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I was prescribed Sertraline HCl and Lamotrigine through my school for my Bipolar. They've been making me drowsy af, and I think the Sertraline is worsening my depressive symptoms, I've been missing work a bit lately (I've gotta face them tomorrow). Last time I was prescribed Sertraline I had a pretty bad hypomanic episode. I need some Adderall, I've got pretty bad Combined-Type ADHD, and I've jumped through all the hoops, signed the stimulant agreement and all that, but the clinic doesn't open until next month. To try and manage sleep I've been taking 50mg Diphenhydramine HCl and 15mg Melatonin. Dreams have been vivid af, and the drowsiness is hardcore, but it doesn't knock me out and my brain finds a way to keep me awake longer than I'd like. I was prescribed Clonidine HCl for sleep and 0.2mg of that would knock me right the fuarrrk out. Anyway, idk where I'm going with this, idk wtf to do, I'm trying to manage some recently diagnosed PTSD as well.

>>4854 That stuff might not be good for you.

For a kid in school that sounds very fuarrrked up to me that you are prescribed all of that. I'm 30 now and feel like i was basically abused by being given SSRIs when i was a teenager. They only hurt me. Try to think critically, sadly you cant trust the psychiatric system

>>4854 bipolar makes everything a little bit more difficult for treatment. i'm one of those people who SSRI (sertraline for me too) worked immediately and changed my life, it's like i wasn't even really alive for like 25 years until i took and my brain didn't work at all. also i have adhd as well, can't say for sure but something tells me taking adderall with bipolar is a not great idea. i don't take any meds specifically for adhd and i've just had to kinda live with it and learn to manage it on my own. anyway definitely don't take sertraline just on its own, because as you mentioned it can cause hypomania. you need to identify what medications work essentially on your own and then take them your way. doctors honestly don't know soykaf other than the basics. maybe it means taking lithium only when you're become hypomanic, maybe it means what you're doing right now, etc. only you know what affects you in what ways so follow your intuition.

>>4906 >wasn't even really alive for like 25 years Yeah, it's like putting on glasses. And yeah, Adderall on its own isn't a great idea with bipolar generally. But I've got that super severe comorbidity with ADHD, and Adderall's the only medication that's worked for me. But yeah, I was managing that with Lamotragine which is an anti-convulsant. Unfortunately I didn't get into school this semester so I'm locked out from the clinic. idk what I'm supposed to do. >>4901 I'm in college btw, not a teenager. Also because of all this stuff my friends have all already graduated.

>>4854 >>4901 Do you take lamotragine at night or day? I don't know if I'd make a blanket statement that you can't trust the psychiatric profession, making blanket statements is the opposite of thinking critically, but do exercise your judgement on a doctor basis. A good psychiatrist will actually listen to you and consider your suggestions and not put up so much of a professional "facade", and they won't tell you to keep taking something that isn't working.

I think cariprazine (vraylar) may be helpful to replace.your current meds for both bipolar and ADHD. It has been approved for use in bipolar and has shown some evidence of improving cognition (though more studied in a schizophrenic model than bipolar) https://pubmed.ncbi.nlm.nih.gov/26655189/ https://pubmed.ncbi.nlm.nih.gov/33302854/ https://academic.oup.com/schizophreniabulletin/article/43/suppl_1/S13/3075375 https://clinicaltrials.gov/ct2/show/NCT04771299 https://www.cambridge.org/core/journals/cns-spectrums/article/effects-of-cariprazine-on-cognition-in-patients-with-bipolar-mania-or-mixed-states-post-hoc-analysis-from-3-randomized-controlled-phase-iii-studies/7641D259CE19306459CDE806234C6A28# more experimentally you could possibly substitute your meds for modadinil but there may be a mania risk. This is less likely they would approve this. https://onlinelibrary.wiley.com/doi/full/10.1111/bdi.12859 https://pubmed.ncbi.nlm.nih.gov/27810669/

>>4908 I take it in the morning with other meds (when I have access to them.) >do exercise your judgement on a doctor basis Absolutely. I think if there's any perk to trying to take care of myself when I don't have access to a system I can work with, it's being able to understand how things effect me in what way, as well as being able to articulate exactly what I'm experiencing. When it comes to Bipolar, I feel fairly lucky to have type 2 and have never had a manic episode (yet) and have had the ability to hold onto enough clarity where I'm able to understand how not to make things worse. >>4909 Thanks for the resources! And thanks to all of you.

>>4910 If you show them the papers they might understand better what the thought process is and will more likely change your meds as you ask once you explain the problems you have. I also should mention cariprazine (vraylar) has insomnia as a side effect like your other meds but I've heard even when it does occur it usually goes away after a week or two. Brexpiprazole (rexulti) is a similar drug to cariprazine (vraylar) so it's possible they may mention that too if they understand the intention but the cariprazine (vraylar) has less risk of weight gain and seems to have more studies revolving around cognitive improvements that ive seen but I could be wrong. There also is a mania risk because how it works but it's also used to help with acute manic and mixed episodes. If you're concerned you could ask for more specifics on frequency. They may attempt to keep you on an SSRI though because often it's combined so you should mention how it feels it is making it worse and they may attempt to just do without one at least at first. I cant be certain because im not in the profession.