So far so good…if you only care about stability. No changes in my mood. Im generally happy, not feeling depressed. Normal anxiety. Same akathisia. Nothing bouncing around.
Well…except my physical energy and dopamine. On a “good” day, I struggle with energy and dopamine. This new medication, at least with the upward titration side effects, is just trashing my physical energy and dopamine, unless I supplement it. I used to supplement with cigarettes and alcohol and kratom. Now I am down to caffeine and a nicotine vape. I hate them both.
Throughout my recovery journey, I have weened myself off almost every dopamine souce, including energy drinks. And it just makes it even worse. Caffeine and nicotine are a lifeline while I wait out this medication titration. I am so physically tired, and mentally drained of dopamine. Energy drinks to the rescue.
“I thought you were stable, why change meds?”
Laced throughout this body fatigue is the inner restlessness of akathisia. Right now, there is a medication tug of war. Vraylar vs Lamotrgine.
I have been on Vraylar, Latuda and Strattera at different times in the last 7 years or so. Latuda and Strattera caused and made akathisia worse. So we went back to Vraylar. About that time, I started drinking more and using Kratom to unknowingly self medicate the akithisia caused by Vraylar. Despite the known side effect of akathisia, I had never personally connected Vraylar with akathisia until recently.
Vraylar has been a very good medication except for the relentlessness of akathisia. When I quit drinking and consuming kratom, the akathisia got incredibly worse to the point that I had to ask for work accomodations and eventually leave traditional employment altogether.
I had a heart to heart with my doctor. Bipolar disorder was not driving me crazy, the akathisia side effects of Vraylar were. Absolutely unsustainable. Unreasonable. Unnecessary. I couldn’t handle it anymore. I had suffered for 7 years with this specific side effect and the effects of substance and alcohol use. And I haven’t even delved into the cholesterol and diabetic side effects.
We decided to explore Lamotrgine and eventually discontinue Vraylar. I am about halfway through the process. Lamotrgine has a pretty good reputation in terms of metabolic side effects and is not known to cause akathisia. In about 6 weeks, we will discontinue Vraylar and hopefully watch akathisia fade into my past.
I had no idea that a single side effect could be so disruptive. It drove me to drink and do kratom. Those combined cause increased bipolar mood disregulation, which drove me to self medicate more. Rinse, repeat, and next thing you know, a crisis develops. You find yourself in a hospital. In psychosis. You get an involuntary shot of haloperidol and take a long sobering nap.
No thanks. I would rather endure 2-3 months of medication change effects than go down that path ever again. Its been almost two years since I have experienced a mental health crisis. I would like to keep it that way.
TLDR…side effects suck.