I have been seriously off-the-wall manic. But not in a very long time. And it hit me recently that I really never had particularly hard-to-treat mania, even back then, I just had really bad psychiatric care- which really dragged things out and let my world get totally out of control.
Depakote doesn't work for me. And I had recently had lithium toxicity. So every psychiatrist I saw at the time would freak out and say there was nothing to do- or try me on some inappropriate medication. But I had been on Tegretol before, and it worked- and that was what eventually got me out of the manias in the end. It must have fallen out of favor. The one doctor I did suggest Tegretol to told me I was "drug-seeking." Well, technically yes, but what a drug to seek. I eventually got put on a baby dose by one doctor- a third of what I had taken in the past- and when he told me I was at a therapeutic level (I wasn't) and there was no point in going higher, and I wasn't responding- well, I was manic. I had no patience for idiots. I told him where he could go and stormed out.
But I now know that Tegretol works, lithium works, Zyprexa works. And for a little transient hypomania, klonopin works. I really don't need a bigger arsenal than that for keeping mania at bay. I am hoping not to to have to re-start the Tegretol anytime soon (and certainly not as long as I am taking Zyprexa- they are both anti-cholinergic), but it is there. Ideally I would like to get off of the Zyprexa- and just rely on the lithium. I hope that I can.
I just cut my Zyprexa a bit more last night after reading another article linking exposure to antipsychotics to brain volume. I've been on Zyprexa 15 years or so- perhaps most of the damage is already done. But who knows.
That's really weird about Tegretol. I was put on it when I stopped lithium the first time and it was no big deal, it just wasn't a good drug for me. (I guess I was on Trileptal but that's just fancy tegretol). To stay awake I had to take 1/32nd of a tablet. It is not easy to use a pill splitter to get that dose....But I did take it for several weeks and wasn't warned about it being anything to be concerned about. In fact before I was officially diagnosed and was worried about needing lithium (which I was already taking) for the rest of my life a friend who is a psychologist told me that tegretol was used more than lithium at that point. Don't know if that was true but he had no reason to lie.
ReplyDeleteMaybe your dr at the time had some reason to want to prescribe trileptal instead for financial reasons? Or had lost faith in both drugs? Weird.
Still, good that you know you have something to fall back on. I think that is a dream of mine.