National Bipolar Awareness Day! New Pills Day!

Today is National Bipolar Awareness Day and to celebrate I’ll be starting yet another round of mood balancing drugs.

For the past nine months I’ve been taking increasing doses of Lithium, the bipolar wonder drug that I believed would, once the right dose was set, stabilise my moods.  I assumed that bipolar sufferers weren’t immediately given Lithium because of the long term effects of the drug – thyroid and kidney problems often requiring additional supporting drugs after several years of Lithium treatment – not to mention the cost to the NHS of regular Lithium level, kidney and thyroid function blood tests.  Whatever the reasons, what I wasn’t aware of were the side effects that I, on reaching only the second highest, ineffectual dose, would experience, tremors and swelling mirroring the symptoms of Lithium toxicity.

A writer and photographer I need steady hands so the tremors quite simply weren’t a worthwhile pay off for the (limited) positive effects of the medication. And right there is what makes the treatment of Bipolar just as awful a thing as the illness itself.

Throughout my treatment, first for Post-Natal Depression then for Major Depressive Disorder then for Bipolar Affective Disorder and Social Anxiety, I have been prescribed a succession of anti-depressants; Citalopram, Duloxetine, Paroxetine, Amitriptyline, Pregabalin, and then later, mood stabilisers; Lamotrigine, Quetiapine, Lithium, I take Diazepam when I feel panicked or anxious.  Some have been taken alone, others in combination with each other.  Sometimes it’s one pill a day, other times it’s four, sometimes they have to be taken in the morning, sometimes last thing at night – the Lithium, for example, has to be taken at the exact same time every evening, the pills are huge; round and dry, sticking to the roof of your mouth if you don’t poke them right down your throat, gagging on a sharp-nailed index finger.


I wonder what the black market value is for this little lot (yes I know you’re supposed to chuck them)

For almost five years I have consumed an endless succession of pills which have made me tired or unable to sleep (often at once), too high or too low, which have made my skin itch or given me acne, swollen my feet, made me confused and forgetful, left me too dopey to drive.  I research every new drug and find that some have high values in prisons – Quetiapine is known as ‘Baby Heroin’ – or that the drugs have their own special ‘syndromes’ (such as the Lithium Tremors I’m currently experiencing) or the skin rotting illnesses of Lamotrigine. I read the pamphlets, which invariably warn me that I could become depressed or suicidal while taking this particular drug, always a reassuring thought for a depressive.

This week I’ll start to taper off my Lithium dosage, breaking the horrid powdery pills in half, while beginning a new round of Lamotrigine, one pill at a time until I’m taking four a day.

Last time I was prescribed Lamotrigine it worked well, until I developed a burning rash, a symptom of one of the handful of deadly side effects Lamotrigine can produce.  I spent the Christmas period in A&E on an antibiotic drip to treat blood poisoning, my in-laws drove a freshly cooked turkey down the M6 from Merseyside so the kids still got a proper dinner.  I’ve since been informed that the infection and the drug weren’t related – it’s a good sign that this could be the one that works, but it doesn’t change the fact that Lamotrigine, with all its side effects, scares me.

When I was first diagnosed with Bipolar I had one major problem: I was tired.  Now I’m aware that all the things I had come to accept as ‘one of those things’ are a problem, now I know that my quality of life could be improved, I want to be successfully treated.  But at the same time I can’t help but feel I was perhaps better off before, when I didn’t have to face the disappointment of another failed treatment, when I didn’t have to wonder if I was ill or if it was another side effect, when I didn’t have to fight the NHS for appointments and when I didn’t have to wait three months to tell my psychiatrist that his latest prescription isn’t working when I knew after three weeks.

By the time I’m fully weaned on to the Lamotrigine and whichever anti-anxiety or anti-depressant drug is chosen to work alongside it, it’ll be five years since I took that first low dose Citalopram.  It’s starting to feel as though the pills do more harm than they do good, I wonder if the stress of never finding the right treatment, the side effects and the knowledge that I’m going to be taking handfuls of pills for the rest of my life is worse than the illness itself.

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Do our children need anti-psychotics

An investigation by Channel 4 news has revealed that as many as 15,000 British under 18s were prescribed anti-psychotic medication last year.

In fact C4’s statistics are taken only from GP surgeries with no official data from specialists and hospitals. In my experience GPs are reluctant to prescribe this level of drug, referring patients to a psychiatrist instead. With that in mind the true figures could be so much higher.

I could regurgitate C4’s piece, which points out that the results of this research come in the wake of the governments crackdown in ‘chemically coshing’ of the elderly, other vulnerable groups, including young people and the often coshed sufferers of depression (er, should we not be cracking down on this practice for everybody? Just a thought…), but you could just go and read that yourself – the link’s up top there.

Instead I’m going to tell you about my own experiences of anti-psychotics, GPs and prescriptions.

I’ve been prescribed a host of different medications, on and off label, over the years including a wide range of anti-depressants for mood and for pain, sleeping pills and anti-psychotics. Yes, I’m a hypochondriac.

I’ve recently stopped taking a drug called Quetiapine, an anti-psychotic, after negative experiences. To give you an idea of the effects of this drug, Quetiapine is often found floating about in prisons, sold as ‘baby heroin’. While for my diagnosis of bipolar this was a perfectly reasonable prescription, if my child was prescribed the same I’d have a few questions.

The Quetiapine had such a sedative effect I could easily sleep for days at a time, at one point during the summer holidays waking at 3pm only for my five year old daughter to tell me ‘I tried to wake you up. It’s ok though, I’ve been cleaning the house.’ My attention would often drift to the point that I’d find myself snapping back to life twenty miles down the A14 or, less dangerously but with monetary consequences, staring unfocused at my computer screen for half an hour, fingers poised but unmoving.

And this was at the lowest starter dose, 25mg. My psychiatrist told me that he had some patients on 800mg. I recall particularly his description of the difficulty of finding a dosage to suit his patients: ‘I have one fifty year old man, a big ex-builder, who functions well on the 25mg dose. Another of my patients has to take 800mg, she’s probably five foot and very slim.’

Last year I spent my Christmas in A&E hooked up to a drip with a suspected reaction to another drug, Lamotrigine, an anti-convulsant often used in the treatment of bipolar and schizophrenia. The allergic reaction is a common one and absolutely deadly.

While for me these drugs weren’t a good fit, for millions they really do work, I don’t dispute for a moment that the responsible prescription of anti-depressants, anti-psychotics and anti-convulsants is a very important thing that improves the lives of many. For myself the treatment of my anxiety through the use of similar drugs has made a marked improvement on my quality of life.

However these aren’t aspirin, they’re hard core, mood altering bastards which can easily send you even crazier, damage your health very seriously or make you suicidal. Their usage in the treatment of ADHD is off-label (by which I mean officially unproven) and one of the dangers lies in ceasing a dosage too quickly – would you trust even the most sensible 16 year old to take a pill at the same time every day? I wouldn’t.

I wonder how many parents, baffled by healthcare jargon and at the end of their tether in the face of an ADHD child has simply accepted a prescription for anti-psychotics? After all, the doc knows what he’s doing and the kid’s finally calming down and going to bed at night. I’ve certainly had days with my perfectly healthy children when I’d have done anything to shut them up.

Not all people have the ability or wherewithal to google their new drug, as I – a web-savvy type with years of experience in the industry – and my husband – an IT professional – do with every new prescription. In fact I wonder if everybody even reads the leaflet in the box.

I’ll tell you what worries me most about this news though, and about the fact that the government isn’t appearing concerned about the chemical coshing of patients outside of the elderly. It’s this:

At the age of 18, having just started uni and found myself struggling I went to the local GP in Cardiff. I walked in and was asked what the problem was.

“I think I need anti-depressants.”
“Right. Have you felt like this for long?”
“Since I started university.” (this was the november of my first year)

Without further question or hesitation I was prescribed Citalopram.

I wonder if I took one of kids to that same GP now and told him ‘I think he has ADHD,’ things would be any different.

*I’d be really interested to hear from anybody with children on mood stabilizers or to hear about other people’s experience of lazy prescriptions so do feel free to post here or message me on http://www.twitter.com/hoola