Finding the right medication to treat bipolar disorder is a bit of a minefield. The difficulty is in finding a drug, or a combination of drugs, which can balance two completely opposite problems – high highs and low lows – bringing one to a comfortable middle ground.
When I was diagnosed about five years ago the psychiatrist explained to me that ‘some patients find the right medication straight away, some can take a couple of years’. Earlier this year the effect of my medication (200mg of Lamotrigine pill-fans!) was deemed ‘as good as it’s going to get’ and I was signed off to live my life psych-free.
Six weeks later I was back to see a nurse – now the psychiatrist’s conduit – because the Lamotrigine side effects had become unbearable. I was suffering with horrible nightsweats comparable, so I’m told, with those experienced by women going through the menopause. The GP had run all the relevant tests and concluded that although nightsweats weren’t listed on the box it was nonetheless my medication causing them. Apparently only the most common or serious side effects are provided with your pills.
The nurse has reduced my Lamotrigine intake which has marginally improved the sweating but rendered it less effective as a mood stabiliser. I’ve also been asked to try Quetiapine for a second time having failed miserably on it previously.
Dealt in prisons as a Heroin substitute, Quetiapine is a superb sedative. This is no doubt just the ticket when you’re bouncing off the walls thinking yourself invincible but in previous trials it only sent me into a disabled haze, making it impossible to do anything. I fell asleep at soft play centres and stayed in bed until midday.
I took my first ‘New Quetiapine’ (a modified release which supposedly helps reduce the somulence) on Tuesday night and awoke at 10:30am on Wednesday in tears, unable to peel myself off of the mattress, my eyes only half open and battling to close the gap. I’d gone from functioning despite the tiredness brought on by the discomfort of nightsweats to a limp rag doll too exhausted to put one foot in front of the other despite sleeping for two and a half extra hours. I worked for nine hours, fighting the urge to take the four steps from my desk to my bed, which was the only place I wanted to be. Then, at 9:30pm I finally felt awake for the first time. At 11pm I fought back the urge to stay up – scared that if I slept I would find myself in the same numb state again in ten, eleven, twelve hours time.
I know I shouldn’t be driving but the kids have clubs to get to after school. I probably shouldn’t be operating the oven or the iron. I’m too out of it to do any of the things I need to get done – things I don’t have an option but to do. So tonight I’m not taking Quetiapine despite the (not very reassuring) promises of the nurse and the information leaflet that ‘the sedative side effects MAY improve’.
But where do I go from here? There’s not enough sheets in the world to deal with Lamotrigine’s side effects. The tremors of Lithium make photography and typing close to impossible. Nothing else has worked and so I’m back to the beginning, trying it all again.
I’ve thought about giving up medication because I’m beginning to think that the side effects and the stress of the never ending cycle of new pills and not knowing whether they’ll work or not may be worse than the bipolar itself. When you consider that the side-effects of bipolar medication are often bipolar symptoms (suicidal thoughts, depression, vivid dreams, feelings of restlessness etc, etc, etc…) it does make you wonder whether its worth it all when you’re rattling like a pill case and still not functioning like a human being. It’s a huge risk but it’s starting to look like the only viable option.