low doses is prescribed for sleep. I take it once or twice weekly in lieu of Trazodone.
 
S

SFGuy

Well-known member
Joined
Mar 28, 2021
Messages
346
Location
California
What do you take to help with the depression? . . .

But I always wondered if she needed some other med permanently to help keep the depression at bay since depakote is typically an anti-manic med...
Depakote's a miracle for the right people, isn't it? It sounds like your wife and I must have some physiology in common.

When I had my last depression, I had IV Ketamine (3 infusions) and followed that with custom compounded nasal spray, which I take up to 3 times a day. I haven't had a major depression in 2 years+ (hoping for the best), so I'm staying on the spray as a prophylactic. Without it, I would have expected a couple bouts at least.

My psychiatrist has tried K with others. It usually looks good at first, then poops out.

I tolerate a relatively low dose of Dextroamphetamine for ADHD. It gets me off the couch and into my day, but doesn't brighten my mood. It's risky since it can trigger mania.

I also have a strong reaction to Lyrica, which I started this year. It has worked to reduce anxiety, but it also brightens my mood. Free bonus.

I have taken Trazodone (400mg) to prevent migraine for decades. It's part of the mix, but I've never felt like it affects my mood.
 
B

BlueWater

Well-known member
Joined
Jul 29, 2021
Messages
594
Location
Earth
Depakote's a miracle for the right people, isn't it? It sounds like your wife and I must have some physiology in common.

When I had my last depression, I had IV Ketamine (3 infusions) and followed that with custom compounded nasal spray, which I take up to 3 times a day. I haven't had a major depression in 2 years+ (hoping for the best), so I'm staying on the spray as a prophylactic. Without it, I would have expected a couple bouts at least.

My psychiatrist has tried K with others. It usually looks good at first, then poops out.

I tolerate a relatively low dose of Dextroamphetamine for ADHD. It gets me off the couch and into my day, but doesn't brighten my mood. It's risky since it can trigger mania.

I also have a strong reaction to Lyrica, which I started this year. It has worked to reduce anxiety, but it also brightens my mood. Free bonus.

I have taken Trazodone (400mg) to prevent migraine for decades. It's part of the mix, but I've never felt like it affects my mood.
Trazodone doesn't do anything for my mood either. I sleep and dream better with it so it least there's an indirect benefit for my irritability because I'm rested. Lyrica is great for anxiety. My first or second day on it I was euphoric.
 
K

keith74

Well-known member
Joined
Sep 14, 2020
Messages
650
Location
Canada
Depakote's a miracle for the right people, isn't it? It sounds like your wife and I must have some physiology in common.

When I had my last depression, I had IV Ketamine (3 infusions) and followed that with custom compounded nasal spray, which I take up to 3 times a day. I haven't had a major depression in 2 years+ (hoping for the best), so I'm staying on the spray as a prophylactic. Without it, I would have expected a couple bouts at least.

My psychiatrist has tried K with others. It usually looks good at first, then poops out.

I tolerate a relatively low dose of Dextroamphetamine for ADHD. It gets me off the couch and into my day, but doesn't brighten my mood. It's risky since it can trigger mania.

I also have a strong reaction to Lyrica, which I started this year. It has worked to reduce anxiety, but it also brightens my mood. Free bonus.

I have taken Trazodone (400mg) to prevent migraine for decades. It's part of the mix, but I've never felt like it affects my mood.
Indeed, depakote has worked well for my wife for a long time. Though she seems to react mostly well to most meds with minimal side effects. She is lucky that way.

I have heard good things about ketamine. It sounds promising. Thank you for sharing your experience. I'll keep it on the radar as a possible alternate treatment for her depressive episodes instead of the quetiapine.
 
Wishbone

Wishbone

Well-known member
Joined
Apr 20, 2019
Messages
2,868
Location
England
I have taken Trazodone (400mg) to prevent migraine for decades. It's part of the mix, but I've never felt like it affects my mood.
To be fair, do you even need that given that Depakote works against migraines? Could be one you could possibly cut out.
 
S

SFGuy

Well-known member
Joined
Mar 28, 2021
Messages
346
Location
California
To be fair, do you even need that given that Depakote works against migraines? Could be one you could possibly cut out.
The discontinuation syndrome is hell itself. I've tried. Migraines, brain zaps, etc. I feel as if I am physically addicted to this one even though I can't be.
 
Similar threads
Thread starter Title Forum Replies Date
A First hypomanic episode at 20 Bipolar Forum 2
F Not Recognizing Hypomanic State ? Bipolar Forum 17
Amazingly Hypomanic all day today Bipolar Forum 11
G hypomanic irritability? Bipolar Forum 3
T Hypomanic and on no meds. Starting Seroquel today. Bipolar Forum 12
D How do you deal with depression that follows a hypomanic episode? Bipolar Forum 7
N Hypomanic again Bipolar Forum 1
N Hypomanic episode Bipolar Forum 11
AnxiousE Hypomanic or just happy? (Stealing this title from another) Bipolar Forum 3
S can you be hypomanic and suicidal at the same time Bipolar Forum 5
D Difference between manic and hypomanic Bipolar Forum 7
H Is it possible for antidepressants to make someone manic/hypomanic without being bipolar? Bipolar Forum 7
A Hypomanic forever I wish Bipolar Forum 1
F What is the longest manic/hypomanic espisode you ever had? Bipolar Forum 7
valleygirl Chronic Insomnia, Exhaustion, and the Occasional Hypomanic Episode Bipolar Forum 1
valleygirl I think I might have been hypomanic Bipolar Forum 2
A Hypomanic or just coping well? Bipolar Forum 4
megirl hypomanic Bipolar Forum 2
P hypomanic!!!! Bipolar Forum 2
Grape Hypomanic Horridness Bipolar Forum 37
S hypomanic Bipolar Forum 2
megirl getting bit hypomanic Bipolar Forum 1
M depression after hypomanic Bipolar Forum 3
M things you do when your manic or hypomanic Bipolar Forum 19
M Is a hypomanic stage coming again. Bipolar Forum 6
A.m.b.e.r Hypomanic! WTF Bipolar Forum 3
T Could I be going hypomanic? Bipolar Forum 10
shaky How do you know if you are hypomanic? Bipolar Forum 1
loulabelle hi guys *hypomanic* Bipolar Forum 4
diamondshine is this the start of manic/hypomanic? Bipolar Forum 8
B My psych nurse feels she can’t help me anymore Bipolar Forum 8
M Help w a bipolar 19 yr old. Bipolar Forum 34
M When to help? Bipolar Forum 15
floatin Psych tomorrow, please help Bipolar Forum 5
J Help after breakdown/major depressive episode Bipolar Forum 9
M No-polar podcasts that help? Bipolar Forum 8
K How to help (convince) someone that they should seek treatment Bipolar Forum 29
M Sleep disorder tied to Bipolar 2? Help Bipolar Forum 59
S Help please - meds and doctors Bipolar Forum 19
A Latuda works, but causes me EXTREME sleepiness, help please Bipolar Forum 9
F Would love some help/advice understanding my first experience with someone who has bipolar - Bipolar Forum 21
floatin Does Meditation Help? Bipolar Forum 28
Julia_2021 Med is killing my libido, is there any help? Bipolar Forum 24
M Help! I am in Pain! Bipolar Forum 12
U Please help Bipolar Forum 17
D Help me Bipolar Forum 10
M My on/off partner has shown all signs of bipolar, and I need help & advice please Bipolar Forum 7
J Bipolar help Bipolar Forum 19
G How do reach out for help when I can't speak about it out loud? Bipolar Forum 1
B Getting help for anxiety Bipolar Forum 4

Similar threads

Top