Its important that when people run out of standard mood stabilizers that some of the remaining choices do have potential side effects of concern, especially personality alterations. That's why some of them aren't often used. I've been through every mood stabilizer. Could detail but it would go on for pages. But after the common ones proved intolerable Keppra caused suicidal ideations. Trileptal caused an agitated mixed state. Now at this point in time having run out of options I could see a mood disorders specialist (which was suggsted in the past) but I've been through their lists of what they've used and have been on what's available.
But as for those of you who know me there is an over riding physical disability which is advanced tardive dyskinesia. I wasn't homebound on Clonidine as that controlled dystonic spasms and I could get out every weekend. But it caused an agitated mixed state. Another alpha blocker Tizanidine caused suicidal ideations. So I was started on Tenex which is also an alpha blocker and asked the movement disorders specialist and he said "its effect was lighter". I respect his judgement and that's proved true and I'm still adjusting and not yet at the full dose. And it controls the dystonic spasms and other dangerous spasms and the dissociation from what they are identifying as tardive psychosis. And its good to be on a mood stabilizer in general. Regardless of how well the experimental antipscychotic glycine works on psychosis I need a mood stabilizer as well. But along with a drop in blood pressure (which is worsened by an interaction with the Zofran which can do the same, but that can be measured, have a blood pressure machine) when I take it I feel a "rush" of elation, that "burns out" and I end up with the potential of an agitated mixed state. I'll speak to the neurologist for sure but I've been on almost every available anti-Parkinsonian med. and mood stabilizers the same. So I may just have to ride this out. We all know anti-depressents can worsen mania in a person with bipolar. But have you ever been on a mood stabilizer that worsened some aspects of bipolar? How did you cope with it? And if you knew you needed it for another more severe physical disability what would you do? I see the outside world and there's a chance I can go out and its been almost six months without that (except for neighborhood walks). And yeah I am at the frontiers of medical science but this is not a particularly good class of medication for mood stabilizers but its what's left that I can tolerate. Unless the neurologist finds something else I may have to "tough this out". What would people suggest (no need to discuss specific meds, just coping strategies). All this is complex, some just being understand by medical science but any simple words of advice would be appreciated. Thanks.