Syndicated from the Bipolar Blog
Sometimes, you may begin to wonder what’s worse—the depression and mania or the side effects from the medications used to control the depression and mania. In fact, one of the main reasons that people with bipolar disorder stop taking their medications is because they simply can no longer tolerate the negative side effects. And who can blame them? Nobody likes to gain 30 pounds, feel groggy all day, become forgetful, walk around feeling dizzy, shake, twitch, feel nauseous, or have an anxiety attack. Yet, all of these side effects and more are possible with one medication or another used to treat bipolar symptoms.
Fortunately, there are a number of techniques for controlling some of the worst side effects. Not all of them are perfect, but the strategies described here, which you and your doctor may consider, can frequently reduce or even eliminate negative side effects.
Warning: Do not try any of the techniques offered here without first consulting with your physician/psychiatrist. We offer these only as possible ideas for discussion. Never make adjustments on your own.
When you experience a particularly unpleasant side effect, a common impulse is to stop or change the medications on your own. Try to avoid this at all costs—talking to you doctor is the best way to manage the side effects without causing further problems. Something else completely unrelated to the medication may be going on, and your doctor can help you sort it all out. If a medication adjustment is required, he or she can also assist you with making those changes.
Tip: Before you begin taking a new medication, ask your doctor to explain the most common and serious side effects, so you know what to watch out for and what to do if you notice a particular side effect.
When you first start taking a medication, side effects tend to be more common, because your body must get acclimated to the new substance you’re ingesting. Just as ramping up your exercise routine too fast can make you feel ill, starting out with full doses of a medication can cause imbalances in your system.
Your doctor will probably increase the dosage gradually to help you avoid or diminish the intensity of the side effects. Don’t increase the medication any faster than is recommended. And if you don’t feel well as you are increasing the dose, ask your doctor if you can increase even more slowly.
If you typically take a medication in the morning, and it makes you too drowsy for work, your doctor may recommend that you take it in the afternoon or evening. If you cannot sleep when you take a particular medication at night, your doctor may recommend taking it earlier in the day.
One of the most common strategies used to reduce side effects is to reduce dosage. After adjusting medication doses upward to get the desired effect, you can sometimes back down a bit without losing the benefit. This isn’t always possible, but it is often one of the first things your doctor will suggest.
Many medications come in extended-release tablets that release the medication to your bloodstream gradually rather than all at once. Consult your doctor concerning your options.
Tip: If no extended-release version of the medication exists, your doctor may recommend that instead of taking one large dose, you take two or more smaller doses throughout the day. This makes taking the medication less convenient, but it may help alleviate the side effects.
For example, if you experience weight gain on Depakote, your doctor may prescribe Topamax in an attempt to reduce weight gain.
We’ve read other articles that recommend dieting and exercising more, which is certainly an option, but such suggestions usually come from people who haven’t experienced a persistent weight problem or don’t know just how frustrating it is to gain 30 or 40 pounds due to a medication that’s supposed to make you feel better.
However, if you are uncomfortable adding more medications and want to pursue more dietary and exercise strategies, then your doctor may have you consult with a nutritionist or physical therapist, who can give you some ideas on small changes that you might be able to make to at least reduce some of these effects.
If a medication causes intolerable side effects, your doctor may wean you off your current medication and prescribe a new medication that’s less likely to produce the same side effect.
Some medications can dry out your mouth, and if you have to talk during the day (as most people are wont to do), this can become very annoying. Sucking on a sugar-free lozenge or sipping water throughout the day can help, but if it becomes too much of a problem, you may want to consult your doctor about other options.
Tip: Your local pharmacy probably has some over-the-counter products specifically developed for reducing dry mouth—dental rinses and such. Ask your pharmacist about what is available.
Caution: If you are on lithium, be very cautious about changing your water intake drastically in any direction—up or down. Even taking small sips, if you are doing it all day, could be enough to change the lithium concentration in your blood and change the effects. Reducing your fluid intake can increase the blood level and create lithium toxicity, a potentially life-threatening situation.
Although medication is the first-line treatment for bipolar depression and mania, it is not the only treatment. By combining medication with various types of therapies, including psycho-education (books, tapes, and so on), cognitive behavioral therapy, interpersonal and social rhythm therapy, and relationship and family therapy, you may be able to reduce your reliance on medications alone, which could result in fewer side effects.
In this article, we address some common, annoying side effects and advise you to contact your physician to discuss any side effects and possible adjustments to deal with these. There are some situations, however, that are potential emergencies. If you experience any of the following side effects, call your doctor immediately:
Remember, you don’t have to simply tough it out when you experience side effects. Call your doctor and see if there is anything else you can do to reduce or eliminate the ill effects of your medication.
Related Posts
You can leave a response, or trackback from your own site.
Weight Loss » Blog Archive » Managing Bipolar Medication Side Effects (December 2, 2008)
Special Needs Business | Bipolar medication side effects | Special Needs Business Directory | Special Needs Business Resource | Special Needs Business Support (December 3, 2008)
current problems in education | Digg hot tags (December 3, 2008)
Managing Bipolar Medication Side Effects | Blog posts trends (December 3, 2008)
From Psych Central's Dr. Candida Fink & Joe Kraynak:
» 10 Bipolar Disorder Self-Help Tips - Bipolar Beat (December 23, 2008)
From Psych Central's Dr. Candida Fink & Joe Kraynak:
Atypical Antipsychotics for Bipolar Disorder - Psych Central (January 14, 2009)
I have been on various psychotropic drugs. All have their own set of side effects. Currently, I am on two of them….Lamictal and Klonopin.
For me, less drugs better off I am. I have been able to gain control over the bipolar disorder instead of it controlling me. That’s 75% of the battle…
What can I do about hair loss from Depakote? It’s the only medication that (sort of) works for me so my doctor won’t switch me to another, and I’m on as low a dose as possible. It’s really awful to be a balding woman. I don’t know what I can do about it.
Hi Brandie –
There have been some studies suggesting that Zinc supplementation may help reduce hair loss from depakote. You can try an over the counter zinc supplementation if your doctor approves – she may have thoughts about dosing the supplement as well.
My brother has suffered from bipolar for years. He tried to kill himself three times in the past 20 years. He is currently recovering from his last big ‘meltdown’ and is being weaned off Lamicdal and seroquel and eventually adding Lexipro. I for one don’t think he’s headed in the right direction but won’t argue with his doctor yet. My question: where do the paranoic thoughts come from? Is that common side effects of one of his drugs? Is it a side effect of bipolar that maybe comes with age? It’s a new symptom in the last year.
Hi, Lauree–
The paranoia is part of bipolar for some people. When my wife is cycling, she experiences psychosis, which includes paranoia and hallucinations (visual and auditory). Most of the docs she’s seen have prescribed various atypical antipsychotics to control the mania and the psychosis which often accompanies it – meds like Seroquel, Abilify, Zyprexa, Risperdal, and Geodon, but most of these trigger weight gain, which she will not tolerate.
I’m no doctor, but I would think that if your brother’s doctor is withdrawing the Lamictal and Seroquel, some other mood stabilizer and/or antipsychotic would need to be in place to replace these. Lexapro is an SSRI antidepressant, which alone will do nothing to muffle the mania or psychosis and may even (without an anti-manic medication in place) worsen the mania and psychosis.
In short, I think your insticts are correct in questioning what the doctor is doing. Although you may not want to argue with the doctor at this point, asking questions never hurts.
Thanks Joe. You affirmed what I was thinking. My only hope is that when I talked to my brother last (yesterday), he misspoke about the new meds the doctor was going to give him and that maybe he meant Zyprexa.
As far as the weight gain associated with that medication, I know first hand the very rapid weight gain caused by Zyprexa. I think at this point my brother would not care so much about the weight gain if he could just get his ‘old’ personality back. It’s so hard listening to a 54 year man cry in agony because he is so sad and feels like such a burden to his wife.
Again, I thank you for your response. I will pursue come kind of communication with his doctor. He (his doctor) is new to my brother’s case and I’m not sure how completely he was filled in by my brother and sister in law.
Agh! So frustrating!
The side effects of the meds are working against me- I have to take 9 medications at bedtime! The interactions make the side effects worse! I work at crafts at home- My hands tremor so much that I can’t thread my sewing machine or put beads onto wire. I feel like a zombie most of the day, then its time to take my meds. Although I was on these meds for some time(5 months) when I stopped them if felt like I was back to normal, but now my doctor says I was hypomanic, which led to my depression and suicidal plans now. Plus all these meds are ASSUMED to work on this or that chemical- show me the blood test that says these chemicals are out of whack in my body and the follow up showing me that the chemical fixed it! I have diabeites- No meds, my sugars high, with meds, its in the normal range- why don’t they find lab tests that tell what chemicals are messed up in our brain, rather than just tweaking an old formuls, slapping on a new label the charging us an arm and a leg??
24 lbs later on Seroquel, and self esteem in the toilet, stopped meds and resorted to alcohol. That certainly didn’t work. Back on meds but very depressed. I don’t know what the correct combo for my body to be, but I resent that the nature of the beast with these meds is trial and error.
Grrrr
Last reviewed: 5 Dec 2008
Copyright © 1992-2010 Psych Central. All rights reserved.
Site last updated: 21 Mar 2010
|
