Diagnosis: Bipolar I (Depression) – 2003
Anxiety – Hypomania – Paranoia
Attempted Suicide – 2009, 2013

Below are my check-ins on dates where my meds have changed or at measurable intervals.

02-11-2020
Lithium Carbonate 900 mg (3x 300mg am/pm)
Risperdal  2 mg (pm)
Welbutrin HCL 300 mg (1x am)

NOTES: Things have been pretty stable. I upped the antipsychotic a few months ago. Was feeling a tad unstable. Now though, even despite hard times, I’m still here and functioning.

11-18-2018
Lithium Carbonate 900 mg (3x 300mg per day)
Risperdal  1 mg (pm)
Welbutrin 400 mg (1x 200mg am/pm)

NOTES: Cut out the Cogentin as it was creating huge cognitive issues, memory loss and other very negative side effects for no benefit. The muscle contractions are something that develops after years of using antipsychotics, but a risk I knew full well when taking. No adjustment last 2 visits and a return of vivid dreaming, and stress related nightmares.

 

8-16-2018
Lithium Carbonate 900 mg (3x 300mg per day)
Risperdal  1 mg (pm)
Cogentin 1 mg (pm)
Welbutrin 400 mg (1x 200mg am/pm)

NOTES: It has only been 3 days since taking on another antipsychotic and the changes I’m feeling are subtle yet relevant. I have definitely been more engaged in my writing. I feel a bit more “springy” or, capable of bouncing rather than falling. I feel good, mood wise. I have a new MH support team, and I am very thankful for that. Hopefully the upward trend continues.  

5-9-2018
Lithium Carbonate 900 mg (3x 300mg per day)
Latuda 60 mg (1x pm)
Welbutrin 400 mg (1x 200mg am/pm)

NOTES:
I am sorry for not updating this sooner. I got off the Geodon as it causes permanent nerve damage if taken for too long. I was switched to Latuda, which at 60mg is a coin flip whether or not I’m going to throw up shortly after taking it. I went down on the Lithium due to the shaking at 1500mg. Basically, I’m doing great, feeling stable, and downright optimistic about my future. I have done a great deal of mental work as well in the intervening months.

6-10-17
Geodon 80 [160] mg (2x am/pm)
Welbutrin 200 [400] mg (2x am/pm)
Lithium 300 [1500] mg (5x am/pm)
Latuda 20 [20] mg (1x pm)

NOTES: The meds I was on for all this time are finally starting to give out, and I quickly took decisive action. I went to my doctor after a two week lon rut, and just laid out my symptoms. She thought getting me off the Geodon would be a good idea, and introducing Latuda (a new medication that treats bipolar depression). I have been on the Latuda for a week now and I can say that I am starting to notice things. I’m much more motivated than I have been. I’m going up to 40mg on Monday and hopefully the trend continues.

2-7-17
Geodon 100 [200] mg (2x am/pm)
Welbutrin 200 [400] mg (2x am/pm)
Lithium 300 [1500] mg (5x am/pm)
Buspar 10 [20] mg (2x am/pm)

NOTES:
Well the only thing that can go up, has gone up rather significantly since last check in. But new stress levels in social and work environments led to this point. Now dramatic action is needed. So the Lithium is just above average, but my body has been disposing of it quickly. Blood tests to confirm.

2-10-16

Geodon 100 [200] mg (2x am/pm)
Welbutrin 200 [400] mg (2x am/pm)
Lithium 300 [600] mg (2x am/pm)
Buspar 10 [20] mg (2x am/pm)

NOTES:

12-2-15
Geodon 100 [200] mg (2x am/pm)
Welbutrin 200 [400] mg (2x am/pm)
Lithium 300 [600] mg (2x am/pm)
Buspar 10 [20] mg (2x am/pm)

NOTES:
Same doses as last time, but now I know the anxiety med works. I have been stable these last few months. My energy level is falling, but that has more to do with life stressors than anything else. It’s a good cocktail and I’m happier on it than I ever have been on any configuration of meds ever before.

8-6-15
Geodon 100 [200] mg (2x am/pm)
Welbutrin 200 [400] mg (2x am/pm)
Lithium 300 [600] mg (2x am/pm)
Buspar 10 [20] mg (2x am/pm)

NOTES: I have only been taking the Buspar for a few days, and have not noticed any dramatic change in anxiety symptoms. But it’s not a fast-acting med like Xanax, so I should be patient. My doctor wants to get me on an SSRI again, which I have no objection to in principal. I think the Welbutrin has done admirably but could also be increasing the anxiety I feel daily. So augmenting the antidepressants with a Serotonin inhibitor might be a good move. I’m cautiously optimistic. I have been unstable lately, having some good days and some bad days. Despite the moderate setbacks, things are improving overall.

7-22-15
Geodon 100 [200] mg (2x am/pm)
Welbutrin 200 [400] mg (2x am/pm)
Lithium 300 [600] mg (2x am/pm)

NOTES: We had been stable and satisfied on the same dose of medication for a good long while. The Sinequan was dropped because it was not helping me sleep, and making my stomach upset at night. Just recently, my mood has taken a dramatic turn for the worse, prompting some decisive action to get my neurochemistry balanced again. Since the Welbutrin and Geodon are already at max dose, the Lithium was the only choice for an adjustment. It will be close to a week before I notice anything different, but my mood is improving naturally (slightly). At this dose, the Lithium is too low to warrant regular blood testing, and even at 900 mg, we could get away with not testing immediately.

11-10-14
Geodon 100 [200] mg (2x am/pm)
Sinequan 75 mg (1x pm)
Welbutrin 200 [400] mg (2x am/pm)
Lithium 300 mg (1x pm)

NOTES: We figured out that I should not eat first thing in the morning, and just accept that that first dose will not be fully metabolized. Second, that we should change the Welbutrin to a slower-release tablet which will keep the antidepressant in my body for longer, and stagger the doses at 7:00 am and 3:00 pm so that I never dip down. Also, we added Lithium as an additional mood stabilizer with the idea that it would help treat the symptoms of the onset of bipolar depression. The Geodon alone can’t really do this effectively, but the Lithium should amplify the effects of the Geodon, while bringing it’s own special touch to the situation. I have the confidence that this scheme will result in a turn-around in both energy levels and mood. I have been slipping since that last entry, and have now redoubled my effort to combat the depression as it was leaking in to my life rapidly.

10-24-14
Geodon 100 [200] mg (2x am/pm)
Sinequan 75 mg (1x pm)
Welbutrin 150 [300] mg (2x am)

NOTES: I’ve been taking the Geodon on an empty stomach in the morning for months, and thus, reduced its effectiveness by 90%. Since eating and then taking the medication, I have experienced extreme drowsiness to the point of not being able to do my job effectively. I will need to find a way to cope with the side effects in order to dose properly.

5-17-14
Geodon 100 [200] mg (2x am/pm)
Sinequan 25 [75] mg (3x pm)
Welbutrin 150 [300] mg (2x am)

NOTES: I’ve been cruising along nicely, and feeling more and more motivated to get out into the world and make a difference. I’m not satisfied with my life where it is, and I continue to strive for the best for myself. I am involved in recovery programs, group therapy and classes. I continue to improve from a long and deep rebuilding phase.

 

POST HOSPITALIZATION DISCHARGE

3-8-14
Geodon 80 [160] mg (2x am/pm)
Sinequan 25 [75] mg (3x pm)

NOTES: Had a full psychotic break, and attempted suicide. This new regimen represents an effort to get back to addressing the mood-stabilization aspect of treatment, while not hitting the depression hard as though it were a stand-alone symptom. We had been treating the depression separately, which did not work. I now understand that to teat severe bipolar depression, you need to address the core of the dysfunction in the instability of mood. Towards the end, my mood cycled violently, entering peaks and troughs quickly, and creating wild instability. I will probably be tweaking this configuration to allow for Lithium to be added, which decreases repeat suicide attempts in patients by 500%. Starting from square one, and after 5 days on this dosage, I’m going along smoothly, without further inflammation despite a new crisis in my life.

1-5-14

Effexor 225 mg (am)
Abilify 15 mg (am)
Lamictal 225 mg (2x am/pm)
Aderall 20 mg (2x am/pm)
Buspar 30 mg (2x am/pm)
Remeron 15 mg (pm)

NOTES: It’s been a steady downturn since last entry. Things are getting harder, movements are slower. My doctor recommended the Remeron, because it’s supposed to assist the Effexor. Aderall seems to be working at this dose. Busbar is doing fine. It’s the depression that’s been getting me. So very acute, and quickly dissolving confidence. Skills thrown out the window. I endeavor to continue to be well, and be introspective.

07-12-13

Effexor 225 mg
Abilify 15 mg
Lamictal 200 mg
Aderall 20 mg 2x am/pm
Buspar 30 mg 2x am/pm

NOTES: Started taking an anxiety med, since I was fidgeting, sweating and stammering nearly all the time. Buspar has helped a lot in calming that symptom set. Other medications working great; normally. Aderall upped, and working on keeping me focused and clear during work. All in all, this is med-routine / set is the best I’ve ever been on. Rolling along nicely.

03-31-13
Effexor 225 mg
Abilify 15 mg
Lamictal 200 mg
Aderall 30 mg

NOTE: Slow release Aderall is working. I take all meds in the AM. Just upped the Lamictal after moods started to wobble every 15 days or so. Core of the medication cocktail is working. I’m stable, employed and high-functioning for the first time in years.

12-21-12
Effexor 225 mg (am)
Abilify 15 mg (am)
Lamictal 150 mg (pm)
Aderall 30 mg x2 (am, pm)

NOTES: Insurance cut off my Aderall days ago. NEEDLESS TO SAY, it’s not been fun working, concentrating, remembering every damn thing… I can’t cope with the total lack of focus in my mind. I am now rapidly distracted, lower energy, and blurry. I do not like this feeling. Hopefully, today is the last day I have to go without. Here’s to improved concentration, which I WAS enjoying until I ran out of 20mg tabs to break in half. FUCK.

12-8-12

Effexor 225 mg (am)
Abilify 15 mg (am)
Lamictal 150 mg (pm)
Aderall 30 mg x2 (am, pm)

NOTES: Just increased the Aderall. I was having the blurred-out-unfocused-vision-daydream problem a little bit still. So, this will probably be as far as I want to go with the Aderall. I think we risk an imbalance of my mood if we go any higher (I suspect). I need concentration, not excessive energy or whatever. I don’t feel any stimulant effects from this med, so far. I CAN focus, however, and make sentences happen. Which is the whole point of me taking it, right?

11-24-12
Effexor 225 mg (am)
Abilify 15 mg (am)
Lamictal 150 mg (pm)
Aderall 20 mg x2 (am, pm)

NOTES: Attention span getting MUCH better. Can write longer pieces, read longer articles. Still having that blurred-out-vision-daydream thing happening ever once and a while. Not too big a deal. Things could improve slightly, but not much more I’d think, within safety parameters.

11-16-12
Effexor 225 mg (am)
Abilify 15 mg (am)
Lamictal 150 mg (pm)
Aderall 20 mg x2 (am, pm)

NOTES: Adderall boost should help with ADD symptoms that remain. Mood has been super-stable. Going out and being active. Mood feels good, positive. Things have improved dramatically.

11-2-12
Effexor 225 mg (am)
Abilify 15 mg (am)
Lamictal 150 mg (am)
Aderall 10 mg x2 (am, pm)

NOTES: Just wanted to confirm, Aderall at this dose has no noticeable effect on concentration or wandering-mind. Experiencing some depression every few days, but because of therapy, not meds. Getting into some stuff. So there you go.

10-26-12
Effexor 225 mg (am)
Abilify 15 mg (am)
Lamictal 150 mg (am)
Aderall 10 mg x2 (am, pm)

NOTES: I am more stable than before, by far. Not as many radical mood swings, better control of emotions. No change on the ADD front, yet. But I just started taking it, so I’ll give it some more time. Doing better for now. 6 out of  10, improving!

10-12-2012
Effexor 225 mg
Abilify 15 mg
Lamictal 150 mg

NOTES: Mood, energy level and motivation are improving. Anger and concentration still a problem. 4 out of 10.

10-2-2012
Effexor 150 mg
Abilify 5 mg
Lamictal 150 mg

NOTES: Moods highly irregular. Thoughts still rampant and oft uncontrollable. Temperament poor, aggressive, agitated, and sad. 2 out of 10.