Bipolar Support Group

This is actually beginning to make a bit of sense to me while I'm writing it. But anyway, he wants me to be on Klonopin first to see how I react to medication. I don't drink or do drugs and I rarely take medication so I'll be taking .5mg (cut in half) twice a day for the next three weeks.

Is this.. right? I'm also supposed to be seeing someone, I had to make an appointment with a counselor to even get the prescription. Of course my original counselor isn't there (maternity leave) and I won't be able to meet with anyone for two weeks.

Should I ask for a referral or second opinion? I've been doing some research and it's actually beginning to make a lot more sense to me, bipolar that is. I want to make sure I'll be getting the right medication but I also don't want to ask for it. I'm not a hypochondriac, promise! Just generally concerned and confused.

Thank you so much for your input.

Mood stabilizers are what I need for every day. They keep me level instead of swinging up and down. (I have mixed states so the depression is right along with the rage/mania.)

It sounds like your doctor is trying to ease you into meds. Sometimes when they start you on a cocktail, you can get tired and feel weird. This is okay for many people at first, but maybe in your situation he wants you to go slow. [Completely unrelated but made me laugh.... I accidentally typed cockatiel instead of cocktail. Haha!)

You can definitely get a second, third, fourth opinion. It's your body and you know it best.

((((hugs))) to you!!

Having said all that, my two primary meds that stabilize me and keep me on the ground are Lithium and Lamictal. These two meds are my lifelines to being functional. I must take them every day, on a schedule, to keep them in my system or else my mania kicks me in the butt quickly and unannounced.

I normally take Xanax here and there to help alleviate symptoms of anxiety that still creep up from time to time, mainly racing thoughts. Recently, though, my Lithium level dropped significantly and I went hypomanic pretty quick. My doc increased my Lithium right away. As it increases in my system, the hypomania is slowly subsiding but I have been taking Xanax daily the last couple weeks to slow down the racing thoughts.

I can tell when I start to go HM because I realize I'm talking A LOT to people and in super long sentences. When I'm talking, I suddenly notice people are looking at me like I'm nuts or weird. Then I slow myself down. But using some Xanax helps that until My Lithium builds back up.

Lastly, I think each of us has to advocate for ourselves in finding the right treatment. It's okay to ask your doctor about medications, if they can help, etc. That doesn't make you "drug-seeking." It just makes you an informed patient.

Good luck, friend.

In all respects, I defer to you psychiatrist, as he/she is the only one who can prescribe for you and knows what's best in your case.

You should get a second opinion if you want one, but I don't hear anything that's going on that would make me seek a second opinion.

It's scary to go on meds for the first time. Most people, no matter what their diagnosis is, have a lot of resistance to the idea. Many people also have some ideas or myths about meds and mental illness that aren't true.

You might want to think about that and feel free to share any thoughts, concerns, or questions here AND with your psychiatrist.

Did you see the psychiatrist for the meds eval? Or are the meds being prescribed based on what the counselor is telling the psychiatrist?

If you haven't seen the psychiatrist personally, I would ask for an evaluation with him/her; in fact, I'd insist upon it.

You didn't mention a diagnosis. Ask for your diagnosis, or at least what they are trying to rule out.

Your symptoms may be consistent with bipolar (we can't and don't diagnose here).

Based on my personal knowledge and experience, I think klonopin is a poor choice for a first drug to try. If they want to try an anti-anxiety med, xanax is a better choice to start with. They may have a University policy that they don't prescribe xanax because it can be addictive and many people abuse it. But, the same can be said of klonopin. In fact, klonopin is just a longer acting benzodiazepine and withdrawal from it is much harder.

If you have bipolar, the most appropriate first step is to prescribe a mood stabilizer. Often, that alone will handle the anxiety that can be part of bipolar. A likely choice in a University setting is Lamictal. Lamictal is a very safe drug used to treat bipolar. It is an anti-convulsant with mood stabilizing properties that may also help depression and anxiety. If you have a University drug plan where you don't pay very much for your drugs, I would insist on the brand name rather than the generic. (But that is another story.)

If they want to give you an anti-anxiety drug, I would ask for buspar (safest choice, not always effective) or xanax, and say no to the klonopin. If you can't sleep, ask for a sleeping pill (Ambien or they may prescribe another bipolar med in lieu of a sleeping pill, but still you'll be able to sleep).

If they want to add something to your Lamictal, I would ask for Abilify (very low dose).

So, at least I've given you lots of drugs to look up.

I think that on some level, docs who tell patients to look up and decide about recommended drugs are shirking their professional responsibility. They seem to operate under the illusion that it decreases their liability if something goes wrong. But, that is simply not true under the law. It is the doctor's job to research the drug, inform the patient of the benefits vs. disadvantages and side effects, let the patient know they can refuse to take the drug, and to have the patient read and sign the appropriate release. In cases where patients are told to look a drug up and decide if they want to take it, typically the patient becomes confused and uncertain. IMHO, this is not practicing medicine.

A physical at your age is ESSENTIAL to rule out any underlying organic causes of your symptoms.

So, if it were me, my basic plan of attack would be:

1) Get a full physical with blood work and a test of your thyroid functioning (including a separate T3 level) ASAP.

2) Get an evaluation with the psychiatrist (unless you have had one).

3) ALWAYS follow your doctor's recommendations for meds. BUT if they are giving you choices like they did this time, I'd be interested in the following meds in this order of trying them: a mood stabilizer like Lamictal (there are others, too); Abilify or other low-dose anti-psychotic; something to sleep, if needed (Ambien or another med for bipolar); maybe an anti-anxiety drug (buspar first, xanax second.) But, AGAIN I'm not a doctor and always defer to your doctor; only your doctor knows what is best for you.

4) Get all of the following forms of treatment: regular visits with a psychiatrist; weekly psychotherapy with a licensed therapist (not a student therapist) - I recommend a psychologist; consider bipolar group therapy (but only with bipolars).

Hope something here helps. Keep us posted. We care about how you are doing. (((HUGS))) -sarah troy

____________________________________________________________ __

Post edited by: sarahtroy, at: 07/04/2012 10:22 AM

I was started on klonopin when i was manic or having a mixed episode to calm me down until the mood stabilizer kicked in, which can take anywhere from a week to a month depending on the medication.