BellaOnline Forums Health and Fitness Mental Health Bipolar - fatigue, meds, weight - vicious cycle

I began seeing my psychiatrist about 5-6 years ago. I feel he saved my life. I had not known I was bipolar but had always been treated with anxiety and depression. I think my doctor is EXCELLENT. My mood swings are very manageable. It took years to find a doctor I trusted.

Problem: the medications make me so lethargic. I feel sleepy or tired most of the time and can sometimes barely function. Until recently I was on 1500mg Depakote and 200mg Lamictal for bipolar, 50mg Zoloft for OCD and 1mg Klonipin 2 x day for anxiety. All of those medications are sedating. I tested very high for ADD and, at my request, we tried Focalin and it worked except the small amount made me too hyper and my doctor did not want to increase Klonipin.

I have two children and simply cannot afford to take 3 hours naps during the day and not have the energy to sweep the floor and no energy to exercise. I've gained 40 pounds. I finally told him I could not continue with the high dosage because I needed better quality of life. The change he made was to bring the Depakote down to 500mg per day. He feels strongly that I need 200mg Lamictal and that 500mg Depakote is the 'corresponding' dosage.

I can drink coffee, pop Excedrin, drink Diet Dr. P., etc. all day long and I STILL am tired. Should I be this tired at this new dosage? It's been about 3 weeks. IS THIS STILL A HIGH DOSAGE? Anyone else been on this 'cocktail' and if so, how did you resolve it to get your life more managable and better quality?

Thank you.

Talk to your pdoc about your fatigue and see if you can gradually and carefully try a new mix.

I have heard that Klonipin can be very sedating, so that may be the major culprit. Also, Depakote is probably causing the weight gain. Lamictal & Zoloft should not effect energy levels or weight too much.

An antidepressant that also helps with anxiety combined with a newer antipsychotic (like Abilify)to control the mania can sometimes create a good balance.

Weight gain may always be a battle with bipolar meds, but as long as you have some energy you can at least excercise and keep excessive weight gain in check. It's all a balancing act:)

I also am bipolar, and take 900mg of seroquel a day, 30mg of lexapro. i am at my low right now and im very depressed, i beat my self up emotionally, the swings are difficult i was walking 5 to 6 days a week for over 3 months, and now i crashed. im back on the couch in my pjs. i am having a very hard time right now. i feel like such a failure.

The truth is - ALL of these medications have listed side effects that include lethargy, insomnia, and drowsiness. Twangganger - your level of sleepiness is normal for many. That's why people often stop taking the medication! They can't function. It is better to take medications in the evening, usually around 5pm, so that they can begin to metabolize a little earlier and not leave you with the 'hangover' effect. Taking an extended release form of those that have this option available will help. Klonopin does not cause sleepiness if you have been on it for a while and neither does Zoloft - your body adapts. Unfortunately, for many of the antipsychotic and antiseizure medications, it can take quite a while for the body to adapt, and if your metabolism is slower in general then you may not completely....it can help to put your body on a schedule. Kind of like a baby: eat, sleep, clean, whatever. Then you give your body a chance to 'get used' to something.

I habe been Bipolar since my preteens & was not DX'd until after 3 hospitilizations...I also have OCD, incest surivor, PTSD & battered woman survivor. My meds are Seroquel, Depakote, Lorazepam & Paxil. Prozac makes me terribly manic & mean. I have gained 140 pounds on the meds & have developed high BP, Dibetes 2 & high Cholesterol. I am trying to get the weight problems down cuz I am so ashamed.

Seroquel is known to cause diabetes!

I went from 140 pounds to 285 pounds in just a couple of years. I try to tell myself that it is okay, but I know it's not. I am middle aged & it is very unhealthy for me. My Pdoc has tried various med cocktails for me, but the Bipolar always wins. Right now I have lost interest in everything. Sorry to be such a sad sack.

Ruby i hear ya, many times my meds cause me to be depressed, i am Bipolar and my lows bring me very down, i lose interest in everything also. its easy for some one to say get moving do something. but depression is just that. How do you not give into it. The weight gain is another reason to be depressed i know, its my problem to. I have a hard time dealing with the highs and lows the lows seem to last so much longer than the highs. hang in there girl, talk to your doctor, tell him or her just what your feeling. Ask about a change in your meds. good luck

Rosie, Hi !! You wouldn't believe how much better I felt just to have someone acknowledge me ! I spent the whole day just rocking in my chair not even watching tv which is how I spend most days until I finally discovered how to use this forum. I feel like I fell into a vat of cracker jacks !!! No insult meant, I feel happy. Thank you !!!!!

Ruby, good to hear that. now put another smile on your face today and feel free to come here and vent all you want. people here care, many of us are dealing with the same issues. Hope your day to day is better than yesterday, smile sweetie ;o)

I take Klonipin and have been for years. It is a addictive drug. The reason the Dr. gave it to me is for sleeping. I take only 2mg, don't know if they make any higher, and I am asleep with in 30 minutes. I go into a deep sleep for about 4 hrs and then I can wake up easily. If I don't get a full 7-8 hrs of sleep in then it affects me the next day, usually in the afternoon.
This is a narcotic and it is really interesting how it works on different people. I am also just starting with phyciatrist and therapist. They say I have Bipolar,Unipolar mainly, but I was just reading about ADD in adults. I could relate to most of the things they were saying about that!
I haven't been on in a while but hope to keep up to learn more about these subjects. My Dr. is still trying different medicines.
I just want to know what is wrong with me!

I take Klonipin, too (or rather the generic Clonazepam) 0.5 mg.
But I take it for panic attacks.

I take Ambien and Seroquel to help with my insomnia. We found that if I took a full dose of Ambien I would sleepwalk terrible, but the Seroquel could not get me to sleep. By taking 1/2 ambien and a seroquel I can get to sleep and stay asleep- and don't have the sleep walking side effects.

And now I take Lexapro for the depression. I do have some weight gain, but it is worth it to me to be able to function during the day.

It is really about what you are willing to trade off.

Hi, I have bipolar for many, many years. For your depression ask your doctor about Wellbutrin XL. I have been taking it for 5 years - works great! Keeps the weight down. I am 122 and never gained a pound - unless I eat Italian pastries!
bye
susje

HI Rose I am sue, have you taken any other medications? I am asking because I have taken many until the doctor found the right one for me. I am taking Carbamazipine, Wellbutrin XL & Geodon - Geodon is for anxiety and panic attacks.
I have tried Zoloft and I became a vegetable! Becareful with that medicine. Some people it works for other people it does not.
Lithium is the basic and it worked for me for 2 years.
Hope they find the right medications for you. Do not give up there is medication that will help you.
Sue

Sue, believe me I've been on them all, I've been on "head meds" since the 70s, I've been locked up in the psych ward 3 times for being suicidal due to depression. When I do find a medication that quotes," makes me feel better" I stop taking it, the reason I'm not used to feeling that way and it freaks me out.

I am also bipolar, plus ADD and a nice pinch of dyslexia. I'm taking Welbutrin and Straterra. I've tried several mixes and so far this one is the "best." I have the most trouble remembering to take them (thanks ADD). I still have mood swings however, and sometimes feel like I'll never be stable.

rubyzmama,
your original post was a while back, but it really touched me and I wanted to let you know that. I've been very overweight my entire life and a couple of years ago in a manic state which lasted a very long time I was able to pull myself together and loose 94lbs. After getting back with my ex I started to fall and eventually spiraled down and gained it back plus more. That's where I am now. I want so badly to loose the weight. Not sure when/if it will happen again. You're right, it's nice to hear someone else going through the same things.
Liz

Hi everyone! I've just found this forum so I hope no one minds me barging in everywhere.

It took me years to find the right doc who could find the right combo of drugs for me (bipolar). I take 225 mg of Effexor, plus 100 mg of Lamictal. Both those drugs have been a godsend for me. I know lots of people are kind of scared of Effexor - there's a lot of scary stuff out there on the web - but I think it's a great med. I also take Seroquel (100 mg) at night to sleep, but it gives me horrible muscle twitches in the first hour or so, so I take 1/8 mg of Xanax with it, which puts me to sleep right away so I don't feel the twitches. Sometimes I take the Seroquel about an hour before I plan to go to bed, and just stay awake and deal with the twitches, but then I think, why should I torture myself when I can take the Xanax? An eighth of a milligram is a pretty darn small dose. I've been taking this combination for years and years now and have not become addicted to the Xanax, so I think it's okay.

None of these things have caused weight gain, but I think that's because of the Effexor, which often causes weight loss. I think that that may cancel out the weight-gain effect of the other drugs.

I still get lethargic and sometimes take naps, but I plan them so that in a certain amount of time, I have to do something - go to the post office before it closes, for instance. Then I can't just stay in bed for hours.

another thing - be kind to yourself. Yeah, my house isn't as neat as it should be. Yeah, I get really behind on laundry. Yup, I still have my Xmas tree up because I haven't gotten around to taking it down. But that's okay. it's a cliche, but really - don't sweat the small stuff. Give yourself permission to take care of yourself.

Michelle, I forgot to say, I tried Ambien too - and I started sleep-eating! It was so bizarre. I'd wake up in the morning and find that I had gotten up in the night and ate a peanut butter sandwich - and I don't even like peanut butter! and no memory of doing it at all. I blamed my husband the first few times! I've never had such a strange side effect.

I've been on clonazepam for years, like Michelle it's for panic attacks. I've been tried on MAOIs, SSRIs, SNRIs, etc and they don't help ... only harm.
Sleep eating! Wow. That would un-nerve me...