Pregnancy And Bipolar Medicines
One of the main problems is that the risks of taking bipolar medicines during pregnancy are not well understood.
If you’re pregnant and you have bipolar disorder, a written plan for your treatment should be developed as soon as possible.
The plan should be drawn up with you, your partner, your obstetrician , midwife, GP and health visitor.
The following medicines are not routinely prescribed for pregnant women with bipolar disorder, as they may harm the baby:
- valproate
What Happens When Bipolar Meds Don’t Work
Bipolar disorder is a severe and life-altering condition. Left untreated, bipolar manic cycles can last between 3 and 6 months. Bipolar-related depression can last even longer, sometimes up to 12 months. Treatment for bipolar aims to manage your episodes for the most balanced life possible.
What Do I Do When My Antidepressant Stops Working
Approximately 25 percent of patients with major depressive disorder experience a recurrent depressive episode while on an adequate maintenance dose of antidepressant medications, according to a 2014 metanalysis published in Innovations in Clinical Neuroscience . The clinical term for this medication poop-out or antidepressant tolerance is antidepressant treatment tachyphylaxis. While psychiatrists and neuroscientists dont know exactly why this happens, it could be due to a tolerance effect from chronic exposure to a medication.
I address this topic because I have experienced antidepressant poop-outs myself, but also because I often hear this concern from persons in my depression communities: What do I do when my antidepressant stops working?
The following strategies are a blend of clinical suggestions from the metanalysis mentioned above and other medical reports Ive read, as well as my own insights on recovering from a relapse.
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The Extremes Both For And Against Meds Give New Meaning To The Word Bipolar
Many people say you should not discuss politics or religion with your friends because you might not be friends much longer. If your friends are Bipolar or associated with it in any way you might want to add meds to the list. The extremes both for and against meds give new meaning to the word Bipolar. The poles often seem further apart than the most intense debates in politics or religion.
I have been speaking with groups about Bipolar for almost ten years, and have tried my best to stay out of the debate. But many in the audience won’t let me. At the end of my talks I am frequently accosted by members of one camp or both. It is pretty clear that neither side even heard what I said and the only thing they listened for is whether I took their side in the only thing that matters to them. I didn’t validate their extreme point of view and they are furious with me.
In his song The Boxer, Paul Simon said, “Still, a man hears what he wants to hear and disregards the rest.” In my case they often hear things that were not even said. In their minds I gave a talk siding with the enemy.
I have always pretty much ignored the med controversy because it is not central to my message. Until now. I heard something recently that made me want to take a stand.
The crowd became much more subdued when he stated that everything was going great until a month ago when he was hospitalized yet again for losing control.
Applying For Disability With Bipolar Disorder
When you apply for Social Security Disability benefits with bipolar disorder, the Social Security Administration will compare your symptoms to the listing in the Blue Book for Affective Disorders and will seek to establish your physical and mental residual functional capacity in order to determine if you meet the eligibility requirements for receiving disability benefits. The Blue Book is the manual of potentially disabling conditions used by the SSA, and RFC defines what kind of work, if any, you may be able to perform, even with the limitations your bipolar disorder places on you.
Being approved for SSD benefits with bipolar disorder requires extensive medical documentation, including statements from your treating physicians and records showing the effects of the condition on your everyday life and your ability to work. Because the eligibility criteria for meeting the Affective Disorders Blue Book definition are complex, its advisable that you seek help from a Social Security advocate and/or attorney when applying for disability benefits.
If you want to find out if you qualify for disability, fill out the free evaluation form on this site to be contacted by a disability attorney in your area.
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Finding The Right Bipolar Disorder Medication
It can take a while to find the right bipolar medication and dose. Everyone responds to medication differently, so you may have to try several bipolar disorder drugs before you find the one that works for you. Be patient, but dont settle for a bipolar medication that makes you feel lousy, either.
Once youve discovered the right bipolar disorder drug or drug cocktail, it may still take time to determine the optimal dose. In the case of mood stabilizing medications such as lithium, the difference between a beneficial dose and a toxic one is small. Frequent office visits to re-evaluate your medication needs and careful monitoring of symptoms and side effects will help you stay safe.
When To See A Doctor
If your depression symptoms return for more than a few days, it’s time to see your doctor. But even if you feel like your antidepressant isn’t working, it’s important to keep taking it until your doctor advises otherwise. You may need a dosage increase or a slow tapering off process. With many antidepressant medications, stopping their use too quickly can cause withdrawal effects such as:
- Headaches
- Greater anxiety
- Suicidal thoughts
Early warning signs of breakthrough depression are the symptoms you typically experience when an episode of depression is coming on, says Nestadt. Depression symptoms vary from person to person, but signs include:
- Low mood
- Changes in sleep or appetite
- Loss of interest in previously enjoyable activities
If your symptoms return, don’t worry adjusting the dose or switching to another antidepressant often solves the problem.
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What Else Should I Consider Before Taking Mood Stabilisers
Sex
Medication can affect sexual desire , arousal and your ability to have an orgasm. If this happens, talk to your doctor. Changing the dose could help with this problem.
Pregnancy
If you are thinking of trying for a baby, speak to your doctor about your medication.
Your doctor should give you information about the effects that medications can have during pregnancy.
If you are pregnant and need to take a mood stabiliser speak to your doctor. Some mood stabilisers can cause problems if you take them whilst you are pregnant. It is important that any decision about treatment during pregnancy weighs up the individual risks and benefits.
LithiumTaking lithium during pregnancy can cause heart problems in the foetus. Lithium should be not be taken when you are pregnant if possible.
ValproateValproate can harm an unborn baby. It can cause birth defects such as:
- spina bifida,
- problems with forming the face and skull, and
- problems forming the limbs, heart, kidney, urinary tract and sexual organs.
It can also cause developmental and learning problems such as:
- being late in learning to walk and talk,
- lower intelligence than other children of the same age,
- poor speech and language skills, and
- memory problems.
Children are also more likely to have autism or autistic spectrum disorders and signs of Attention Deficit Hyperactivity Disorder .
Lamotrigine
What To Do About Tolerance
No one really knows what to do about tolerance either. Sometimes switching to another medication in the same class or another medication in a different class is successful. Sometimes it isnt. Sometimes a dosage change helps. Sometimes augmentation with another medication is the way to go. Unfortunately it puts people in the position of grasping around in the dark for another medication or medication combination and this can take months to find, all the while the person is suffering from their illness.
The one thing I can say is that an interesting piece of research suggests that spending some time off the medication and then restarting the medication can make it effective again. Do not take this as a recommendation I recommend you work with your doctor to find the right solution for you. But if you are suffering from spontaneous medication tolerance, I recommend you read or talk to your doctor about this article.
APA ReferenceTracy, N. . Tolerance When Psychiatric Drugs Stop Working, HealthyPlace. Retrieved on 2021, November 30 from https://www.healthyplace.com/blogs/breakingbipolar/2012/05/tolerance-when-psychiatric-drugs-stop-working
LilysaraiLisa
I was on Prozac about 20 years ago. It Worked great for eight years then I became immune to it. Nothing is quite worked his good sense. Do you think if I tried the Prozac now 20 years later it would work again?
Brad KSandyKatelolDebbieLoganLarry Kinder
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Increase The Current Antidepressant Dose
Increasing the dose of an antidepressant is a logical next course of action if you and your doctor determine that your relapse has more to do with a medication poop-out than anything else. Many patients take too little medication for too short period of time to achieve a response that can last. In a 2002 review in , doubling the dose of Prozac from 20 to 40mg daily was effective in 57 percent of patients, and doubling the 90mg from once weekly to twice weekly was effective in 72 percent of patients.
Why Do People With Mental Illness Stop Taking Medication
Posted by Natasha Tracy | Jul 27, 2020 | Bipolar blog, mental illness issues, noncompliance, treatment issues | 6
People with mental illness frequently stop taking their medication. This is known as medication non-adherence or medication noncompliance. No matter what doctors choose to call it, however, its a problem. By and large, when the mentally ill stop taking their medication bad things happen to them. But if this is the case, then why do people with mental illness stop taking their medication?
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Bipolar Disorder And Physical Capacity
Bipolar disorder symptoms are primarily mental or psychological in nature. As such, the impact that the disorder has on your ability to perform the physical duties of your job, like lifting, carrying, pushing or pulling items, or walking, standing or operating equipment may not be significant. However, because the mental capacity to safely and effectively perform physical duties may be compromised by your bipolar disorder, the implications of the condition on your overall ability to work can be far reaching. Additionally, because bipolar disorder often affects sleep patterns, you may be physically fatigued and experience balance problems or muscle weakness. These and other physical manifestations of symptoms can impact your capability to perform physical job requirements.
Can I Drive When Taking Mood Stabilisers
Some mood stabilisers may make you drowsy and affect your driving. Tell the DVLA if you are taking medication that may affect your driving. You should also tell them if you have a medical condition that could affect your driving.
You can find out more about Driving and mental illness by clicking here.
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The Role Of Mitochondria
Experts also believe mitochondria which you may remember from science class as the cells that generate energy, aka the powerhouse of the cell may have something to do with the development of mood disorders.
When cells dont produce or metabolize energy as they typically would, the resulting imbalances in brain energy could lead to the changes in mood and behavior often seen with bipolar disorder.
What You Can Do
Try these suggestions if you find your mood slipping and depression symptoms returning, despite taking antidepressants:
- Take your medicine as prescribed. Its common for patients to stop taking their medicine or to reduce the dosage, thinking they can get by on less, Dr. Anable says. This is not a cold or flu that is treated and gone. Its a lot like diabetes or high blood pressure, something you have to deal with a long time.
He cautions against changing your medication unless you talk with your health care provider. To get the maximum benefit from your antidepressant, he suggests, Its important to take your medicine at the same time every day. Either in the morning when you get up or at night when you go to bed is a good idea. Routine makes missing a does less likely and better regulates the medicine in your system.
- Avoid excessive use of alcohol and other drugs. Depression and substance abuse often go together and need to be treated simultaneously, Dr. Anable says. If you are struggling at all while taking antidepressants, try giving up alcohol. Any type of substance abuse alcohol or drugs changes the chemicals in the brain, making it harder for antidepressants to work.
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What Are Mood Stabilisers
Mood stabilisers are a type of medication that can help if you have unhelpful moods swings such as mania, hypomania and depression They help to control and even out these mood swings.
Mania
Symptoms of mania can include:
- feeling happy or excited, even if things are not going well for you,
- being full of new and exciting ideas,
- moving quickly from one idea to another,
- hearing voices that other people cant hear,
- being more irritable than normal,
- feeling more important than usual,
- talking very quickly, jumping from one idea to another, racing thoughts,
- being easily distracted and struggle to focus on one topic,
- being over familiar with people,
- not being able to sleep, or feel that you dont want to sleep,
- thinking you can do much more than you actually can,
- making unusual, or big decisions without thinking them through, and
- doing things you normally wouldnt which can cause problems. Such as:
- spending a lot of money,
- being more interested in sex,
- using drugs or alcohol,
- making unwise business decisions.
Hypomania
Hypomania is like mania but you will have milder symptoms. Treatment for hypomania is similar to the treatment for mania.
Depression
Symptoms of depression can include:
- low mood,
- sleeping too much or not being able to sleep,
- feeling more or less hungry than usual,
- losing or gaining weight, when you do not mean to, and
- thoughts of death or suicide, or suicide attempts.
Your mood may change quickly between mania and depression.
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Why Bipolar Lying Is Wrong
When we tell another person a lie we are behaving in a way that is controlling and contemptuous of that person. Telling someone a lie reduces the lied-to person from a subject to an object. That person cannot exercise their free will and personal judgment because they do not have all the facts. Rather, they become a prop for our playacting.3
Bipolar liars may not manipulate and attempt to control people out of malice, but mania can turn us into fantasists. And, as outlined above, there are many reasons Bipolar Disorder and lying is so tightly linked. The grandiosity, superiority, impulsivity, and loss of control experienced in a manic state contribute to the Bipolar liars attempts at controlling others and everything around them. Their goal is to create a new reality-a sort of alternative universe-that supports their delusional state. However, we have a duty when we are well to reflect on why we lie during mood episodes and to include strategies for avoiding lies in our Treatment Contracts and Wellness Plans.
References:
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Lithium In Episodes With Mixed Features And Rapid Cycling
BD, especially in the lifelong course, is typically characterized by recurring mood episodes of opposite polarity. However, patients may also experience episodes in which depressive and manic symptoms co-occur. These phases were traditionally called mixed states or mixed episodes. The DSM-5 substituted these terms by the so-called mixed specifier, which indicates the presence of mixed symptoms in either manic or depressive episodes . Patients with mixed features in the course of their illness have a considerably higher risk to commit suicide and higher rates of comorbidities . They suffer from high rates of relapses and experience a larger number of new episodes compared to BD patients without mixed symptoms .
Treatment of patients suffering from affective episodes with mixed features is particularly demanding for clinicians, especially as there is a lack of RCTs investigating these patients. The available data on the effectiveness of lithium in mood episodes with mixed symptoms are inconclusive . In patients with a manic episode and additional depressive symptoms, lithium was found to be less effective than valproate .
How Fast Do Bipolar Meds Work
It depends on what type of medication you are prescribed. There are many different types of medications for bipolar disorder, and they all work differently.
The most common medications used to treat bipolar disorder are mood stabilizers. There are many different types of mood stabilizers, and each works a bit differently But generally, it takes at least 2 weeks for them to take effect. If you are hospitalized for a severe manic episode, a psychiatrist might temporarily give you a higher dose to help you get back on your feet more quickly.
Sometimes people with bipolar disorder are also prescribed antidepressants. These generally take 4-6 weeks to take effect. Antidepressants only help with depression, not with manic episodesso you might not notice their benefits right away unless you are having a depressive episode.
People with bipolar disorder can also be prescribed anti-anxiety medications, like benzodiazepines. These work very quickly , and wear off after a few hours.
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