Sleep and Meds: Working against Each Other

You take Zyprex, which is soporific, but at the same time take Wellbutrin AND Rexulti, which both can cause insomnia. And if I understand correctly, you plan to taper off Zyprexa completely in favor of Rexulti. But then what will happen with your sleep? If you find it hard to fall asleep now that you still have some Zyprexa in your blood, what will happen when you don't? What's the pdoc's plan wrt sleep?

Yes, you are correct about my meds. I have no idea what pdoc's plan is re: sleep. I had insomnia pretty bad when I first started Wellbutrin. I am having some again. I did sleep last night. Its hit and miss. Melatonin is hit and miss too. I'm using my weighted blanket every night. What will happen without zyprexa indeed. I am determined to get off zyprexa and stay off it! I see pdoc in two weeks, so I'll bring this up, even though I don't think I'm going to be completely off zyprexa for another couple months at the rate I'm going.

The above was a post conversation on a bulletin board I had today. The second paragraph is mine, the first is another member's. She brings up a good point. As I think this through, or get more information- especially from my psych nurse practitioner- I'll post more.

Ways I SHOULD know I'm manic

I know I'm manic when I've figured out the thread that binds the meaning of my life. And then I start jumping in circles. And water in the shower feels orgasmic on my skin. And I stop sleeping and don't feel like I need any sleep anyway. And I can't stop talking a mile a minute, and tapping on things over and over. And I want to scream and so I jump in circles some more. I start hallucinating angels, or aliens. These are just a few ways I should know I'm manic. Emphasis on "should".

Rexulti & Zyprexa Dose Changes Again

I talked with her nurse this morning to report how the (total) 2 mg increase since Friday is working. I told her I'd been sleepier but my symptoms have improved. So now I wait for Pdoc to call back and hopefully call in a new script of the new dose as I'll be out of this one (1 mg) soon at the new rate.

I'm waiting for pdoc to call me. I'm beginning to think she won't. (It's 5:35 p.m.) I thought she said to call her nurse this morning and report how I am doing and the nurse would email her and she'd get back to me about my Rexulti. I need my new script in the next few days because I will run out of the other one.

My psych nurse is usually really understanding and nice. Her nurse is usually businesslike and today was no exception. I mean, maybe its just a case of her being slammed today, but tomorrow, I'm calling again and telling them that I'm running out of pills the next day. That's something I didn't realize or tell them today.

January 25: I had an appointment with a doctor at the hospital today. We were looking at my liver because I have fatty liver disease, I think in part from zyprexa. But we went over everything. They did an ultrasound. I was told to eat more fruit and veg., exercise, cut carbs... basically everything I'm already doing. They weighed me and although I've lost weight according to my scale at home, this scale thought my jeans and sweat shirt should be counted too. Above all, they took a detailed medical history, including my premature birth, all my surgeries, my asthma, my drug allergies, etc. But they just finally came up with "You're fat; lose weight". They did blood work- a bunch of it. I don't know the results of my ultrasounds. My primary doctor will get back to me with the results and what to do next.

On the Rexulti front, I called the pharmacy to see if a script had been called in but after being on hold for 20 minutes, it hadn't. My psych dr. hasn't called today again. I'm not sure that she needs to call, but just to get straight what the plan is would be nice. I see her on Monday. (Today is Wednesday.) But tomorrow is my last day of pills and I would go three days without until my appointment.

January 26:My nurse practitioner called back!!!

We switched my appointment to two weeks from now instead of Monday because she switched my dose of Rexulti from 2 mg to 3 mg (I had only been on 2 for a week) and my Zyprexa is down from 12.5 to 10. (Baby steps.) I'm going to go to the pharmacy asap. Gotta go pay bills at my mom's. Have something to eat, too.

I'm so happy now!!!

The pharmacy had to order my Rexulti (guess they didn't have 3mg) so it will be in tomorrow after 2. That's right before I have to get my daughter to take her to the doctor. I'm also having lunch with friends at 12. Whirlwind day. And I'm just home from an intense church choir rehearsal. Sight reading a Haydn mass. I'm beat.

January 27: Picked up new dose of Rexulti and lower dose of zyprexa. We're getting there slowly but surely! I had a sleepless night the night before last, but I am not sure if it was related to Rexulti (happened before the higher dose) or something else.

Rexulti Change Effects On a Long Day

Today I made a late start but made it to church/choir with my youngest. We had lunch with my ex between church service and when we are meeting to leave for another church to sing another service. Personally, I'd like to nap now but I can't. No time, no CPAP, no bed. My lunch wasn't exactly on my diet but I'll be good later. It was nice of my ex to buy us lunch.

Drowsiness sedation fatigue.... All listed as side effects of Rexulti. I just took my second increased dose of Rexulti about an hour ago and I feel so dozey. My choir is supposed to leave in 45 minutes for a gig. I'm not driving thank goodness! But still I just want to be in bed.

I pushed through the gig. Pdoc just increased the dose to deal with anxiety and guilt.

Sang gig. Was so disorganized. Missed half of one piece!! I couldn't find it!

I think I'm gonna explode! My daughter is at her boyfriend's and is ignoring me when I said I want to pick her up. My son is talking to my friend here and I want to leave and go to bed. I want to scream at everybody.

Omg my friend won't shut the hell up about politics!!

**********************

These are a few posts I made on a bulletin board today. I had to be up for church choir at the normal time, but we had an extra service at 4:30 about 45 minutes away at another church. Between the time that the service at our church ended and the time we had to leave, my ex husband and our youngest and I went out to eat. I took my second day of increased Rexulti. (Double the original dose.) About an hour later, I began to feel very drowsy and fatigued. Not just tired, but as if I were ill, without actually feeling sick. I pushed through and went to the service. However, I couldn't track very well. I wasn't sure what was coming next to sing most of the time and even one piece I couldn't find until we were half way through it! Then later in the evening, I became agitated at my daughter for not answering her phone (turns out she lost it; is that better?) and I became angry at my friend for not shutting up about politics. He just kept going on and on and on! That might be part of my problem: I'm tired. Makes one grumpy. Starting out tired from meds then going on a trip then doing a lot of work (singing) then more driving (even though I was a passenger) takes it out of you. That plus I visited with a friend for a bit after. The politics talk further exhausted me.

So I'm not going to call my "pdoc" about this because I prefer it to feeling guilty and anxious and I do so want to give Rexulti a chance. Feeling drowsy mentally and physically is an ok side effect to doubling a dose, I think. Maybe tomorrow, things will even out a bit, though.

Anxious

Maybe it's my money snafoo or my EBT card taking days to come in the mail* or something I can't put my finger on. I went to church choir rehearsal but I'm still anxious tonight. The singing did well at distracting me I'll give it that. And now I'm under my beloved weighted blanked which is touted to be great for erasing anxiety. I just dunno where it came from. I feel like something (s) is going to go really wrong and my brain won't stop trying to figure out what it is.

*My original card wore out. The strip wore right off the plastic card in several spots.

EDIT 1/20/17: I just called my pdoc's nurse. I told her that I've been feeling anxious for the last week, that its random and not to do with any one thing. I keep feeling guilty by random things I've done. She said she'd talk with my pdoc and get back to me. I hope they don't change my meds; well, if they want to up my Wellbutrin, that would be okay, but I like the Rexulti and I'm happy going down on the zyprexa. I'll update when she gets back to me. Its weird though because my mood, in general, is my silly chipper, more hypomanic self, today. That mixed with anxiety is a weird combo.

My psych nurse practitioner just called! She wants me to double my Rexulti to 2 mg through Tuesday and then call her and report how I'm doing. Actually, she wants me to report to her nurse who will then email her and then she (pdoc) can call me back. She thinks that I need more Rexulti in me since the Zyprexa is being lowered and that this is why I'm having anxiety and guilty feelings. Once I decide that the Rexulti increase has helped, she will call in a new script for 2 mg so I won't run out early.

Diagnosis

They say it takes an average of 10 years to get diagnosed as bipolar. I was showing symptoms early in life, but was not diagnosed. I even asked to see a psychiatrist at age 16 but was told I was "a normal teenager".

At age 27, I decided that I needed to work through being an adult child of an alcoholic. I found and saw a specialist in this. As I recall, we didn't get very far, and I never went to any meetings with other "ACOA"s. There are definite traits to being an adult child of an alcoholic and I bought books about this a few years later and tried to work through this. I also bought books on "highly emotional people". I thought I was just full of emotions and "extra sensitive". Of course, I read only a few pages of each.

When I first started having more symptoms at age 33 or so, I saw a doctor that worked with my primary doctor. He thought I had PMDD: Premenstrual Dysphoric Disorder. My primary reviewed this and referred me to psychiatry. There, I was seen by a student psych. nurse who diagnosed me with "bipolar NOS". (Not Otherwise Specified.) (The diagnosis of PMDD was thrown out.) It took several months for them to finally give me the specific marker of "bipolar I". I remember being psychotic before my first appointments, but you don't just walk into an appointment and say, "Hi. I was psychotic 2 months ago. Give me drugs." I was put on Depakote and the rest, they say, is history.

I'm still ACOA, but the symptoms that I thought were because I'm ACOA, and emotional person can be attributed to being bipolar.

Sideways

Usually I feel great but today I feel anxious and intrusive thoughts have entered my mind at the thought of losing my health insurance. Didn't I just go through this a few weeks ago with DHS? I can't not take my meds. After church today, my ex-husband teased me about "You'd better get all the tests you can before your health insurance goes away,". He was referring to Trump cancelling- or severely paring down, I suppose- Medicaid. I think he's going to do it to Medicare, too, if I'm not mistaken. This has made me anxious. I know! Go use my blessed blanket, right? The weighted magical blanket that's supposed to cure anxiety. Well, I just might! I just dealt with my insurance maybe being cancelled a few weeks ago, and now this rumor is flying around like wild fire. If I have to go without my meds, serious shit is going to hit the fan. I don't want to know what I'm like off meds, and I'm sure the people who know me don't either. I know how I am with breakthrough symptoms- like hallucinations- on meds, I don't know what my brain would do with no meds at all. Destabilize is all I can think of.

I was feeling great yesterday, because I got up early and got new tires on my car. Then I got new jewelry for my nose and my lip. Now today, I'm feeling depressed and guilty for doing that, even though the car needed tires badly. I didn't need new jewelry. So up down up sideways (anxiety) down.... Plus, last time I paid the rent, I went out and had a check made out for what I thought the rent was (what it had been previously) plus a guess on my water bill. (Included at the same time as the rent.) When I got to the complex office, they told me I don't owe rent this month. (Section 8 paid it all.) But I already had the check and made out to the complex. So I just gave it to them figuring they'd give me a credit like they did another time. Now I'm worried that, even though they gave me a receipt, they'll take that credit and say it never existed. Sideways thinking? See? I'm not always on top of everything. I'm going to panera with my younger son in a bit. Maybe that will calm me down.