Turning into depression

[sleepy1968]

After being on Seroquel for 2 years, I've just been put on a low dose of Topomax and sodium valproex.  Started May 10th.  Been increasing slowly.  I was on the valporoex sometime ago with olanzepene and had a huge weight gain.  I went off those meds, lost all the weight and ended up on seroquel.  I know I suffer from anxiety and that's why the seroquel worked so well for so long.  Problem is, when you increase that stuff, it gets hard to function because it's such a sedative.  Anyway, I have had a diagnosis of being bi polar.  Seems that I'm ALWAYS in a mixed state.  Doctor thought he would try to put me back onto the sodium valproex because it did seem to work for me years ago.  It didn't though because we added the olanzepene to it and I remember having absolutly no sex drive. We added the Topomax just incase I gained the weight back.  I'm already struggling with weight issues.  I quit smoking in October and since then, I have gained 25 pounds.  No matter how much I excercise or dont eat, I can't lose that weight.  I did not know at the time that the doctor prescribed the topomax that it was for weight also.  I sure was excited when I read about it.  I have increased my meds according to instructions.  My doctor signed me out of work for 3 weeks.  He has gone on holiday.  I live alone and am already suffering with severe mental health issues.  I have no one to talk to.  I do not have any sort of therapy.  I have talked to my psychiatrist numerous times about this. He feels it's not his job to find me therapy.  I have been seeing this man for a very long time.  I have an appointment to see my family doctor on may 29.  My question is.  I seem to be feeling very depressed.  I don't suffer from depression.  Could either one of these meds be making me feel depressed?  This started yesterday.  I cryed all day and I have never felt so alone.  I can't stop thinking.  All I do is think!!!  Should I start cutting back on the meds the way I increased?  Are these side effects that will go away?  Also, what is causing my itchiness?  Its one of these pills.  Thanks for listening.

[sleepy1968]

Thank you to everyone who has replied.  I'm feeling somewhat stable now.  The topomax was givin to me to offset the weight gain that I would probably have.  I personally think that the Topomax and the Divalproex was a terrible combination for me.  Put me into horrible depression, horrible obsessive thinking.  My brain would not shut down.  They were terrible thoughts too.  I had major insomnia.  That was awful to me considering I had been on seroquel for 2 years.  I slept like a baby.  Prior to being switched to these 2 meds, I was just on 50 mg of seroquel.  Lowest dose.  In my messed up opinion, I really don't think I need my medication switched, I need therapy.  Someone to talk to on a regular basis.  I have a ton of workplace stress and that is what is hard to deal with.  I reach for different drugs or more drugs because it's a quick fix.  Over the course of the last 2 weeks of my life, I feel that I was standing in the gates of hell.  I just didn't enter.  I'm back onto Seroquel now.  3 night ago.  Still a little insomnia, but I feel that I can think straight.  Waiting to get in to see the doctor and trying really hard to find ongoing therapy.  The itchiness that I was feeling by the way has a name that starts with an A.  It isn't actually itching, it's just a sensation and it effects the central nervous system.  Had to wait until the Divalproex and topomax were out of my sytem before that went away.  It was a drug reaction.  Couldn't take any antihistimines for it either.  It was awful.  I do feel like I'm on the road to recovery though:)

[ILADVOCATE]

  Depakoate (the other name for one of the medications you are taking) is less effective on symptoms of depression than it is of mania. I did experience this when I was prescribed this and was informed this by one of my psychiatrists. However each person responds differently to each medication and as other people noted you are just starting it so it will take some time to build up to a proper blood level. Topomax is generally prescribed as an adjunct (additional) mood stabilizer to other mood stabilizers. However only a psychiatrist would understand the clinical specifics of this and be able to advise what the best course of action it.
  I agree it is essential for you to speak to your psychiatrist. Also its important to keep track of how mood changes occur, improve, remain the same or worsen. The mood tracker can be helpful for this over time as your psychiatrists adjusts your medications to a working dose. Then you can print out the results for them. it would also be worthwhile to discuss with your psychiatrists how they believe those specific medications might be of help for you and what concerns they have noted.

[adel_ezz]

rule:

no 1: finding the EXACT combo is out of the question, you only try to optimize what is available
no 2: the more drugs you take you can't tell which is not functioning and which gives side effects.

I am not aware of topamax yet is one of the anticonvulsants like the sodium divalporex. I can't understand why the pdoc put you on two of the same type. Again he put you before on the latter + olanzapine (antipsychotic) both are the worst drugs for weight gain. My view your pdoc isn't that efficient. Also I understood you are a female and the sodium div... will cause ovarian cysts. I think seroquel was better than this mess but i can't advise being not a pdoc. perhaps you should have more patience or change your pdoc.

[sleepy1968]

Thank you Anonymouse88

I did go speak to my pharmacist tonight.  As he said, that's the thing about starting new meds.  You never know how you're going to react.  Not only did I start 2 new ones the same night, I also came off the only one I was on the same night.  You cannot take Topomax and Seroquel.  I haven't.  No wonder my brain is so screwed up and to make matters just so much worse, I have had NO ONE to talk me through this.  I have no idea how I should be feeling.  Maybe this is normal.  Nope.  My pharmacist says to get ahold of whoever is on call for my psychiatrist or call my family doctor.  I know that depression does tend to go with being bi polar, and I have had depression in the past.  I don't feel depressed ever.  I feel more stressed than anything.  Very aggressive too.  I need some serious therapy and to maybe just go back on my seroquel.  Problem is, you have to have both to work.  I have never had any consistant therapy.  I have told my psychiatrist that and it just falls on deaf ears.  I only came into contact with him through mental health crisis centre.  I called a couple of years ago when I wasn't medicated and relapsed.  The itching the pharmacist said could be caused by either of the meds.  There is no rash though.

Thank you so much for your great advice.  I will call the doctor tomorrow.

[Anonymouse88]

That's troublesome that your psychiatrist won't help you find therapy if he isn't doing it himself.  It might be time for a new psychiatrist if he's getting in the way of your treatment.  Is there someone else at his office you can talk to, or can you get them to page him since you're having major issues?  There should be someone to cover for urgent cases while he's away.  

Bipolar disorder comes with depression.  That's part of the disease.  Some people spend more time elevated or mixed (both manic and depressed at the same time) than they do depressed, but you're pretty much guaranteed depression at some point if you aren't well controlled.  I would guess that the meds you're on aren't doing the job, and you're starting to cycle.  Some drugs also just don't work for some people, and can make them worse.  If that's the case, I would guess it's the topomax, just because that's the one you haven't tried before.  Do you think the overthinking could be partially anxiety?  

It's generally not a good idea to adjust your meds by yourself, but you could ask a pharmacist about a tapering schedule for the new meds.  You might have to go down more slowly than you came up.  If you can get a doctor on the phone, ask them about maybe tapering back until your psychiatrist is in town and can advise you.  And itching, if caused by a med, isn't a very good sign.  If you break out in a rash, you'll probably need to go to the ER or get an appointment immediately and see if you need to come off of something FAST.  The itching could be benign, or unrelated, but you want a doctor to make sure it's nothing problematic.

There are psych ERs in most cities, which deal with mental health crises specifically.  If you're really feeling like you can't deal, one of those might be better than the local ER.  There are also hotlines you can call if you're feeling really awful and need someone to talk to.  I hope things get better for you.

What other drugs have you tried?  And are you BP I or II?  There might be other drug options that don't include an atypical antipsychotic, which have more of a risk of weight gain, or that involve the atypicals that are least likely to cause weight gain.