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-   -   Hypomanic- new to Latuda- other concerns (https://www.neurotalk.org/bipolar-disorder/223273-hypomanic-latuda-concerns.html)

Mari 07-21-2015 01:53 PM

Kay,
We completely understand you. You are very clear.
It is going to be easier for me to post to you in small pieces because of my own issues. (I have multiple issues right now and I apologize.)

Quote:

She said she has had a lot of success with Latuda
That is flat out not true.
The drug, as far as I know, was approved in the US in 2013.


Quote:

mood stabilizer long term come from concerns
You do not need a mood stabilizer long term. You need something for right now.You are getting a head of yourself with your thinking.


Quote:

But the toll hypomania takes on my body is awful. My body can still feel it (but not so much if I'm drunk), nonetheless my mind drags that body a long. I guess how long I crash afterwards depends on how much damage is done, and how long the episode lasts.
I really and truly understand what you are saying about hypomania and MS.
That really really stinks. You need a pdoc sensitive to this.

The pdoc practice is not appropriate for you. They do not have the expertise or the stamina to deal with your type of mania.

Your very best bet is the ER although it can be a crap shoot because depending on what you reveal, what is in your record, and which pdoc you get, you could be locked up.
The good thing is that while you are locked up, you should have access to a social worker who can find you an appropriate placement for a pdoc when you get out.

Criteria for getting locked up varies by state.
It is usually something like this:
>>harmful to self or others.

In some states there is an another component more vaguely worded having to do with being able to take care of yourself. Find out which state here.

http://www.treatmentadvocacycenter.o...Procedures.pdf

http://www.treatmentadvocacycenter.o...-in-your-state

Depending on the law of the state, a pdoc can usually hold you temporarily for 72 hours. After that a judge can keep you in longer. Most states want you out as fast as they can (that initial 72 hours or so) due to shortage of beds and other costs but you could get unlucky / lucky enough to stay longer.


If you have access to a therapist, put in an emergency call now about possible hospitalization. You need to reach out to all your support people.

Quote:

She'll keep me on Latuda. "You were already hypomanic. Give it time to work." LOL
Refuse the med. Do try to keep a relationship with her for now until you get someone else.


M

Mari 07-21-2015 02:03 PM

Kay,

I see that Waves has posted. She is more knowledgeable than I am.

D/C-ing the Latuda is a good idea.

Decrease the Zoloft for tonight and tomorrow,
========
Call your MS doc to leave a message that you are at / very close to an emergency situation.
If you trust that office to care for you, reach out to them (1) in order to be on record and (2) with the hope that they can help you now and (3) with the hope that they can help you from the hospital after you are in-patient.

That office needs to have information regarding the degree of your hypo-mania right now.

===
In case your husband does not already have all doctor names and phone numbers and a list of your drugs, give him those now.

I send my very best thoughts for your safety, well being, and comfort.

M

waves 07-21-2015 04:37 PM

Quote:

Originally Posted by OhKay (Post 1156557)
I will try to get my pdoc on the phone tomorrow. Maybe she'll prescribe something, maybe she won't. She'll keep me on Latuda. "You were already hypomanic. Give it time to work." LOL

Akathisia is no freaking joke, and it seems pretty clear it's med induced. If your pdoc doesn't respond by reducing or suspending the offending med, see a different doc, even if that means going to the ER.

Do you have any other extra-pyramidal symptoms? If so you should report those too....

I am angry you didn't get a better response from the sub-pdoc. :mad:

:hug:

waves

p.s. I've read that benzo's sometimes do give benefit as well... I'd be careful increasing those though... but maybe an occasional dose can serve as a pad if things are particularly bad.

waves 07-21-2015 04:39 PM

Quote:

Originally Posted by Mari (Post 1156576)
Decrease the Zoloft for tonight and tomorrow,

That's actually a very good idea, given the hypomania. Zoloft can be activating ... especially if one is already activated, and will not help with the akathisia either. (SSRI's can actually cause it, even if that does not seem to be the case here if you were on it already.)

OhKay 07-21-2015 06:26 PM

Thank you Waves and thank you Benadryl!!!

50mg and I can sit still (to some degree)! But it's not helping the hypo, of course. I told my sister the pdoc should have suggested it, she responded that some people have "a bad reaction to it." LOL Let's start comparing benadryl to anti-psychotics now.

If that (expletive) thinks I'm going on a 6th psych med to counter-act akasthisia caused by a drug that's likely wrong for me in the first place, she's got another thing coming.

I've only had one appointment with my new neurologist, the next one is in August. Although BP is very common in MS, I doubt he would be of any help here. But I should make an appointment with my PCP. He's wonderful. My husband knows I keep a list of all my current meds on my computer desktop. I also keep a copy in my wallet along with business cards for all my doctors.

I'm not going to the ER unless I'm s/s...
My local is where they took me after my s/s attempt, I had to stay in the cardiac unit there for a while after I did it, and I went there for a severe anxiety attack about a month after I came home. So there's history.
Also, even though I'm not s/s, I'm critiquing my own s/s attempt. If I'm 100% honest, this will no doubt raise flags of some color or another. Vague. Depending on who I get for an MD, I could very well get locked up.

I'm safe right now, and much more comfortable thanks to Waves' advice re:Benadryl.

I am going to take the Latuda and Zoloft tonight
since I am much more comfortable because of the Benadryl and don't want to screw around with too much on my own...
I see the therapist on Thursday, pdoc on Friday.No doubt there will be news.

Kay

Dmom3005 07-21-2015 07:58 PM

So glad the benedryl helped.

Donna :hug::grouphug:

bizi 07-21-2015 08:30 PM

glad it worked, for some they have the exact opposite reaction. It is like gambling....
bizi

Mari 07-22-2015 01:06 AM

Quote:

I should make an appointment with my PCP. He's wonderful.
Quote:

I see the therapist on Thursday, pdoc on Friday.
Dear Kay,

You have a lot of courage. :hug::hug::hug:
Do call the PCP.


Very glad that Waves's Benedryl suggestion is helping you.

Mari

waves 07-22-2015 08:34 AM

Quote:

Originally Posted by bizi (Post 1156682)
glad it worked, for some they have the exact opposite reaction. It is like gambling....
bizi

The paradoxical reaction you are referring to is possible, but improbable, and it is more common (less uncommon) in children than adults. Most adults find first-generation antihistamines sedating, and Benadryl specifically very sedating. It is even sold as a sleep aid.

In any event, that is why I suggested Kay take 50 mg only if she had already used it before and found it sedating, otherwise 25mg.

waves 07-22-2015 08:43 AM

Quote:

Originally Posted by OhKay (Post 1156656)
Thank you Waves and thank you Benadryl!!!

I am so glad you are feeling better! The pdoc really could have suggested it rather than tell you to suck it up or go to ER. People have done bad things when suffering from akathisia. That stupid doc deserves a taste of it her/himself. Forgive me for saying that but it makes me mad how utterly unresponsive they were to your needs.

I had it once in reaction to an excessive dose of Paxil (my second failure on Paxil). It really, really, really BITES. I not have any Benadryl. I took another first generation antihistamine having anticholinergic properties -- this is what is thought to help control EPS -- but mine had much less of that than Benadryl does, and in fact it did not help me. It really is hard to think under those conditions too, isn't it.

Quote:

I've only had one appointment with my new neurologist, the next one is in August. Although BP is very common in MS, I doubt he would be of any help here. But I should make an appointment with my PCP. He's wonderful.
Definitely yes to GP, but also, when you see your neurologist, bring any questions you have regarding whatever is on the table with meds. And if you are still negotiating over the Latuda by then (I hope not!) talk to him about it. As a neuro, I believe he will be aware of the meds somewhat, and as well as these side kinds of effects (EPS), so might be able to offer some input.
Quote:

I am going to take the Latuda and Zoloft tonight
Ask your "real" pdoc (not the stupid sub) about reducing the Zoloft given the hypomania. I've always had SSRI's reduced or suspended when hypo.


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