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Why Bipolar Medication Changes Suck

December 15, 2016 Natasha Tracy

When you’re changing medications, it becomes very clear how much bipolar medication changes suck. Being on the first one(s) sucks and changing to the next one(s) sucks, too. And people not on medication may not get this. They may not get what it’s like to have to take medication for bipolar and they certainly may not get why bipolar medication changes suck.

Why Change Bipolar Medications?

There are several reasons for changing medications in bipolar disorder. (Whether you’re changing a single medication or a medication in a cocktail, it’s pretty much the same.)

  1. The medications aren’t working.
  2. The medications are causing unacceptable side effects.
  3. The medications aren’t working well enough.
  4. The current medications are clashing in some way.

But no matter for what reason you are changing medications, it’s never an easy decision to make and it’s never good news, per se, when that decision is reached.

Bipolar Medication Changes: Getting Off of a Medication

While many doctors don’t recognize it professionally, there absolutely are withdrawal effects when getting off of a medication. This is not true of all medications, but it is for some. What’s more, some people may experience this withdrawal while some others don’t so you can’t anticipate what your withdrawal experience might be. In my experience, the more difficult it was to get on the medication, the more difficult it is to get off it, too. Of course, there are exceptions to every rule.

There are ways to reduce withdrawal effects such as:

  • Only changing one medication at a time (always a good rule).
  • Withdrawing very, very slowly – much slower than you think.
  • Doing a cross-taper where one medication is added slowly as you slowly reduce the other.
  • Ceasing or slowing withdrawal even further if major bipolar symptoms re-occur.

Of course, no one should try to do any of the above without a doctor’s sign-off.

Bipolar Medication Changes: Getting On a Medication

Similar to getting off a bipolar medication, getting on one can really suck as well. Getting on a bipolar medication often involves withstanding many side effects – often many nasty side effects. The good news is that side effects often go away over time, but the bad news is that they may go away only after many weeks to months.

To reduce side effects when getting on a bipolar medication, slowly, slowly getting on the medication helps a lot. Again, this is much more slowly than you think. Also, starting with a tiny dose is helpful. (Of course, this isn’t always possible as some people are in such distress that they simply can’t wait this amount of time.)

Changes in Bipolar Medication Sucks

In short, between the side effects of getting on a medication and the withdrawal effects from getting off a medication, it’s no wonder that people are scared of changing their medications. I have made changes more times than I can count but I can tell you at this point, that changes scare me more than ever because my balance is just so delicate now.

Nevertheless, it’s important to change bipolar medications sometimes. It’s obvious when you’re in a terrible state that you need to change them but often even when you’re in a so-so state it’s worth changing them because “just good enough” isn’t. Because just surviving with bipolar isn’t enough. Because every person with a mental illness deserves to live his or her best life. Because there often is better, if we can handle releasing a tepid reality.

Of course, it’s also okay to make the decision not to change medications if you just feel like it’s too dangerous for your own mental health. This is a perfectly acceptable decision. Because while side effects and withdrawal effects suck, they do tend to fade. A massive amount of instability, psychosis, etc., is much more difficult to deal with and sometimes it’s just not worth the risk. And no one should judge a person for making that decision.

APA Reference
Tracy, N. (2016, December 15). Why Bipolar Medication Changes Suck, HealthyPlace. Retrieved on 2024, November 15 from https://www.healthyplace.com/blogs/breakingbipolar/2016/12/why-bipolar-medication-changes-suck



Author: Natasha Tracy

Natasha Tracy is a renowned speaker, award-winning advocate, and author of Lost Marbles: Insights into My Life with Depression & Bipolar. She also hosted the podcast Snap Out of It! The Mental Illness in the Workplace Podcast.

Natasha will be unveiling a new book, Bipolar Rules! Hacks to Live Successfully with Bipolar Disorder, late 2024.

Find Natasha Tracy here as well as on X, InstagramFacebook, Threads, and YouTube.

kelly ledford
June, 20 2017 at 12:49 pm

I just changed mine am i going to go threw withdrawing from my other one i was using

Nancy
June, 5 2017 at 10:50 am

I've been all med for more that 30 years; first those prescribed for my depression, and then more when I was diagnosed Bipolar 2. For the last few years, my doctor and I have tried some of the lates new meds for bipolar, all of which caused side effects that were tolerable. Of course, that mean lots of weeks inccreasing dosage and then weeks tapering off. My doctor thinks she has found me core group of meds. (there is not much left to try) which I find discouraging. I'm almost 70. After all these years she wants to wean me off of Ativan because long term use can cause some of the side effects I am experiencing. Fatigue, cognitive impairment, and more. Of course we will do this very gradually. I feel very unhappy about the whole thing. Does this mean this is best it ever is going to be? How am I going to handle my anxiety. And am I every get it together to do those others things they keep encouraging: exercise, meditation. For some reason, this next step is really bothering my husband who has always been supportive. I am high functioning, and very good at 'acting'. I am working at getting outmore but it is acting and everyone things I am great. Is it wrong to ruin my husband's day because I feel bad. He wants me to be honest but doesn't handle the ups and downs very well anymore. At the same time he doesn't want me to act for him.

Matthew Morris
May, 25 2017 at 9:31 am

I love this blog on medication change. I have been diagnosed bipolar (type I) for 15 years now. I am in fear of changing medication due to withdrawal symptoms and having to go back to hospital for stabilization. Thanks again for writing this blog.

sarah
January, 8 2017 at 9:09 am

I sense a frisson of light breaking through the cracked glass
Of pain and truth
Where lies the bluntness of what is there
An animal broken,tainted and scared.
But this beam of light,this ray of brightness
Slight and all though it may be.
Gives some hope,some fight to include
Better times to come through the blues.

Amy
December, 31 2016 at 1:37 pm

I've been through years of the medication circles. All sorts of trial and errors. All sorts of adjustments and dealing with the unwanted side-effects, particularly the weight-gain. Unfortunately the lithium, which worked best, ended up causing endocrine system problems and so we had to not only remove my thyroid, but stop taking it. It also caused hyperparathyroidism.
What ended up happening though is that the weight-gain pushed the limits too far with other health issues...arthritis got severe, near diabetes and so on. Before trying to replace the lithium, and the whole rest of the weight-gaining cocktail of drugs, my physician, psychiatrist, psychologist and I all agreed that I could try going medication-free. Very hard getting safely off everything (about 5-6 meds at the time), even harder to find a way to cope without the meds, but it has been 2 and a half years without them. 95 pounds lighter. A much better physical health, and I have to admit that I'm not in a position where I keep going on and off my psych meds in those manic modes, which was horrible of me to do. I sleep very well at night because I added exercise 6 days a week (part of my agreement with the doctors as a healthy routine to stay off meds), which keeps my arthritis in better condition.
So...I know that meds are needed for a lot of people and this plan won't work for everyone. I just knew that the weight gain was a side-effect I couldn't keep living with and I'm very determined to stay off the meds. I'm not saying I don't still go through the mood swings and have hard times. Fortunately all my doctors are on board with the plan though and for the most part it works. Weekly appointments with the psychologist really help me work through the tough times. She's the hero in all this. I do take medication to help with sleep and migraines, I'm not opposed to medication. I just avoid the ones with weight gain possibilities. While my pharmacist and I love talking sports, it is kind of nice to not have to walk in with a load of scripts and changes every few weeks or each month. Sort of weird to have been on the same stuff for the last 20 months.

Effective Communication With Your Dr Is Of Paramount Importance
December, 30 2016 at 3:48 am

Mr Ferati
First off, my previous posts were not intended to be discriminatory, only constructive. Nor were they meant to be exclusive for that matter. I am sorry that you took them to mean otherwise. You are certainly free to express yourself however you wish.
English is my first language. My frustration in wanting to understand you better keeps getting in the way though. I was merely suggesting another possible method of communication that might be helpful if considered
Language can sometimes be a barrier to effectively communicating with others both in word and tone
I guess I wrongly assumed that a learned man such as yourself in a "helping" profession" such as yours would be interested and open to possible ways of improving their communication, especially with those suffering depression.
Sometimes you come off sounding a bit pretentious. Also it's not necessary to be so verbose in trying to get your point across. Less is sometimes better. Just try to keep it simple. It works a lot better when there are language barriers and there ARE language barriers. I know this from experience. I've worked every day with international travellers for over 30 years
Yes, the depressed community may have trouble concentrating at times but please try to remember we are still intelligent people worthy of respect. No need to discriminate
Thank you for YOUR understanding
Peace
PS the misspelling of your first name was merely a typo. An honest mistake. Chill. My father who was one of two people responsible for naming me still spells my first name wrong from time to time, LOL
R

Dr Musli Ferati
December, 28 2016 at 11:27 pm

Dear Mr. R,
Thanks for your compliment to my professional engagement on my comments in HealthPlace. But, I have got some observations: firstly my fist name is Musli not Musely. Second, mental health isn't national distinct space, it is international issue with specific sociocultural features. My native language is albanian, but isn't the barrier to write and exprees my observation in English. And thirdly, psychiatry isn't simply medical science, it is complex and not enough explicit clinical branch. These and many others characteristic of mental pathology greats challenges that should be overcame by benevolent collaboration and not by discrimination and exclusion.
Tanks for your understanding !

In reply to by Anonymous (not verified)

Natasha Tracy
December, 30 2016 at 4:43 am

Hi folks,
Both of you have had your say, let's move on, please.
- Natasha Tracy

R
December, 27 2016 at 9:50 am

To Dr Museli Ferati
Pardon my bluntness, but I always find it very frustrating trying to read and fully comprehend the points you are trying to make in your posts and I suspect others do too especially those who suffer from depression since difficulty concentrating is often a symptom
If I may, I would like to offer a bit of constructive criticism. Because it is apparent that English is not your first language I believe it would be a lot easier to grasp your train of thought and understand you much better if you broke your entries into succinct paragraphs and used more simplistic language.
For instance instead of saying
"conditio sine qua non" just say "essential"
Or instead of saying
"It ought be more creative and inventive to supervise the algorithm of bipolar medication" maybe say, it's better to monitor medication changes, otherwise"...
Another suggestion might be to type your comments into an on line program that effectively translates what it is you want to say from your native tongue into English in order to be of maximum benefit to others
Yes medication changes suck especially when some doctors don't follow proper dosing protocol or the side effects of the new medication are worse than the old one(s)

Dr Musli Ferati
December, 27 2016 at 4:28 am

Bipolar mood disorder as periodic mental disorder sink under seasonal and others phases that complicate its medications. Indeed, it ought be more creative and inventive to supervise the algorhythm of bipolar medication, Otherwise, we shall to face with many therapeutics difficulties such are worsening of side effects, accelerations of breaking of psychotic episodes and shortening of remission episodes. These unsafe course of bipolar disorder is very difficult to control by medications and it is associated with hard ad serious repercussions for definitive prognosis of this changeable mood disorder. You are right when support individual needs and deeds of bipolar ill patients, because it have got crucial role on improving the tolerance and compliance to respective bipolar medication. Another aspect of rightful medication in bipolar disorder is the creation of therapeutic alliance as paramedical condition on successful psychiatric treatment of this mood deflection. However, it is preferable to be careful with changing of medication through treatment of bipolar disorder, because psychotropics have got many side effects, particularly when they are taken of one,s own accord. There are strict and rigorous criteria on dosing and changing of medication during medication of bipolar mood disorder. They should be on close control and supervision of clinical psychiatrist, with satisfying experience and knowledge on bipolar medication. Its sincere engagement and unconditioned pledge to bipolar patient are "conditio sine qua non".

heaven watts
December, 25 2016 at 1:12 pm

Does anyone have any advice for me?

heaven watts
December, 25 2016 at 1:11 pm

I recently was taken off lamictal due to a few hives after bumping my dose from 50 mg a day to 50 mg twice a day. I loved that medicine and felt it was starting to work for me. I am now on abilify and I've been takin it for 3 days and I'm miserably tired and idk if I reacted to lamictal due to bumping up to 100 mg or what but I was much happier on that

thomas
December, 19 2016 at 1:54 pm

funny to read this today... kinda a month and a half late for me. I was taking 2000 mg Depakote a day and 5 mg Zyprexa. my blood test showed too much Depakote so they went to 100 mg a day and took away Zyprexa replacing it with 200 mg. serequil. aaayyyaya!!! within a week I was coocoo for the coco puffs (again) I went from Houston and a loving relationship to Portland??? don't ask me why... I never been there before??? now in Alabama recuperating... now I have gotten back on the meds that are prolly killing me but I cant and wont sacrifice 1 millimeter of my sanity... next adventure move back to Texas and try to get the girl back... HAAA did that sound cliché or what???

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