Latuda
 

Hello all,
I haven't checked in in a while. I am still creeping along the road w ups and downs. Yesterday I was very, very anxious maybe manic. I had an appt with my doc yesterday and that probably gave me incentive to calm down. We concluded at the appt that my Meds aren't working so we are going to try Latuda.

I get very shaky and anxious, stuttering and then super depressed sometimes in a matter of minutes to hours.

Can anyone relate or has anyone been on latuda?

sorry I have never even heard of the medication. hope it works for you!
bizi

Hi,

I understand about being anxious and depressed at the same time.

I hope that the Latuda works for you.

Mari

Thanks Mari
 

I love the lotus on your signature.

I don't know what that medicine is,but I certainly understand the feelings,pains,and conditions of depression,anxiety,shakiness,and allot more. I'm so sorry that you are going through this. I hope that the medication helps. BF:hug::hug::hug:

Acceptance
 

Thanks BF,
This is all so far out of my control, I work daily on accepting it, as we all do I am sure.

I have been on Latuda (I just like saying it!) for two days now as I gradually build up the Latuda I am gradually reducing Lamictal. I look forward to being full up on Latuda and off of Lamictal and seeing what the difference is. Thanks again.

Hi,

Usually we only change one medicaiton at a time --- unless the old/current med (Lamictal is causing a crisis). If two meds are being changed at the same time, we do not know which one is doing what.
I am am concerned.

Mari

Hi TBI/PTSD,

I'm not sure if I read your full post so If I'm mistaken about anything I apologize, I'm just trying to help.

Anyhow you mentioned you were "very, very anxious maybe manic" and that you were "anxious then super depressed sometimes in a matter of minutes to hours." Lamictal can actually cause destabilization in many people before they reach a stabilizing or therapeutic dose. Low doses of Lamictal can act almost like an antidepressant to some bipolars, resulting in anxiety, panic, erratic moods or rapid cycling or sad to hypo to manic, and anger. It's the higher doses of Lamictal that act like a true mood stabilizer.

Hope that helps abit, if not I do apologize.

I certainly hope you are feeling better soon and Latuda will offer you some relief.

Take care.

WindWalker

welcome windwalker!

Welcome to the forum WindWalker. Broken Friend :grouphug:

Thank you for the welcome everyone, happy to be here.

WindWalker

Hi,TBI,

Thanks.

I do not have a formal meditation practice but I try to have some moments here and there in the day when I think about the present instead of worrying about the future.

Mari

Thankyou
 

Thanks WindWalker and Mari,

Maybe that is it, I am reducing the Lamictal (under doc orders) and introducing the Latuda gradually? But then all of this mood swinging starred before the new Meds. I don't know. I seem to feel. A little better, more flat less manic, less depressed. I have to keep doing things. The Lamictal makes me tired. I go to bed at 8 and wake up at 0500. I am not very hungry but I bought a vitamix and I am surprised at how that is making me feel about food. I get super satiated from a breakfast smoothie. Who knows.

I am just trying to be ok.

Thanks guys,
Tbi/PTSD

Hi, Tbi/Ptsd,

It is good to hear that the med changes are helping you.

The vitamixes are great machines but I have not gotten one. I have an o.k. blender. Smoothies in the morning are wonderful.
Keep trying to be o.k. That is what we do here -- keep trying and keep hoping.

Mari

hi tbi,
just trying to be ok with you too.
bizi

Hi there
 

Hi TBI/PTSD,

I hope the Latuda is helping you and that you are feeling better by now. The state you described sounds totally yucky! I have had depression with high anxiety and it is positively awful.

As for your meds...

Gradual reduction of Lamictal with introduction of Latuda will be fine, as long as your prescribing doctor is aware of your complete medical situation. My main concern reading the first post was with seizures, since Lamictal protects against seizures while Latuda would lower seizure threshold (i.e., both med changes increase seizure vulnerability). However, a gradual change really should not be problematic unless you have a seizure disorder.

You initially had some questions about the Latuda itself. I don't know what your doc told you about it. I had to look it up - looks very interesting. It is an atypical (i.e. "new generation") antipsychotic, used to treat positive symptoms of schizophrenia and depression in bipolar disorder.

While most antipsychotics treat manic symptoms, I did not see anything about this with Latuda. It should help some, since it tends to be sedating. Generally speaking, it might be less effective than other antipsychotics for mania, due to its unique pharmacodynamics; alternatively, it may not yet have been fully evaluated for treatment of mania.

It is a very new drug, and still in phase 3 clinical trials for general maintenance treatment of bipolar disorder in conjunction with lithium or divalproex. (See http://clinicaltrials.gov/ct2/show/results/NCT01358357.) Primary results are expected 2015. Secondary data expected from this trial will include the amount of time to a manic episode... this could open doors for other trials.

---------------------

You sound as though you are taking really good care of yourself, with the smoothies and all to help nourish yourself despite the loss of appetite. Keep on keeping on. :)

waves

Thanks Waves
 

I have tried Risperidone, Seroquil, lithium, ambilify, and some others, I can't remember. My doc has been with me since the beginning of this new phase of my life and he is wonderful. He is a Forensic Psychiatrist and probably the most brilliant man I have ever met. The best thing about him is that he really listens to me.
I thought all was well w the Latuda but yesterday I was very anxious and verrrrrryyyy angry. Friday will be a week on 20mg of Latuda at which time I will increase to 40 mg.

I really appreciate you taking the time to reply.

Hi TBI/PTSD Try not to worry about the anxiety,and anger at this time. In my experience of over forty years of mental health challenges,these emotions can happen over a period of time no matter what type of medication your on,or changing.

It can really be confusing,and frightening. I know. I'm so sorry. Hang in there,and you will find out in time. If you feel a need,by all means call your doctor. BF:hug::hug::hug:

hi again
 

Hi again TBI/PTSD,

Your doctor sounds wonderful! It is so important to have someone who listens!

Wow, you have tried quite a few different drugs. I sure hope this one works out for you. I've tried several too - the antipsychotic (AP) that worked best for me was Zyprexa, but I couldn't handle that because of the weight gain. My current mood stabilizer is Depakote but that works mostly to prevent mania.

Hopefully the anger and anxiety from yesterday are just a bump in the road. In case you are wondering, it is highly unlikely that the Latuda caused those sx. It's likely that that you are still not quite leveled out. From your post, the Latuda does seem to have helped a little, so far. That is good.

Some APs are only effective on activation sx in higher dosage ranges. If that is the case with Latuda, there is lots of room for improvement here, as long as you tolerate it well. Let's keep our fingers crossed.

I wish you well with this new med!

waves

FOOD-DRUG interaction between Latuda and Grapefruit Juice
 

Just a note about a FOOD-DRUG interaction:

It is advisable to avoid grapefruit juice and grapefruit while on Latuda. Grapefruit juice will raise the blood-levels of the drug (via CYP3A4 inhibition). Now, I don't honestly know whether the interaction would bring Latuda to toxic levels (depends on drug toxicity), but an increase in adverse reactions might still be problematic. A simple example might be excessive sedation.

Your doc may have already told you about this interaction, but I figured I'd mention it, since I didn't see it in the prescribing information. The enzyme pathway responsible for this interaction is very clearly disclosed with some of the drug-drug interactions.

If you want to consume grapefruit juice while on this drug, please consult your doctor. He will be aware of the drug's toxicity, adverse effects etc, in relation to your dosage, so he can advise whether there would be a significant problem for you, or not.

IMHO, it would never be a good idea to consume grapefruit while you are increasing or decreasing Latuda. It will throw a wrench into the gradual level change one is performing at these times.

waves

P.S. St. John's Wort and other herbs can also interact with Latuda, via the CYP3A4 enzyme pathway. Some herbs increase drug concentration, others reduce it. (In the latter case, therapeutic response will also be reduced.) It is important to consult your doctor before taking any herbal "supplement" with Latuda.

Yes. With the medications that we are on,try to avoid grapefruit. Hey Waves. That's a good reminder. BF:hug::hug::hug:

Hi, Tbi/PTSD,

Yes, stay for the course and keep hoping for the best.
Having a great doc you can trust helps you get through the bumps in the road.

Mari

Update
 

Ok, I pulled a rookie move. I wasn't supposed to start tapering the Lamictal until I was on full dose 40 mg Latuda. I saw my doc yesterday. I feel crazy, I know....but I hear people talking to me in my head and I answer them out loud. I am super angry still. I know I am going through a change w the Meds so I am trying to get through it. My parents are out of town, my dear friends that are my dash 2 parents are out of town, so I told my neighbors that they are it if I have trouble, I will call them first.

I see things people are not supposed to see, I am too observant, I am exhausted from taking all the superfluous info in. I check people's license plates to see of they are up to date, I notice things that I shouldn't pay any mind to but I can't let go.

Thanks for the tips on grapefruit juice. I like just about all food/drinks but I do have a hard time w grapefruit juice. I really appreciate you taking the time to check it out. So far I find that I am not hungry. I push a vitamix fruit veggie protein powder smoothie down in the AM but the rest of the meals are a struggle.

I am not sure what the other people like us do without this site, I gain so much from you guys, thanks.

What did your doctor say about your increased symptoms?
This must seem crazy for you.
sounds manic to me or headed there.
I amsorry that you are having these strong emotions, just because you are feeling them doesn't mean you have to act on them.
Try if you can to reel your behavior in. What is a full dose for the new medication?
and when do you expect it to be in your system?
worried....
bizi

Thanks Bizi,
 

My doctor attributes the moods to the stress of changing Meds. I have an appt w him again in a week instead of two. I can't remember what he said about it, unfortunately. I started taking my full dose of 40 mgThur night so this is day one of the first full dose. As far as the Meds getting to my system, I am not sure.

I am trying to stay real busy. Today I ran, went to dr. Appts and went kayaking for three hours. I wanted to relax but I couldn't so I went to the grocery store and cam home and cooked and now heading to bed.

I have made it through another day.

Thanks BIZI

[QUOTE=bizi;1004262]What did your doctor say about your increased symptoms?
This must seem crazy for you.
sounds manic to me or headed there.
I amsorry that you are having these strong emotions, just because you are feeling them doesn't mean you have to act on them.
Try if you can to reel your behavior in. What is a full dose for the new medication?
and when do you expect it to be in your system?
worrie

I bet you are very sore of 3 hours of kayaking! that sounds like a lot if you aren't already used to that level.
try to take it a day at a time. I am hoping that you are sleeping thru the night. so important.
bizi

Latuda - time to steady-state is 3.75-5.25 days, based on 18-hour mean half-life
 

Hi there TBI/PTSD,

well I was a bit worried too about the voices and such. I was happy to hear that you have people you can count on, and that even though the folks you are closest too are away, you have reached out to your neighbors. That was a very good idea. :)

I am glad to hear that you have talked to your doctor about what is going on and that he feels it is related to changing meds. You are getting there with the meds, so hopefully you will feel better soon.

Good that you are now on your target dose of 40 mg Latuda.

--------
As far as when it will be in your system - i.e. at steady-state - that should take about 4-5 days from the first 40mg dose. This is based on the mean half-life of 18 hours. (Steady-state is considered reached at 5-7 half-lives. At 5 half-lives the drug level is pretty close to target. The half-life of a drug varies some across individuals and time to steady-state varies accordingly: the numbers I've given are only statistical predictors, not empirical data as pertains to you.)
--------

I think you are doing a great job keeping afloat. If you need to stay busy, kayaking and cooking sound like healthy ways to do it... assuming, as Bizi says, you have the physical endurance for the kayaking! LOL! I could not do that for 3 hours! :eek: I probably would not last 5 minutes, LOL. :D

Hang in there. :hug:

waves

Hi,

Somedays when you feel you could have more nutrition, make another smoothie later in the day.
Or make two smoothies in the morning, put the second in the fridge and have it in the afternoon / evening.
A smoothie does not have the same texture when it is a half a day old, but it will work.

How is your service dog?

Mari

Hi TBI/PTSD
 

See if you can slow down just a little bit. What I do is do a few things,and then sit down to pace myself.

I use to run around,and do one thing after another,but in the long run,I think that it caused some anger,and stress. If someone would stop me,it would agitate me because I had all of these other things to do. I have OCD along with several other mental health challenges. If you have a job,this doesn't apply.

I hope that this helps. BF:hug::hug::hug:

Hi, Steve and Biz,
I am remembering that TBI/PTSD is active and in very good shape and that she likes the outdoors.


Hi,TBI/PTSD
I hope that the med changes work out for you.
It takes patience to deal with med transitions.
It also requires a great deal of faith --- faith that medical science can help. Keep the faith.

Mari


__________________________________
There shall be eternal summer in the grateful heart. ~ Celia Thaxter

Thank you Mari. You are right. You cannot coin a word for the amount of patience that we have to have with finding the right medicines,and/or medicine combinations. I'm on three different medicines for different aspects of my mental health issues.

Everyone is unique,and every experience is different. BF:hug::hug::hug:

You are all wonderful
 

Waves, thanks for breaking the Meds down for me, I get confused with the half lives and all. I should be at steady state on Latuda in two to three days so that is Sun to Mon! Yeah. I guess I really just need to get through the weekend.

I am in pretty good shape, good enought to do things that bring me peace. I used to push push push myself for faster run times (from the USMC) now I don't wear a watch. When I paddle I take Trip my service dog and it isn't a race, just peaceful enjoyment for us. Yoga, well, I am not the steadiest Yogi but I am enjoying the road of developing my practice....wow that all sounds pretty good. Maybe the Latuda is working.

Mari, thank you for asking about Trip. He partially tore his cruciate ligament and had surgery May 10. I followed the dr rehab instructions to a T which meant I couldn't take him out with me for two mos. he is back on the road with me now and his leg is in the final stages of healing (still gets sore) but he was out frolicking a ling time yesterday and is doing well.thanks for the smoothie tip. Tat is a really good idea for an afternoon pick me up. I went to Costco to pick up my contacts yesterday and they had the vitamix demo. Oh that poor lady. I went on and on about my vitamix. She probably thought I was nuts, she is right.

Bizi, thanks so much I knock out at night no problem around 8. I am on Depakote, trazadone, and buspar at nighti think the trazadone helps me sleep. I usually wake up at 10-1030 thinking it is morning but go right back to sleep until three or four. I am my 8 hours albeit a little earlier than most. My doc says it is my circadian rhythm and to let it ride.

BF thanks for the input too. I learned in therapy yesterday that buzzing around and putting too much thought (obsessing) into other people's stuff is avoidance.i mean I know food,shopping. Excessive exercise can all be avoidance too. I try to rest a bit, I find it really hard to sit still w/o doing anything. I love word finds and I have recently started jigsaw puzzles. So I am still busy but not exerting myself. Today I am going to yoga and maybe repot some plants and do puzzles. I know my car needs to be vacuumed and washed too so we will see how this day goes down.

Thanks tons for your replies, you are more supportive than physical people in my life today because you get it. Thanks.
I am going to to upload a pic of Tripon the kayak.

I forget are you bipolar?
bizi

Bipolar
 

Yes, I am bipolar. I think I have had it for a long time but when I got my fifth concussion (unconscious) I couldn't control my life anymore or keep bipolar in check. I have TBI, this, PTSD, Cognative Disorder.

You have been thru so much. I am sorry. You sound like you are BP1, so am I. Do you suffer with depression much?

bizi

Hi TBI/PTSD,

I don't want to cut in but I hope you're feeling better now and the Latuda helps alleviate some of your symptoms. It sounds like you have wonderful support on here from people who care about you.

Good luck!!!

WindWalker

Thanks WW and Bizi
 

I think the funny thing is you don't realize how messed up things are until you start to get better!

Bizi I know it sounds silly to know remember which bipolar I am I or II, but I figured it doesn't really matter. I have it all written down in my paperwork and I can find out but I always forget. I do have depression, most of the time. Sometimes anxiety WITH depression, sometimes (seldom) I am super manic.

I am very uncomfortable outside of my home. I like routines. I can't take overstimulation, noise, and I startle super easy.

Anyway....I hope everyone has a nice Sunday.

ye sit sounds like BP2 or even mixed at times. I am sorry for your depression...There are many here who suffer with depression. You are not alone. If you are feeling suicidal at all reach out for help. there is a survivors of suicide SOS forum here at neurotalk that is for people who deal with suicidal feelings and for those who have lost someone to suicide. so both sides are represented. My mom Alffee helped start it years ago. We lost a brother to suicide some 23 yeras ago. Really awful. WE have some members here who post there on occasion.
hugs to you today.
bizi

Mania and BP2 mutually exclusive
 

TBI/PTSD,

If you have been "super manic" even just once, you are BP1. The only other possibility, if there are peculiarities to your case, would be BP NOS. Your formal dx may be something different if a pdoc did not witness the mania, but technically, you couldn't be BP2 if you've been manic. BP2's, by definition, only ever get hypo. Major depression can be present in all types of bipolar - BP1 is no exception. Some BP1's don't have depression, but many do - and bad.

You are right though, that it is much more important to know that you are on the bipolar spectrum, so you can receive treatments that work for you as a person and your symptoms, such as they are. The formal dx is not so important.

---------

It was great to get an update on Trip. I was not sure if it was you... I remember the CostCo incident now... and some other things. :) I guess that is a pic of Trip on your profile page. What a cutie. Glad he healing up well - he is lucky to have you taking care of him.

Keep taking good care of the both of you, as you have been. I hope the new treatment plan helps you a lot.

waves

mixed
 

Hi, TBI/PTSD,

Basically, having been manic puts one in the Bipolar I category even though one might feel depressed most of the time.

It does not matter that much about exact diagnosis.
(But do not take my word for it because others disagree.)
With treatment I am Bipolar II --mostly depressed. . . . although the anxiety often is stronger than the depression.
Without treatment or with poor treatment I was sometimes mixed http://pro.psychcentral.com/2013/dsm...s/004312.html#
(Mixed is more likely to cause suicides that any other type of bipolar.)
The DMS IV had mixed as a clear cateagory.
The DSM 5 has moved mixed to "with mixed modifiers:"

http://pro.psychcentral.com/2013/dsm...s/004312.html#
I got diagnosed in the late 1980's when pdocs were still working with two types of of bipolar -- adult and pediatric.
Later, no pdoc re-named my version. (I get very agitated and energetic in ways that go so much beyond anxiety.)

Current pdoc probably has decided on a diagnosis based on one 30-minute session but that is o.k. with me.
He can call me whatever he wants as long as he gets the meds right.

Mari