How can I be up to 90mg Cymbalta, 600mg Trileptal and recently added 5mg of Abilify for Bipolar & I feel worse

Question

I am getting very discouraged. After taking nothing but 40mg of Paxil for 9 years, how can I be on so much medication and not getting better.

My thoughts are rambled, detached and disorganized.

any words of encouragement?

Answer 1

You are on too many medications and the doseage of the cymbalta is quite high. I would find a new doctor

Answer 2

If this treatment has been going on for more than a couple of months, and you still don't feel well (whether you're going through a depressive or manic episode), there's still plenty left to do. 5 mg Abilify is a negligible dose, you should get that up to at least 15 mg. You can try switching Trileptal for lithium, which has more side-effects but is way better at controlling refractory depression and mania. If none of this works I would recommend ECT (electroconvulsive therapy). Some people refuse to receive ECT because of the bad press. If this is your case, TMS (transcranial magnetic stimulation) might help if your episode is purely depressive. In any case, duloxetine (Cymbalta) is not approved at present for bipolar depression, since there is evidence it can induce rapid or even ultra-rapid cycling. And 60 mg should be the top dose, since there is no evidence that higher doses provide any benefit. If you are feeling worse, this might be the reason. You should see another psychiatrist at least for a second opinion.

As you can see, you are not out of options here. I've seen many cases like yours, and very few indeed were ultimately untreatable. And I'm bipolar too, so I know what you are going through. In my case it also took some time to get the meds right, but now I'm doing great.

Take care and good luck. I hope you get well soon.

Answer 3

Hang in there, medication changes are not fun. Did you have to get off Paxil because it stopped working, or was it due to kidney or liver damage, or potential damage? If not, you may want to ask your doctor to change you back to the Paxil.



You should probably touch base with your doctor tomorrow, if it has been at least a week or two and you still experience these symptoms. I do know that some anti-depressants and psycho-pharmaceuticals take a while to build up in your system and become effective.



Sometimes the side-effects of medications make a particular drug not good for a particular person. I often have opposite reactions to meds, such as a sedative will make me pep up...and one drug that was supposed to give me energy made me feel like I couldn't wake up completely and was walking through Jello.



Just don't be afraid to advocate for yourself--sometimes doctors can be very stubborn, but if yours doesn't listen to you, consider a new doctor who will work with you on meds.

Answer 4

A good site for psych med info from the user perspective is http://www.crazymeds.us There are links to legit research and med info. There also is a talk board where you can read posts by others just starting stabilizers, and can post your own questions. The info you need to provide for decent answers includes why you were put on stabilizers and whether you are in a depressed or hypo/manic state.



In either mood state, when first put on stabilizers it takes time to find the meds that work for you. That includes the particular mix of meds and particular doses. Assuming there was a very good reason to put you on stabilizers, that your not feeling better may mean that without the meds you would feel worse. I have gotten to where I feel fine and with my pdoc's okay, have tried lowering meds to only find out that, nope, very bad idea. Anyway, be patient (I know, hard). It does get better.

Answer 5

If all this happened after you were switched from the 40mg Paxil, then it is quite possible you are being medicated with 3 drugs for Paxil withdrawal effects, with the Cymbalta (SNRI) not masking the Paxil (SSRI) withdrawal.



If it is the Paxil - known to be the worst of the SSRIs from which to withdraw - then you will find much pertinent information over at the 'Paxil Progress' site which has amassed the knowledge of several thousand Paxil withdrawal experiences.



It could also be the new drug side-effects and/or combination effects. Something to talk through with your doctor.

Answer 6

dude- see another doctor. with that much medication--i'm surprised that you're coherent at all. all you need for bipolar is 60mg 1xdaily, xanax 3xdaily, and 2mg of abilify. you definitely need another doctor/opinion. you are taking too much medication. you also need psychotherapy. good luck

Answer 7

see about being tested for ADHD - whether the hyperactive or inattentive type, they are both very real and very life-altering disorders. if you do have it, the great news is that there are a lot of new medications on the market that WILL help...Adderall XR is my top choice.