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Meds for rapid cycling

A

ArubaRocks7

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Jul 30, 2021
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Hi all! I’m new to the group and have a burning question. I’m a Bipolar 2 rapid cycler (daily) and Trileptal was a literal lifesaver.

Unfortunately it has caused dangerously low sodium levels (no one caught that and I’ve been on it since 2018). I ended up in the ICU Tues due to my levels going all the way down to 120 (normal is 135-145). I have to stop Trileptal because I can’t take salt tablets due to heart issues.

Currently on Seroquel, Lamictal, Topamax, Trileptal, Clonazepam

Tried Abilify, Lithium, Latuda, Risperdal

Finally found my perfect cocktail (took 6 years) and now this!

Any rapid cyclers out there with suggestions of meds that work for you? I really don't want to go back to that partial hell. Thanks all!
 
Wishbone

Wishbone

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Apr 20, 2019
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I hate to see cocktails of drugs like this. You've got ones to bring you up and ones to bring you down, it's no wonder you're cycling too quickly. Two meds should be the maximum anyone needs with a PRN optional at the most. Just my opinion.
Maybe ask for something like Valproate.
 
Amazingly

Amazingly

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Jul 7, 2021
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I have ultra rapid cycling bipolar type 1
and Depakote is excellent for slowing down extremely fast mood shifts.

I agree with @Wishbone
Being on so many meds can sometimes worsen the picture even more.

Have a heartfelt discussion with your doctor about it.
 
K

keith74

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People with bipolar 2 rapid cycling tend to respond well to Lamotrigine (Lamictal). If that is not working, you may want to explore another mood stabilizer like Valporate (Depakote). I agree with Wishbone that it would be good to trim down some of the medication you are on (if possible). Usually one mood stabilizer and one antipsychotic does the trick for most (though of course everyone is different)
 
S

SFGuy

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Mar 28, 2021
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California
Finally found my perfect cocktail (took 6 years) and now this!

Any rapid cyclers out there with suggestions of meds that work for you? I really don't want to go back to that partial hell. Thanks all!
Sorry to hear about your trip to the ER and your loss of a mainstay med.

I'm on a complicated cocktail, too. I'm happy to say it's working today.

The cocktail has evolved over the years, but the backbone is Depakote. It relieves my mixed states and turned down my Ultradian cycling so much that I'm not bothered by it. I still have a mildly hypomanic peak around 2:00 in the afternoon, but it isn't destabilizing or even bothersome any more.

I felt some effect from Depakote the day after I took my first dose and it hit full force within a month. I'm told that if it doesn't work quickly, it probably won't work at all.

I started Lyrica ~4 months ago. It has a nice add-on effect, but Depakote is king.

If you're a woman who might get pregnant, Depakote is a no-no. Birth defects.
 
A

ArubaRocks7

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Jul 30, 2021
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Thanks everyone! I SO appreciate your responses. I’ve never tried Depakote (although my husband takes it and he likes it). My only hesitation is Seroquel works for me - especially with sleep. I could probably get down to either Seroquel (or try Depakote), 1 antiepleptic (either Lamictal or Topamax and not replace Trileptal) and Clonazepam (I have very severe panic disorder so that’s a non negotiable) and perhaps get rid of Ambien but I’d have to see because I have severe insomnia and typically anything that makes you tired has the opposite effect on me (I’ve tried everything natural, antihistamines, other drugs, only Ambien has worked)
 
A

ArubaRocks7

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I can’t figure out how to edit but I also tried Lyrica and that was a no go. I’m in my 50’s so no worries about getting pregnant. Thanks again everyone!
 
S

SFGuy

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I don't respond well to sleeping meds (Z drugs don't work), so my doc put me on a weird one, a muscle relaxer called Baclofen. Knocks me silly in about 10 minutes. If Ambien works for you, that's great, but if it poops out, Baclofen might be a useful backup.

Sorry Lyrica didn't work out.

By the way, welcome to the Bipolar board.
 
A

ArubaRocks7

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Joined
Jul 30, 2021
Messages
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Location
PA
I don't respond well to sleeping meds (Z drugs don't work), so my doc put me on a weird one, a muscle relaxer called Baclofen. Knocks me silly in about 10 minutes. If Ambien works for you, that's great, but if it poops out, Baclofen might be a useful backup.

Sorry Lyrica didn't work out.

By the way, welcome to the Bipolar board.
Thanks so much! Muscle relaxers make me speed 😁 I know I’m a mess.
 
I

InnovatingProfessor

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Aug 3, 2021
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66
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Belgium
I use Depakote and Lithium combination. Depakote works, but the levels need be the high in blood, ones they are just therapeutically it doesn't work for the ultra RC.

My suggestion is also: very strict routin and structure if you have ultra RC.
 
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