Side Effects

As explained in my previous post, in the recent past I have suffered greatly with the withdrawal effects of Lithium and Quetiapine. But unfortunately it didn’t stop there- Now that I have started on a new drug, I am regretting my decision to go back on it due to its nasty side effects.

So I have decided to dedicate a post to the different medications I have taken for bipolar over the years and the various side effects I have experienced with each of them.

Qutiapine (Seroquel)

I have been on and off Quetiapine for the last five years and it was the first medication I was prescribed when I was diagnosed with bipolar at the age of 21. Initially I had to start on a small dose, something like 200mg and it made me very sleepy. Part of the reason my psychiatrist prescribed it was because I also suffer with insomnia and this medication is often used to treat that, too. Around thirty minutes after taking it I would find myself unable to stay awake and I would fall asleep the second my head hit the pillow. Had it not been for the daytime drowsiness as well, this would have been bliss for me. But 200mg was not a therapeutic dose for me and, anyway, over time one’s tolerance to the drug grows and smaller amounts will not make you sleep. My dose was eventually adjusted to 800mg, both to control Mania and allow me to sleep well (for the record, these days, legally, the maximum amount that can be prescribed is 750mg).

My psychiatrist once told me that, for a small person, I was technically on a dose which was much too high for me, and 800mg of Quetiapine would be more appropriate for a body builder. But my mood swings were just too bad and I couldn’t sleep on a lower dose anymore.

I was at university at the time and I found myself needing to sleep for 12 hours at a time (minimum) and unable to make half of my lectures. I became so tired and sedated during the day that I was losing interest in social events. My mania was pretty much under control but it did not eradicate my depression.

One of the worst things that happened to me as a result of long-term Quetiapine use was that I developed an incredibly rapid heartbeat, and last year, when I had an ECG, it was shown to be irregular from taking it on an empty stomach every night (due to anorexia). After taking it in the evening, I was unable to move in my bed or walk to the toilet for fear of having a heart attack because my heart would race. I went on having this problem for years until it got to the point, this year, where I was experiencing severe anxiety attacks.

Another major problem I encountered while taking this medication was the weight gain. Gaining large amounts of weight is not a pleasant experience for anyone, let alone a long-term anorexic. I could eat and eat throughout the day and night and never feel full; often the hunger was insatiable. By the time I gained two dress sizes I relapsed back into anorexia which I definitely attribute to the effects of the medication.

After putting up with all the nasty side effects and suffering from flu-like symptoms even if I missed my dose for just one night; and after trying it out time and time again and getting the same results, eight weeks ago I decided to stop it for good. Because it was causing such a rapid heart rate and leading to anxiety attacks every day, and the fact that it was no longer controlling my moods and bipolar symptoms at all, I wanted to come off of it as quickly as possible. Against medical advice, I staged my withdrawal process over the space of only two weeks (I do not recommend this to anyone).

I went through absolute hell as a result. I cried desperately, I had giggle fits that turned to tears; I shouted and screamed at my boyfriend, I hallucinated and believed someone was going to murder me. For two weeks I lay shivering in the bed with terrible physical withdrawals, as if it was the worst case of flu and fever you can imagine. I am lucky my relationship did not end because of my insane and angry behaviour over that time. I went crazy and I had to take Valium to help with my symptoms, it was the only thing that brought me any peace. My boyfriend confiscated my remaining tablets so that I wouldn’t go back to it merely to feel better.

On the plus side, if you suffer with manic episodes and insomnia, Quetiapine can be an effective drug. On the downside- for me- it did not control my rapid cycling moods, or my depression and I gained so much weight that I began to starve myself completely to lose it again. In my experience, it can cause damage to your heart and you daren’t take it without eating dinner. No matter what a doctor might say about it, Quetiapine is heavily physically addictive and withdrawing from it too quickly can cause effects on the body and mind that could lead to serious consequences. Of course it is different for every individual, but based on my experiences, I don’t want to ever go near it again.

Olanzapine (Zyprexa)

Olanzapine is another heavily sedating drug used to control the symptoms of mania and hypomania in bipolar. In many ways it is very similar to Quetiapine.

I have taken Olanzapine three separate times, once again hoping that it would be better each time. I have tended to switch between Quetiapine and Olanzapine over the years because I found that Olanzapine was worse for weight gain and Quetiapine made me sleep better.

Although Olanzapine does not give the same level of drowsiness (in order to get to sleep) as Quetiapine, it will make you sleepy after an hour or two and help you to drift off. On the other hand, as far as it goes for me, it does not help you stay asleep during the night. Most nights I wake up over and over to go to the bathroom and have a cigarette or even eat. During the daytime, on the other hand, Olanzapine is a lot worse in the sense that you feel incredibly tired the whole of the time. When I was taking it last year, I was bedridden with an eating disorder and I did not notice how drowsy it made me feel. This time though, now that I am eating again and more active, I notice the daily fatigue. I’m so tired that by 3pm, despite not leaving the house or doing anything active, I want to go back to sleep. Most days I don’t feel like doing anything or going out and coffee just doesn’t do the trick.

If I stand up too fast from sitting or lying, I black out and feel like I will pass out. I feel dizzy all the time and feel myself swaying on my feet.

Under the impression that it was only the Quetiapine affecting the speed of my heart, I assumed I would feel better once I switched medications, but it turns out that Olanzapine does exactly the same thing. And it’s not just when I take it at night, for the majority of the day I feel like my heart is going far too fast which often leads to me panicking and launching into an anxiety attack.

I find it gives me ‘brain fog,’ I slur my words and sometimes make little sense when I try to express myself.

It is just so relentlessly tiring.

Going back on it this time around, so far, I have gained 1.5 stone over the space of eight weeks. I am now on a diet to lose the weight and get back to a size I am comfortable with. I have to say I do this with great difficulty because this drug makes me hungry all day and night.

Lithium

Over the years of taking it, I never felt that Lithium was a bad drug for me, at least in the sense of its side-effects. Yes, it gave me a hand tremor but I didn’t feel like it made me particularly tired and I didn’t withdraw if I missed it for a day.

It was only when I stopped it a few months ago that I noticed it had stolen my imagination, creativity and most favoured personality traits.  On stopping it, I felt a whole lot of life and energy spill back into me and suddenly I felt alive again after years of my real personality being supressed by the drug.

Lithium flattens you, but it flattens you for a reason. It is a very good mood-stabilizer. My mistake was expecting it to cure my mania and depression entirely, which it didn’t, so I stopped it completely and suddenly. I hadn’t intended on it, but one day, three months ago, I ran out and I couldn’t get to the surgery to get some more so I went without it for a week, and that’s when I started to feel like myself again, so, as it was out of my system completely, I made the decision to stay off it (and remain to be).

But I underestimated how much it was actually helping with my bipolar symptoms, and I found myself suddenly on a downward spiral of rapid cycling mood swings, hypomania and depression, and that went on until very recently. Perhaps my sudden withdrawal also contributed to why I keep having these anxiety attacks.

As a result, I recently thought about starting it again, but I only have 400mg tablets in Greece and I would need to begin the process again on a much lower dose to avoid toxicity.

Although I have not experienced it myself, Lithium can be a dangerous drug in the sense that it can literally poison you. Take ibuprofen, eat or drink grapefruit or simply not drink enough water and you could be facing a visit to the hospital. I can’t stress how important it is to drink plenty of fluids while you are taking Lithium to flush it out of your liver.

I would personally recommend Lithium as a decent mood-stabilizer, but you should expect to feel kind of flat and you have to be careful with your diet.

Lamotrigine (Lamictal)

Lamotrigine has been the most effective drug for depression in my personal experience. In fact, before I began taking it in 2012, I didn’t think I would make it to my 22nd birthday because I thought about killing myself on a daily basis. I went through a period of years where I would cry every day; cry myself to sleep and cry as soon as I woke up. It takes a long time to get into your system, approximately three months, but it was worth the wait for me.

I have not really experienced any negative side effects from this medication aside from the occasional facial twitch which has been pointed out to me. However in some cases it can lead to an illness called ‘Stevens Johnson Syndrome.’ This is rare but the symptoms include a rash, fever, sore throat, and fatigue, so do keep an eye out for these things.

I stopped Lamotrigine at one stage because I couldn’t stand the taste of it lingering in my mouth. I can only describe it as tasting like you are swallowing pure chemicals, and if you don’t swallow it soon enough it will melt on your tongue and this would sometimes make me bring it back up or dry heave.  Now I make sure I take it down with something nice to drink, like orange juice, but you can also coat the tablets in something sweet like jam.

I encountered some serious problems with Lamotrigine during my anorexia last year. Little did I know that you can’t just go taking a 450mg dose all at once and little did I know taking it while eating nothing could cause a serious allergic reaction. After taking this large amount, I would begin to see double, often throw up and feel extremely dizzy. This happened to me every morning that I took it but at the time I attributed these issues to my eating disorder.

Lamotrigine has side effects like any medication, but it is one of the best medications you can take for both rapid cycling bipolar and bipolar depression.

Aripiprazole (Abilify)

I didn’t take Aripiprazole for very long as I found it ineffective for my illness and it was quite some time ago so I have looked up the most common side effects. Google gave me the following information:

‘Common side effects of Abilify include dizziness, weakness, lightheadedness, nausea, vomiting, stomach upset, tiredness, excess saliva or drooling, choking or trouble swallowing, blurred vision, headache, anxiety, weight gain, drowsiness, sleep problems (insomnia), and constipation.’

And so it appears that it has similar side effects to the other medications I have spoken about in this post.

In summation; every drug I have taken to control the symptoms of bipolar have caused unpleasant and sometimes unbearable side effects. But you have to really weigh-up the pros and cons of taking heavy psychiatric medications. It’s a tossup between experiencing these negative effects or being unwell with your illness(es). Personally I choose to take Olanzapine and Lamotrigine at present because, as I have tried and tested, I become too unwell without medication.

 

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