Bipolar Medication Woes

For an unknown reason, my Lamictal stopped working for a few months.  I do have some ideas on why this happened, but to be honest, they are not great explanations:

1. I really got off track with my dosage for a few weeks. It was hard to remember what I had or had not taken. I tried a variety of ways to deal with this. I have special pill boxes and reminders. I did everything that was needed.  (I got back on track quickly and it seemed like things were getting better. )

2. I have more stress in my life than normal. This can definitely make it harder for my meds to work effectively.  ( I use my Health Cards Treatment Plan for trigger management and dealing with stress.)

3. I had a different bottle of Lamictal. I don’t take generics as they don’t work for me, but the bottle was definitely a new design.  ( I researched this idea and realized that unlike generics that can be made all over the place with different recipes added to active ingredients- my brand Lamictal is quite regulated but Glaxo Smith Kline.  So there went that theory!)

I actually think the above reasons did contribute to the two months of terrible mood swings, but I’m pretty sure that the real problem was that the dosage I have taken for the past few years simply didn’t get the job done.  I get a lot of side effects when my meds are low. I actually have a lot less side effects when I am on the right dose. My main indicator is that I twitch like a marionette when the Lamictal isn’t working. It makes my friends laugh a lot and it doesn’t hurt, but it’s scary.

I seem to have found a solution to the problem as I am feeling better.  I  write about this in my next newsletter. Right now I am happy to have a focused and get it done mentality mind. I always take advantage of these days!


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9 comments to Bipolar Medication Woes

  • HB

    I’m sorry to hear that your meds stopped working. I know it’s hard to tell sometimes whether it is the meds or something else causing the problems. I’ve had a similar experience recently. I look forward to reading about your solution.

    I wrote about your book “Loving Someone with Bipolar Disorder” on my blog recently:

    Your unique list of symptoms that are in the book gave me some insight into myself. Thanks!

  • Triggers (stress) make my meds less effective. I’m going through some heavy stress right now, and I’m hearing “breakthrough” voices despite the fact that I’m on some heavy doses of Risperdol. I realize that the stress will go away and that with counseling the stress should go back down and the Risperdol will kick in at 100 percent and the voices should be gone shortly. But for a little bit of time it’s scary, wondering if the drugs will indeed work again like they’re supposed to.

  • My guy’s medications have stopped working too. It seems that he achieves tolerance really, really soon. I’m really looking forward to reading your solution soon.

  • bpbookworm

    I experienced a situation in 2008 where a prescribed dosage of Prednisone for a bronchial infection threw off the efficacy of my Depakote. Basically, I experienced a brief (one-week or less) period of either light mania or extreme hypomania (I live with BP II) and then dropped into about ten months of mostly moderate depression. It felt so bad because it dragged on and on for what felt like forever, and because I’d been well for more than a decade on my treatment plan (no significant episodes of depression, as depression if unmedicated/untreated properly is the most serious facet of my bp II). I also beat myself up over the situation because I took the Prednisone despite my misgivings (I had had to see a physician at a convenient care clinic who was not my regular physician – and I thought about calling my psychiatrist to double-check about taking the Prednisone but didn’t – next time I will follow my gut instinct and always double-check potential med interactions!) I am doing well now again, but that time of my life gave me insight that I didn’t have before. It made me aware that sometimes meds that “always” work for you to keep you stable can stop working for whatever reason – and it’s really important during those times not to “shut down” out of fear – we have to be prepared to handle those situations. Julie, thank you for talking about your situation.

  • Bindi

    I had 2 family members taking meds including myself. One of them refuses to take any meds at all, refuses to even admit he needs them in spite of several episodes that landed him in the psych ward. Eventually we know he will probably go through this again (and take us all with him). The second family member who had been taking meds since prozac was first introduced eventually experienced the need for other drugs and was subjected to many alternatives. The simple side effects of both constipation and diharrea became unbearable for her. She eventually went off all her meds at once with the intention to start them one at a time. Unfortunately the sudden shock to her system caused massive anxiety and she took her own life.

    I myself take lamictil, lexapro, and seroquel. The side effects of a very lowered libido could be troublesome but I’m past that and can live with it. Not in my twenties tho. I swear by lamictil and haven’t changed my dose in years, but the Seroquel is gradually being increased as it loses power. Lexapro seems to just be there for whatever. However if I stopped any of these I would experience profound anxiety and depression.

  • Barry Marshall

    Concerning side effects with medications, I am now 55 years old and have suffered with bipolar 2 depression about 37 years. The med that is helping a lot is Zyprexa but it causes a lot of weight gain; I have gone from 205lbs to 253lbs. The drug does increase the appetite greatly but I’m told there is also an effect on glucose metabolism in the body. In any event, this drug is affecting me the most. I am also on Prozac, Cymbalta, Lamictal(200mg/day–I haven’t had any eye trouble), Adderal (causes stimulation),and valium if needed twice a day and two at bedtime. I have been doing well on these medications for the past couple of months, I’m thinking of going back to work (I collect Social Security Disability), but I need to give it a little more time. My problem are the depressions that just seem to attack and incapacitate me.

  • colette

    Hi Julie,

    My question is, when can one tell when enough is enough with drug toxicity? I’ve never got any benefit out of drugs but that certainly wasn’t for the lack of trying. I have been through 3 years of the standard first and second line of drug treatments for bipolar 1 in various combinations. The side effects were extreme. Sure, my hair fell out, my face was puffy and I gained 20kg. I don’t make a living out of how I look, so that wasn’t the deal. The thing was the anxiety attacks, social anxiety, tardive dyskinesia, nightmares, sleeplessness, depression, suicidal ideation, tiredness, loss of interest in everything, overdoses, vomiting, nausea etc. etc. My psychiatrist confirms that these were all drug toxicity which was reducing my capacity to deal with the illness itself. Currently, I am not on meds but am using coping and lifestyle strategies such as your work suggests.

    It’s been 4 months now and I’ve never been so well since I first became ill. Is that a problem? Should I go back to taking drugs when I am guaranteed of feeling unwell? It really feels like bipolar is a breeze compared to its treatment. I know all the research says that bipolar is a chronic and sporadic condition and so I should be on some sort of medication. I see my psychiatrist 6 weekly to monitor me. He’s quite OK with me not being on meds as we are at a loss as to what to try next, anyway. What would you suggest?


  • My Lamictal (500 mg) is in break-thru for the 1st time since Spring of 2000 — and it’s the only med that works for me at all — and it, not much (ultradian, mixed state, dysphoric highs, chronic untreatable depression; can’t take ADs or antipsychotics; am not psychotic or paranoid but am disabled nonetheless). The symptoms that have returned in flames are: computer solitaire for hrs. without being able to stop; Amazon book buying; hypergraphic e-mails and 1-hr. phone calls; immobilizing depression alternating with too fast and thus useless hypomania — skipping baths and dressing and meals; suicidal ideation and swimming in the sluice of despond (my faith, and 3 kids and 7 gkids keep me safe, so far), etc. The cause: Some unusual stress, but primarily, I think, Tylenol almost every day for a year — after brain surgery (benign, successful), sinus infections, migraines, scoliosis, pulled groin muscles, etc. Tylenol, and stress, over an extended period of time diminishes the effectiveness of Lamictal. (The Pill Book, H. Silverstein,ed. Bantam, 13th rev. ed.,2008, p.618.) I once took 600 mg of Lamictal accidentally and got a wonderful antidepressant effect, but also fuzzy vision and dizziness for about 30 min. I also keep puffy eyes, BTW, probably from L, but not enough to bother me unless it coincides with allergies/sinus that swell my eyes, too. I have a paradoxical reaction to L, BTW — it energizes me, not sedates me; thus, I have to take Topamax (400 mg), the sedating effects of which offset the enegizing effects of the L.
    Thanks, Julie, for being you.

  • Connie

    I have recently started taking Lamictal. Actually I’m taking the generic Lamotrigine manufactured by Mylan. 25mg for 2 weeks and today will be the first day of an additional 25mg. My concern is headaches. Problem is I was having headaches before starting the meds. I’m in Florida and we had the coldest December on record here (those from up north don’t laugh too hard). Anyway, the cold, dry air gives me headaches. We’ve had some warmer days with more humidity, but that hasn’t helped. I’ve taken ibuprofen, which only helps a little. Today I tried Tylenol. I’m concerned about the headaches being a side effect, getting worse and/or an indication that I shouldn’t be on this medication. As a side note, I’m also prone to migraines which I haven’t had in awhile, but this feels like I’m gearing up for one. Any suggestions?

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