It has happened again ... the dreaded side effects. I have no time for side effects! Within the past 6 years I have been on 40 medications, some have been repeats of the same old ones, but mostly they have been new. I am wondering if anyone else has concurrent side effects that prevents them from really being well?
Lets prognosticate for a moment. A tooth ache is underway, it subsides but reoccurs. I can take medication to kill the pain or by excision, the root of the problem cured.
But with a mental disorder there is no cure, so we rely on the science of medication. And with a broad brush we are painted and we fall in line.
So when does our cure occur?
Patience ... I suppose it is about patience.
Cynthia (www.LifeIsLikeALine.com-Life Is Like A Line-for and about bipolar unwellness)
Cynthia, your meds path sounds like mine. Diagnosed at 42; 7 years to stability. I don't know how many meds along the way but I fired a doctor after 3 years because he wasn't getting me anywhere. I now see an MD who has had a clinical research career focusing on adult bipolar and adult ADHD (which is not my issue), who can discuss treatment options clearly and thoroughly with me.
I've ended up on a polypharmacy regimen of very small doses of five meds, each of which provides me specific benefit and none of which is in sufficient quantity to have major side impact. I know that I need all of them because, as small as the doses are, if I run out of one, I begin to have paranoid thoughts; another my thoughts start to race such that I will not be able to sleep. Etc. The main side effect I still deal with is somewhat reduced small motor coordination (impact on typing, etc), plus I haven't taken off all the Zyprexa weight yet. I think that my relative inability to manage multiple activities (I used to be considered "the queen of multitasking" at my company!) just represents becoming more normal.
The most significant meds change for me (and you and I both know that everyone's chemistry is unique, so what works for one is by no means a prescription for another) was replacing lithium, which made me very forgetful and sleepy (to the point that I actually fell asleep in a business meeting and couldn't remember my boss's directions once I walked through his door. What we were able to substitute was Zonegran, an Eisai product that had been, at the time, only recently approved for the US market although it had been in use for about 12 years in Japan. It's an anticonvulsant, so it's used more nearly like the way carbamazepine is used as a second-line, off-label choice. And for what it's worth, the generic zonesimide doesn't work for me at all.
Complex polypharmacy is not extremely popular or easy to administer. I've had a well-reputed psychiatrist tell me "If I were your doc I'd take you off half of those" -- but she's not my doc and she doesn't understand how we got here and why. Plus, I know she takes four meds for bipolar, and I'm not really sure what the huge difference between four meds and five is anyway!
So ... If your doc can't help you, get the best doc your community has. And if that's who you're seeing now, consider how far you'd be willing to travel once a month -- and how much you'd be willing to pay -- to see an even better doc until you're stable. My appointments aren't 15 minutes; they're a half hour. That's reasonable to do the kind of work it's required, but no insurance will pay for all that time. Do what it takes. Because I really believe that if you're determined and find an outstanding practitioner, you'll get there.