It's strange to have to kind of ask myself- or make myself do something again. I was right to question my judgement... I must have been higher than I thought I was much of the time.

how did it go?
bizi

It takes a lot to self regulate.

We get can get pretty good at it once we are in a comfortable range, but we need an MD we love who is watching out for us.


M

Pdoc was very pleased that we've made such great progress...

She prescribed 400mg caps of Gabapentin so I wouldn't have to split the 600mg tabs into 3/4's. The 450mg is sedating now, too. I hope dropping 50mg off the current dose helps. There's no plan to reduce the dosage to 300mg any time soon. I haven't been evened out for very long- it would be flirting with disaster.

She suggested taking a small dose of Seroquel in the am to control my anxiety. Anything I take to treat anxiety will contribute to the sedation to some extent, but I think that would really snow me. Instead, I'm switching from Xanax to Klonopin to see if that makes any difference.

My cognitive problems have returned. I think it's due to the fact that I'm not functioning at the high level I was when I was hypo, I'm slightly sedated, and I'm dealing with a high level of anxiety.

I see pdoc again in two weeks. In the meantime, I may have to rethink my position on Seroquel if my anxiety is too much for the Klonopin to handle. I'm going to have to accept at least a temporary period of sedation- that all too familiar trade off.

how much klonopin do you take now. In the morning i take 1 and 1/2 and at night now I take 1 and 1/2. lately i have been taking two at time because of my high anxiety.
bobby

Kay,

Yes about the trade off.
I can get sad thinking about all of our trade offs.

Do you get what you feel is enough sleep, esp with regard to
your concern about sedation?

M

Pdoc wrote the Klonopin: 1mg 3xday. I took it for the first time this morning because my husband didn't take me to the pharmacy until yesterday :(
The score: Anxiety-1, Klonopin-0. But it did work slightly better than the Xanax.

It seems like every time my husband speaks I say, "what?" Before he responds again, I finally get what he said. He thinks I'm hard of hearing and gets testy, but I'm really not giving myself enough time to let what he said process before I open my big mouth. I'm going to have to adjust.

I've had neuropsych evaluations done for my cognitive issues, but they were done before I was diagnosed with BP. Medication wasn't an issue then. The problems were attributed to a combination of MS, depression, anxiety, and fatigue. Believe it or not, when I'm not hypo fatigue is a major issue. It's the main draw-back of MS for me. Add in sedation...

I'm really missing being hypomanic right now. I feel like a (expletive) idiot. It's absolutely amazing how the brain works. How could I suddenly become so functional (in almost every way) when I was so dysfunctional? Pick which way you want to be sick, Kay.

I had a bunch of tricks that made functioning this way easier. But I've spent most of the last year manic/hypomanic, so I've forgotten them, but I'm sure they'll come back to me soon.

Kay


I am sleeping, except for the occasional night when MS takes a few hrs away. I think all the Seroquel helps with that. I can't complain there.

Hi Kay. With OCD,the mind is already occupied,so that's why you say What more then likely. He should be patient with you,and understand that you are dealing with a disability eventually.

I'm not a medical health professional, but the Klonopin alone would only work for a short period of time. Adding other medications to klonopin should present a better result over the (((Long run ))).

I've been taking the Xanax family of meds. for about 45 years. I started this when I was a teenager. This family of medications work at a low dose, with other meds over a long period of time. I've seen the big picture because of my experience with them. I started with Valium. It doesn't work for long,and the psychiatrists seemed to be helping with short term ideas. I was also put on Librium,then Ativan,then Xanax. I tried Klonopin,and felt no difference. It was only with the use of other meds. like Luvox for my OCD,and after a while Seroquel for the depression,and major anxiety before I got some results, but with side affects. These meds will make you tired in many occasions.

This has been my experience. At one time I was given powerful sleeping pills that I became addicted to. It's a long story,but they don't give those meds out very often now. Addiction on top of our anxieties is almost more then one can bare. These meds that they give us now are not as addictive.

BF:hug::hug::hug:

(((Also))) The minor anxiety drugs Valium,Librium,Ativan,Xanax,and Klonopin are addictive. So when ever you change these type of meds,taper off slowly unless you are being changed to another in this family of drugs. Like if you are being changed from Xanax to Klonopin,don't worry,but Xanax is the best for panic disorder.

Everyone is different,but this has been my experience. It's been a long road full of misunderstandings by me,and everyone around me. BF:hug::hug::hug:

:hug::hug::hug:Thank you again for your experience Steve:hug::hug::hug:

OCD is another thing that hypomania kept at bay. Some of my symptoms are starting to come back now, but not on an epic scale. At this point, it's just taking longer to get things done. Prior to this recent long episode, I was on Zoloft. It was helping, but I absolutely can't take an antidepressant now.

I applied for disability about 9yrs ago, and have been on disability d/t MS for 7. Not mental health reasons. My BP disorder is not on the books because I was not diagnosed at the time when I applied.

-----

I only started the Klonopin yesterday and it seems to be working slightly better than the Xanax for GAD, but I haven't had a panic attack yet.
I'll give the Klonopin a week, but I'm probably going to have to try taking the low dose of Seroquel in the morning and will probably need either Klonopin or Xanax, too.

Pdoc started talking about other options, but I'm obviously still very concerned about sedation. I'd rather retain control by taking prn meds than taking a daily med because once you take that kind of med you can't take it back.

While I'm dealing with a lot of issues right now, I am in familiar territory. And I have to keep reminding myself that the most important thing is I'm safe and even. I fought hard for that.

Kay

yes you did fight hard to get here and we are glad that you are here!
((((HUGS))))
bizi

Kay,

Yes re the familiar territory.
It is good and bad. Bad sometimes in that we live in a place not of our choosing but good that the territory is not unfriendly and we do know how to navigate it.

M

Right now I'm only leaving the house to go to the grocery store, pharmacy, or psych appointments. Aside from my 3 cats and the TV, there isn't much here to amuse me since I've suspended my epic cleaning mission.

But yesterday I made some soy candles. I sent away for a kit. It had simple instructions, the process was slow-paced, and it was as easy as making cookies from a mix. It kept me occupied for a couple of hours and at the end I had a product I was (somewhat) proud of.

Of course I can't make candles everyday, but at least I did something besides watch TV, clean, or do laundry.

I am sure your candles are nice!
bizi

My first batch of candles did come out well for a first effort. It's difficult to get the wick in the center, but I managed. :)
We burned the first one last night. The scent is very faint. Once I use up all the materials in the kit, I'm going to experiment with different products to make better candles. Hopefully, I they'll have a more concentrated scent.

My anxiety hasn't been quite as high the last two days, so the Klonopin has been doing a better job.

I had to take 0.5mg of Klonopin close to bedtime last night and it combined with the Seroquel and Gabapentin into a magical cocktail that led me to oversleep by three hours, but I'm no more sedated than usual this morning.

HI, Kay

I once considered soy candles. Probably there are companies and specific scents that are stronger. There are probably YouTube channels devoted to this subject if you up to dealing with that.


I keep these essential oils in little containers
1 peppermint for energy - but has a calming/ focusing characteristic as well.
2 Lemon balm for calming (somewhat) Also Lemon grass.


M

weighted blankets /heated blankets
 

Kay,

Have you every hear of weighted blankets?
They are marketed to autistic children who suffer from sensory overloads.
http://www.sensacalm.com/adult-lengt...hted-blankets/


They work for some people with bipolar as well.
Searching Google Scholar I found that Heated Blankets can
help as well and they are much cheaper.

This can calm some people:
Soaking feet in Epsom salts -- magnesium can relax.

M

Unfortunately, heat is an issue in MS. It exacerbates symptoms in many pts (myself included). I hide in the AC or shade in the summer. But if my neck goes out, I do have to use a heating pad, heat is the only thing that works.

Some waxes will absorb scent better than others, but most of the fragrance oils are formulated for 4-5% concentration. The essential oils are much stronger, but my husband is fixated on sandalwood. I'll probably just add extra and see what happens. I'm going to be a mad scientist ;)

I've had a lucky couple of days where my anxiety has been manageable, but it was out of control yesterday.
I took 1mg of Klonopin first, but it did nothing. After a couple of hours, I finally decided to try 25mg of Seroquel. It didn't do much, so I took 25mg more.
It took care of the anxiety, but it was a little sedating.
The late afternoon hours aren't my best on any given day (I usually have a fourth cup of coffee around 4), but I ended up needing a nap and that's out of the norm.

I know I won't need that much med every day. But I'm going to have to play around a little. The Klonopin doesn't do much on its own. I already took it this morning and I'm contemplating taking 25mg of Seroquel now. I may take the Seroquel first tomorrow to see if it can stand alone (I doubt it).

I hope you have a good day kay..
((((HUGS))))
bizi
day at a time...
fall down 7 times get up 8....

I like that :)

I decided to stick it out yesterday and didn't take the Seroquel.

I took 25mg of Seroquel first this morning. It can't stand alone. Apparently pairing it with 1mg of Klonopin isn't enough today either.

Today I'm going to try taking 0.5mg more of Klonopin to see what happens. I don't want to take another 25mg of Seroquel on top of what I've already taken Tomorrow I'm going to skip the Klonopin and take 50mg of Seroquel- omitting the Klonopin should help with the sedation.


Not too long ago I was 113lb at 5'8". My goal was to get up to 130-145. Thanks to Twinkies and Seroquel I'm at 135 now- finally a healthy weight. But I was so used to looking in the mirror and seeing a bag of bones I feel like I'm fat now. My body image is warped. I'm going to have to get my butt on the exercise bike. Maybe if I build up a little muscle I won't feel as bad. I should be on there anyway. My gait is worse because I'm not getting out and using my legs. In the past, my legs have only allowed 3 minutes at a time though. I'll probably have to work back up to that. My regular exercises are really only for ROM.

I surprised myself... 4.5min on the bike.

And the extra .5mg of Klonopin took care of the anxiety. I'm going to abandon the previous plan and try 1.5mg tomorrow.

that is fantastic!
bobby

I hope you find what works for you ASAP!
congratulations on getting on the bike!!!
bizi

I tried 1.5mg of Klonopin this morning and it did the job.

I see pdoc tomorrow. I don't know how happy she'll be that I took it upon myself to take more Klonopin than ordered, but I'll be honest. 50mg of Seroquel may do the job, but the Klonopin is less sedating.

No exercise bike yet today. I'm stuck at the DMV waiting to get a non-driver's ID. I think I'll die here waiting. At least I'll make a pretty corpse... I put on make up for the first time in an eon... Hoping my picture will be less horrendous.

Hi Kay. The problem about the Klonopin is that it is one of those drugs that will stop working when you take a large dose over a period of time. Dependence comes after that.

I wish that those type of meds worked over a long period of time at a high dose, but they don't. I wish that they did. OOOHHH is wish that they would work like that.

I'm on a small dose of Xanax with Seroquel,and Luvox. I wish that I had the answers. BF:hug::hug::hug:

Kay

Sounds like your doing pretty good.

Donna :hug::grouphug:

I'm going to take your advice BF... I often feel like you understand a lot of what I'm going through, and that it goes beyond the fact that we both take Seroquel.

I'm not going to try to take the 1.5mg of Klonopin again until I talk to my pdoc. I don't think she'll like it either.

I want to reiterate that you were right about the Seroquel weight gain- at least 10lbs of what I gained is thanks to it.

:hug: and Thanks,
Kay

Thank you Donna, I am doing a lot better! :) I'm even! :)

I took 1mg of Klonopin + 25mg of Seroquel and am "okay." I'm not going beyond that today.
I'm going to jump right into the deep end tomorrow, take 50mg of Seroquel and see how sedating it is. My husband will be home all day. There will be plenty of opportunity for conversation, so I'll be able to see how it effects my cognitive function, too.

My pdoc appointment was cancelled and rescheduled for Monday. At least I'll have more information about my anxiety test projects for her by then. I'm keeping notes. I don't know if it's going to be realistic for me to get rid of all my anxiety without an amount of sedation I'm comfortable with, but we'll see what she says. I'm leaning towards accepting some anxiety over sedation.

My case manager called and she is discharging me because I'm stable, even though it's only been for a couple of weeks, and she knows my history. The plan is for me, my husband, or the hospital to call my PCP to request a new referral if I become out of control again?

My left side is my weak side and I tend to lean that way. Between the exercise bike and sitting on the hard wooden bench for almost 3hrs at the DMV yesterday I have a sore red spot (the beginnings of a pressure sore) on my left butt cheek now. Not my first, so I know how to handle them. No exercise bike for a while... For (expletive's) sake- it was 4min! :(

Kay

Hi Kay. Please be careful concerning those sores. My sister developed a sore that turned into a bed sore awhile back,and she had to go though an extended stay at a hospital,and months of rehabilitation at a facility outside of the hospital. It took the whole family by surprise. BF:hug::hug::hug:

Kay,

That is great about being discharged.
Sorry to hear about the sore spot.

M

I may have given out to much information about possible bed sores. I'm sorry. I apologize.

It's been a difficult year for me. BF:hug::hug::hug:

Don't worry BF, I know plenty about bed sores... I worked as a CNA in hospitals for years (was also a nursing student) and helped treat bed sores as bad as most pictures found on the internet.
It's a small stage one, my skin is intact. Fortunately, I'm mobile enough to stay off of it. And I'll use a barrier cream to protect the skin. It should go away soon.
Enough about that... Gross.

I think my body has adjusted to the 400mg dose of Gabapentin :) I'm not waking up feeling sedated. Sometimes with the anti-anxiety meds I feel sedation, but the rest of what I'm dealing with is just baseline. I realize the rise and fall of my cognitive problems and fatigue aren't due to meds now, it's probably just the MS and anxiety.

I tried the 50mg of Seroquel. It causes a tolerable level of sedation, was fairly effective the first time, but doesn't last as long for anxiety as I thought it would. I guess it makes a little sense, since the pm dose never carried over to the am and I had to take prns to treat my hypomania.

I had an appointment with my pdoc this morning. I took the 50mg of Seroquel. My cab was a half an hour late, so I was 10min late for my appointment. Pdoc got to see how effective the Seroquel was today lol. I freaked out. I was a mess.
1.5mg of Klonopin works the best, the longest. My anxiety is at it's height in the morning, I'll take it then. I can take up to 3mg a day, but I doubt I'll get up to that. If the Klonopin isn't enough for my am anxiety, I'll throw some Seroquel at it.
I took a Klonopin when I got home, so I'm a little sedated, but it's for a good cause.

Kay

What did your pdoc say when she saw you like that?
good for you for keeping up with your meds.
You are doing great!
bizi

She had to spend some time calming me down, she's never seen me like that (and she's seen me PLENTY), so obviously she realized that 50mg of Seroquel isn't effective in managing major anxiety by itself.

So that's why we went with the 1.5mg of Klonopin- it works better and longer. I have a 3mg daily limit. I'll still have the Seroquel there if I need it. I need more anti-anxiety med in the am, a little less in the afternoon, and I don't take anything in the evening because of that 600mg pm dose of Seroquel.
I actually told her what BF had to say about being careful with the benzo's. Obviously she agreed, and she thinks he's a very smart guy ;)
We talked about alternatives to benzos on my last visit, but not yesterday. I still like to have control... I'd like to get back to where I was before my last hospital visit. I was managing my anxiety better and was averaging 1mg of Xanax a day. I'm a long way off right now though.

We also talked about my OCD. She said that we might have to start talking about treatment for that sometime in the future, but I shut that down. I won't take anything for OCD unless it's to the point where it's handicapping because the treatments will leave me too vulnerable to mania. I was adamant about that.

Integrative Interventions

I stumbled upon glycine for sleep difficulties besides muscle strength and i saw it was also recommended for ocd..there appear to be a lot of studies showing that it works. these are all non prescription.
bobby




http://www.lifeextension.com/Protoco...er/Page-01?p=1

Inositol: In a double-blind controlled trial of patients with OCD, oral inositol resulted in a significant reduction in the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) score, while placebo treatment resulted in average Y-BOCS score reductions of less than one point.
N-Acetyl L-Cysteine (NAC): In a randomized controlled trial, 48 patients with OCD who had not responded to a 12-week course of high-dose SRI medication received either additive NAC or placebo for an additional 12 weeks. In the NAC group, almost 53% had a full clinical response (defined as a decrease in Y-BOCS score of more than 35%), while only 15% in the placebo group achieved a full clinical response.
Glycine: In a randomized controlled trial in OCD patients, very high-dose glycine or placebo was added to ongoing pharmaceutical or behavioral therapy. Patients in the glycine group experienced a mean decrease of over six points in Y-BOCS score compared with a mean one point decrease for those receiving placebo.
Milk thistle: A double-blind randomized trial in participants with OCD compared milk thistle extract to fluoxetine (Prozac). Judged on the basis of change in Y-BOCS scores, milk thistle extract and fluoxetine were similarly effective.
Valerian: In a placebo-controlled trial of valerian root extract in patients with OCD, those taking valerian showed statistically significant reductions in Y-BOCS scores at four, six, and eight weeks compared with those taking placebo.

Kay Thank you. BF:hug::hug::hug:

From the same article:

" In a randomized controlled trial in 24 OCD patients with a Y-BOCS score greater than or equal to 18, very high-dose glycine (60 g/day) or placebo was added to ongoing pharmaceutical or behavioral therapy. Patients in the glycine group experienced an average decrease of over six points in Y-BOCS score compared with an average one point decrease for those receiving placebo. Eight of twelve participants in the glycine group dropped out of the study due to side effects from the large dose of glycine, though two patients who responded to glycine treatment continued to take glycine for over a year (Greenberg 2009).

In a case report of a 22-year old male patient with severe, debilitating OCD and no satisfactory response to SSRIs, five years of glycine treatment led to a large reduction in OCD symptoms, and resumption of education and social life (Cleveland 2009)".

It sounds promising, but they're not there yet. The research sample was very small, and it 2/3 of the test subjects taking glycine found the side effects of the high dose too much to tolerate and dropped out.
But I will mention glycine to my pdoc.


Right now I'm hoping that getting a handle on my general anxiety will help with the OCD. Intrusive thoughts are back. I'm not hoping for a cure. Just a some relief.

Kay

there are a lot of articles about glycine. it seems to help a lot of things.
bobby

My NP said that I may need a new OCD medication. She said that one of her patients became use to the Luvox,and it wasn't working anymore. I've been on Luvox for about 20 years.

Recently I have had so many painful thoughts that they appear to be panic attacks. It seems that I get obsessed with a concern,and I think that it's more of a panic attack,and OCD. With the OCD,it's hard to turn the page so to speak in my mind.

Panic attacks hit me like a ton of bricks one night when I was a teenager. I got better,then I got worse after going away to school. BF:hug::hug::hug: