Hi! I was diagnosed with Bipolar Type II last month, and was put on an antidepressant (Effexor 37.5 mg), without a mood stabilizer. I am in a much better mood, btu I am unable to sleep. I haven't slept in a week, and am really sick of it. I am still able to function normally (although I yawn quite a bit), but have enough energy to make it through the day. It is kind of scary, and I hate that at night I can't sleep. I try so hard. And no naps either. I am worknig 8 hour days, and still nothing. The psychiatrist from Mayo Clinic prescribed Neurontin, but I can't afford it right now, so I don't know what to do. He said that I could go back up there and get samples, so I am, but that is next week. Right now I am going crazy. I don't know if this is a hypomanic phase, or if I am depressed, all I know is I am not sleeping! It totally stinks. Any suggestions? I can't get with a local psychiatrist until October 18th, which is a whole month away! Not sure about what to do.

Have you tried all the usual calming and relaxing things.

No caffiene after 6
Baths
No tele in bedroom
Calming music
Reading for half an hour or so before bed
No exercise before sleeping.

Also try having a set time to go to bed and get up. Like going to bed at half past 10 every night, regardless and getting up at 7.

I am giving you my totally uninformed opinion...but you'll notice, that isn't stopping me!! I think effexor is a really terrible medication and from everything I've read, it is not good for anyone who has BP. It does have a tendency to make people manic. Without any mood stabilizer in place, I would really personally think you can blame everything going on in your life that you don't like on Effexor. I'm partially kidding, but I really do not like Effexor.

I remember when you first posted. I was really curious why the docs had given you these two meds. They are very strange choices and I really can't imagine why, from all the meds in existence, these two would be selected for you!

Effexor is often a last resort for seriously depressed patients who are not helped by other antidepressants. It is very difficult to get off of when you don't want to take it any longer and/or don't need it.

On the other hand, 37.5 mgs is a really small dosage...usually what you start on when titrating up to higher dosages, so I wouldn't think you'd be noticing so many changes just from this amount.

I'm not helping you much, but I would definitely ask your doctor why effexor and not another, more suitable medication. Something like Lamictal works well for those on the depressive side, is a mood stabilizer and is weight-neutral in most people.

Neurontin is an interesting choice, too. It is an anti-epilepsy drug that is used for a variety of things like migraine, neurology, nerve pain, etc. and occasionally, mood disorders.

If I were you I would do alot of reading on the various meds that are used to treat BP and then I would go talk with the pdoc and ask him why these meds.

I believe the Effexor is giving you more energy and making you more on the manic side.

Also, you can get some over-the-counter melatonin. That might help.

To me, it sounds like you have "flipped" to a hypomanic state. The insomnia coupled with having enough energy to get through the day equals a reduced need for sleep. That with feeling better always means hypomania for me.

Antidepressants have insomnia as a side effect. Serotonin, norepinphrine and dopamine are all excitatory neurotransmitters, not inhibitory. So it makes sense that antidepressants could make some people insomniacs, although not everyone responds the same to all medications.

Jennita, which neurotransmitters are inhibitory?

Have you tried all the usual calming and relaxing things.

No caffiene after 6
Baths
No tele in bedroom
Calming music
Reading for half an hour or so before bed
No exercise before sleeping.

Also try having a set time to go to bed and get up. Like going to bed at half past 10 every night, regardless and getting up at 7.

I have tried all of those! I don't have caffeine ever! I have tried a hot bath, I don't have a tv in the room, I can't listen to anything repetitive to sleep, I read all night long, and I don't really exercise ever. I am going absolutely bonkers with this!!! Also, the lady that I am living with has a set bedtime of 9:30, and we get up at 7:30 every morning. I have been doing this for a couple of weeks, and then things started going haywire. Thank you so much for your reply, and your advice!

I am giving you my totally uninformed opinion...but you'll notice, that isn't stopping me!! I think effexor is a really terrible medication and from everything I've read, it is not good for anyone who has BP. It does have a tendency to make people manic. Without any mood stabilizer in place, I would really personally think you can blame everything going on in your life that you don't like on Effexor. I'm partially kidding, but I really do not like Effexor.

I remember when you first posted. I was really curious why the docs had given you these two meds. They are very strange choices and I really can't imagine why, from all the meds in existence, these two would be selected for you!

Effexor is often a last resort for seriously depressed patients who are not helped by other antidepressants. It is very difficult to get off of when you don't want to take it any longer and/or don't need it.

On the other hand, 37.5 mgs is a really small dosage...usually what you start on when titrating up to higher dosages, so I wouldn't think you'd be noticing so many changes just from this amount.

I'm not helping you much, but I would definitely ask your doctor why effexor and not another, more suitable medication. Something like Lamictal works well for those on the depressive side, is a mood stabilizer and is weight-neutral in most people.

Neurontin is an interesting choice, too. It is an anti-epilepsy drug that is used for a variety of things like migraine, neurology, nerve pain, etc. and occasionally, mood disorders.

If I were you I would do alot of reading on the various meds that are used to treat BP and then I would go talk with the pdoc and ask him why these meds.

I believe the Effexor is giving you more energy and making you more on the manic side.

Thanks for your opinion! I appreciate it a lot. I have not taken the Neurontin as of yet. The pdoc actually told me that he will give me samples of Lamictal next week when I go to Mayo Clinic, so I have an appointment set up with him again, which is good. I didn't realize that Effexor was so bad. I was really depressed about a month ago, and was suicidal. I am not depressed anymore! That is good. I actually just stopped the Effexor a couple of days ago, to see if I could sleep without it. Yeah, still not sleeping. I am hoping that I will be able to sleep before I get on the other medication. I hate this not sleeping!!

Thank you guys for your responses! I appreciate them so much. I am so sick of not sleeping, I am almost willing to try anything at this point. It is really hard to want to function the next day, even though I have the energy. I get out of bed, and just want to curl up and go to sleep. What is the melatonin? Is it something that is specifically for sleep? This is not the first time I haven't been able to sleep for long periods of time. It happened last summer for a couple of weeks, but I was really sick with some type of upper respiratory infection. I wasn't on any antidepresseants or anything. I don't really understand.

Jennita, which neurotransmitters are inhibitory?

Well, GABA and glycine are two. I also read some can have duel effects, they act on both excitatory and inhibitory. Serotonin is excitatory but it's metabolism gives us melatonin, that's good for sleep and inhibitory.

Unfortunately, SSri's are made to sustain serotonin as long as possible, thus some sleep problems can occur, although the drugs improve mood. I'm guessing people who sleep well on SSRi's might override that or metabolize them quicker, or even have paradoxial reaction but I'm only guessing by information that I have read concerning psychoactive drugs and some of the neurotransmitters in general. Come to think of it, most is guessing anyway even the drug co's and professional go on scientific theories only, not fact when it comes to neurotransmitters and things like depression, ADD.

And it' unfortunate that the drugs cause changes as the time goes by which could bring on new symptoms or sometimes what they call culmative side effects, or ones that maybe didn't show up for awhile but a few years later here they come.

It's also very interesting that neuros are formed in the first place by synthesis of proteins to amino acids. Seems that complex carbs and b vitamins help process the amino acids into neurotransmitters, all the good ones we need like serotonin and such! The SSRi's merely prevent the availabe serotonin from it's NATURAL metabolism (doesn't sound like that should be done IMHO), these drugs do not create serotonin itself as many have believed they do!

I've also read that many chemicals/drugs can thwart that action by way of nutritional deficiencies.

Even exercise effects our neurotransmitters(aka the endorphins). So personally, I think lifestyle REALLY helps although isn't the only factor in things like depression and other problems.

I have not only been having trouble sleeping, but now that I am off of the Efexor, have been extremely dizzy. Last night at work I was extremely hyper, couldn't stop giggling and all, and then today I woke up and I am so dizzy. I feel like I am going to fall over right now and I am sitting. Not a fun reaction to medication. The psychiatrist has now prescribed a sleep medication, but that is $10, and I only have $5. It sucks pretty bad that I can afford nothing that I need. He also said I really need to see a doctor as soon as possible about the dizziness, but I can't do that either. He told me to take 1 dose of Effexor a day until I get there next week. That should stop the dizziness if it is a side effect of stopping the medication. I don't know what is going on. I hate my body right now!!!!!!

Now i realise why im not sleeping well. Could itbe my antidepressant Prozac?

Hi,

When I was put on Prozac, I had terrible insomnia. It's a well-known side effect for some people.
How long have you been on it? Usually, this gets better in a month or so.

bannana, you could try some benedryl, that's cheap. You know what sucks? Insomnia is not only a side effect of some meds but also a withdrawal symptom. How's that for damd' if you do and damd' if you don't?

How's that for damd' if you do and damd' if you don't?

Pretty much sums up bipolar disorder in a nutshell, I'd say.

I have been taking trazadone for the past 6 years to sleep. I love it because I don't wake up groggy and it is so inexpensive.

Good Luck! :)

Trazadone, in my humble experience, works great if you aren't manic or hypomanic. If you are, trazadone (and benadryl) ain't gonna touch it!

Seaturtle,

Ive been on Prozac 20mg a day for almost 9 weeks now, and to be honest im having worse side effects now than in the beginning with it.

worst is i cant get a straight good nights sleep and am exhausted most of the time, also i get loss of sex drive :( and intermittantly dry mouth, not all day long but all of a sudden my mouth will dry up , its horrible. At night its worse and wakes me up. Horrible !!

I really thought it was taking the edge of my shortness of breath episodes but i have just had 2 bad days, and ive been going whole days without having an attack at all, so im feeling a little down at the moment. :(

I have tried Benadryl. That just keeps me wired. I did get a few hours of sleep last night, finally, which is amazing. I am so tired of not sleeping! But I am still exhausted. Seeing the psychiatrist at Mayo on Tuesday, so hopefully the samples of the Lamictal work on stabilizing my moods, and getting me on the right track.
Thanks for all of your advice! I really appreciate it. It helps to know that I am not alone, although I must admit that I hate that you guys have been suffering as well with this.

I'm right there with you, banana! It's been well over a month since I've had a full night's sleep. Good luck to you on Tuesday and to me on Wednesday with our doctors' appointments.

Wishing you luck as well! I won't be back on until Thursday or Friday, as I have to wait until I get home from Jacksonville to give a report on what the doctor said. I'll be on tomorrow, though. I like having a computer right here. That is the one thing I miss where I live now. I am at my parents house right now. Hope you are feeling ok.

I meant to respond sooner when I read about you being dizzy, but got interrupted and then forgot. Effexor is just about the most difficult of the SSRIs to get off of. Even when you taper back down VERY slowly it can still result in nasty side effects like the dizziness you were experiencing. It can also cause terrible headaches, pounding heart, high heartrate, feelings of disorientation, etc. I forgot to take mine two days in a row and couldn't figure out what was wrong with me -- but I thought I was having a heart attack or something really major. I was traveling; ended up going to a pharmacy and begging them to give (or sell) me one or two pills -- enough to get me back home where my prescription was awaiting me.

We miss you on the board when you aren't near a computer. Please let us know how your appointment at the Mayo Clinic goes.

Take good care,

:wave: Tsohl

Thanks for replying! Let's just say, I wish they would have told me that I needed to taper off of them, not just quit cold turkey. That was one of the most miserable days of my life, for real. Icky.
I love having a computer right here! It is one of the major things I miss while I am not living at home. Hopefully I will be able to get to the school more often when I go back, however, I am trying to get a second job, but that one I am going to go full time, and still keep Chick-fil-A, that way I can make more money. I don't know how I am going to handle that many hours, but I really need the money. I can't afford my medications, much less the doctor visits. I already owe Mayo over $2,000! Oh well, at least they are doing a really good job of figuring out what is wrong. I'm really glad that they figured out that I was bipolar, before I had to go through years of doctors just thinking I had depression. Why they just gave me an antidepressant I will never know, but at least they are fixing that on Tuesday.
I wonder if the psyhchiatrist is going to keep me on the Effexor as well as the Lamictal. I know that I have been having an issue with being suicidal again, but I think I was just really anxious about this week, and it was making me stressed out, and the fact that I haven't been sleeping. I am just going to tell him what is going on and hope that he makes the best choice.

Those years they thought you had depression may have actually been correct. Hate to mention this, but antidepressants can cause mania as a side effect and side effects can be culmative, meaning they might not show up intil after a few years. I personally know of a person who was told she was bi-polar after some time on antidepressants (she didn't have the mania before their antidepressant use) and she simply discontinued her antidepressant(oh, not so simply but she did anyway). Seems the mania eventually stopped for good. Her depression even got a bit better as it could have been situational anyway.

This might be why you were given only antidepressants all those years; could be the mania/bipolar was not present then. The effects of the antidepressant culmative side effects may have resulted in your hypomania.

Jennita, do you have bipolar disorder?

I did have some "symptoms" once a long time ago due to some so called innocent medications, mainly given for a non-mental issue, but I am not the one I refer to that I know who had the mania although I had a simular not exact experience as her. I am not bi-polar but have had some experiences and know some unipolar/bipolar people and have had a nephew diagnoised ADHD.

I do know alot about meds and neurotransmitters I have studied, although not a professional, I do know mania is a side effect of antidepressants extremely underplayed by doctors, as though only a latent undiscovered bi-polar was to blame for the drug-induced mania. Latent bipolar seems a stretch considering the usually very strong symptoms of a bi-polar, how could one miss those, especially professional doctors, unless it wasn't really there in the beginning.

Quite frankly, if an antidepressant actually did "unmask" bipolar as per the popular theory, common sense would say stop taking an antidepressant to "mask "it up again. If something gave you diabetes and stopping it would take away the diabetes, wouldn't stopping be sensible?

But this is only IMHO I do not usually tell people what to take or do, only to be aware of potential complications of medications, one of which is actually causing certain disorders and diseases, not just mental but also physical such as the diabetes complications of many drugs not limited to Zyprexa, prednisone and beta blockers, for example.

It's better IMHO to know which waters are shark infested, only then can one really choose whether to jump or not to jump, or at least know why they got bitten.

I am not bi-polar but have had some experiences ....

Yeah, that's what I figured.

Editting to add: I don't mean that to be insulting. I just mean it's different if you've lived it rather than read or heard about it. So, it's helpful to know your background.

I don't mean this to be insulting either, but knowing the issues of medications is not the same issue as living bi-polar. They are separate issues. The facts are that many cases of unipolar end up bi-polar because of medication side effects; antidepressants are not unique to such mental side effects as we have read some medications even for illness can cause mental effects in some, not all people, for example, Accutane does not cause psychosis in every single person but it is a factual side effect of that med and has caused that effect.

Luckily, it's a dermatology med so the dermatologist is not going to turn around and prescribe an antipsychotic, but rather discontinue the Accutane and try something else for the acne. This is not usually what happens in the realm of psychiatry, however.

Consider this, if a person has enough serotonin but is given an SSRi anyway(based on theory of depression+how would one know a deficiency since there are no biological tests) then what happens, well, the drug will still do what it does, and that person could end up with too much serotonin stimulation and thus adverse effects which might include mania, irritability, nervousness, racing thoughts, etc.

This MIGHT be what happened to the poster I was addressing concerning her question of how didn't they know she was bi-polar all those years ago. She most likely wasn't. I know I'm not living bi-polar so I cannot know exactly what it is like, however, from what I've read, it's not too hard to recognize the symptoms as they are quite bad, yes? At least that's what most bi-polars I've heard from say, it's a pretty bad problem, wouldn't you agree?

Medication side effects, especially ones that cause other mental issues than the original for which the medication was prescribed, are largely ignored by psychiatry because they'd rather treat the side effects by incurring a new diagnosis of a new mental disorder than admit their medication might have caused a problem rather than helped.

Have you heard of down regulation and up regulation of brain receptors? It's the brain's version of Newton's law "for every action there is an opposite and equal reaction".

Take benzodiazepines, these are ones I know about the best because I used to be on them. They effect GABA receptors, which are inhibitory, helps with sleep, nervous system, muscle spasms and calm. When the brain receptors are consistently stimulated by drugs, the brain eventually shut down or desensitize those receptors, and up regulation occurs in opposing receptors to aid in the brain's attempt to regain control against the drugs' oppression.

This occurs over time, sometimes slowly, and results in less GABA receptors and more of the excitatory ones like serotonin , norepinphrine, etc. in the brain. This is how "tolerance" aka drug poop out develops and then symptoms of withdrawal can occur in between doses(tolerance withdrawals) or sometimes during the actual dosage timeframe because the brain at this point needs more dosage for the same previous effects. This is the proverbial electrical storm, if you will....too much stimulation of the excitatory, almost no inhibitory action and no where to go.

Too much stimualtion without enough inhibition, because:
1) the brain became dependant on the drug to do the job of inhibition, so it stopped producing it's own inhibitory neurotransmitters.
2) It has been fighting the chemical's intrusion by developing an opposing army(upregulation) of excitatory receptors.

This is why, depending on the amount of damage, that benzo users have such a terrible and sometimes protracted withdrawal, big dependancy and tolerance issues(which can lead to overdose or abuses). I know this firsthand.

Only patience and determination got me out of that situation, it was so long-lasting at times I wasn't sure if I'd make it. Insomnia, the issue of this thread, is the trademark worst symptom of benzo withdrawals, that's what caught my eye to even come to this forum at all because, as you state correctly, I do not live with bi-polar, so I do not frequent this forum.

Let me also say that I'm very sorry that there is such a thing as bi-polar that causes such suffering; just the sleep issues alone must be torture because yes that is one part of it I can relate and do know about. I hope they find a way to prevent and cure it someday for your sakes. You do have my sympathy.

But I do know a bit about sleep and how medication impacts it. If I didn't study it, by now surely I would be bi-polar or who knows what, because I can truly say benzos were leading me down that road of mental illness thru sleep deprivation.

Thank God I can sleep now after so many years.... yes years :( it took, of recovering my natural sleep back to a decent level again.

As you can tell, I think psychiatry as a whole has become corrupt. Yes, it's all some people have as far as hope, and there are a section of people who really are mentally ill for whatever reason or cause, but psychiatry, with the big pharma push, are creating and manufacturing alot of what's going on today IMHO and making big money doing so, only specialists and surgeons lead psychiatrists in the top 10 money making positions in the USA according to Forbes; psychiatrists are at #8. The DSM manual of theirs is ever thickening and they are putting even normal people under a magnifying glass and picking at everything.

But then again, with all the drugs, alcohol, medications, toxic environment, processed foods, high stress lifestyle, tainted everything, immorality, pain, hurt, betrayal, fear, etc. we are all exposed to, I guess almost everyone at one point or another ends up thinking they need a psychiatrist and well, there you have it.

I was actually put on antidepressants for like 3 weeks before being told that I was bipolar. By that time I was completely off of them and had been for 3 weeks due to side effects. I don't really think that they caused the bipolar, but I can't know for sure.

I just got back from Mayo Clinic. The psychiatrist said that I was doing much better. So did the GIM doctor. I am on Lamictal, Effexor, and Seroquel. The Seroquel is only as needed for sleep, because the Lamictal is supposed to take 5-6 weeks to start working.
The doctors also think they have figured out the root of my other problems. I am deficient in Vit D, B12, B2, Iron, and Calcium. The doctor said my iron is the lowest he has ever seen. I also have a slightly herniated disk.

It's quite possible the AD caused mania; side effects can be culmative OR they show themselves right away.

A woman married to a colleague of my husbands became bi-polar from diet pills; I don't know which one(I imagine prescribed since those are pretty strong) but she said when she started taking them she acted different than usual, having too much energy for days on end, couldn't sleep, and then she'd crash and feel depressed and sleep for days. The cycle continued. She finally stopped the pills but by then she was on meds for bi-polar.

I didn't know her then and I guess she figured she was ill permanently but who knows maybe she would have been ok after awhile since it was originally drug induced.

I wonder why you have so many deficiencies? Many can effect both physical and mental, especially B12 which has been linked to depression symptoms. The B-vitamins are important and even chronic fatigue syndrome has been linked to a deficiency in those. It will be very important to find out what is causing this, because that in itself could even be the root cause of your mental symptoms.

The calcium is so important if you are having spinal disc problems. I know you said you hardly exercise, but you should get in the habit of weight-bearing exercise for your bones as it has been clinically proven to increase bone density.

But first get the doctor's advice on that since you have the disc problem. When you get the green light, start out slow and build up....soon what seems hard now will be easy later if you are consistant with it. I strongly advise exercise for not only physical but mental benefits as well via endorphins and other factors. I personally notice a huge difference in my own moods and energy if I slack off. It's so apparent that now I'll even workout through colds if I can, it's that important!

Anyway, hopefully your sleep issues also will resolve. It's so important to have good sleep. Good luck.

Thank you so much for your reply. I didn't realize that Bipolar could be medication induced. I have tried even walking, and it hurts my back so much after a few minutes that I just turn around and come home. I used to love walking, but it hurts. And lifting my legs while lying down is horrible. Doing those two MRIs, and when they had me lift my legs to put the cushion under my legs, I couldn't help but cry. When they pulled the cushion out, I had to have them pick up my legs for me, because it just hurt so bad. I don't know how much exercise I can do. I am starting physical therapy next Monday. Hopefully that will help a lot. I hate being in pain.
Do you have any siggestions as to how I can exercise without being in so much pain? I don't have the money for any more painkillers right now. It will be at least 2 more weeks, because I have a bunch of new meds that I have to buy.
I really hope that my sleep pattern will return to normal soon. It is miserable not sleeping. I have had a couple of good nights sleep, but right now I can't sleep hardly at all. Uggh. And I am getting moody again. I hate constantly changing moods. And it isn't fair for my friends and family to have to deal with either. But at least I am not suicidal anymore. I have been really suicidal lately, because I am so tired of the pain. But, now I am seeing a light at the end of th etunnel, and thinking that life might just be worth living. Hopefully that trend will last. I hate wanting to die.
Well, I am going to go and try and take a morning nap. So tired. Thanks again for your reply!

Yes I know back problems are very painful... my mother went through some of that sort of thing(disc fractures). :(

But the physical therapy does help and the pain will definately get better as you recover. It does take awhile, and you really shouldn't do anything other than the what they tell you to do in physical therapy intil your back heals up. Then you can find out more what other exercises you can get into.

The pain will get better with time, but while it is here, have you tried any OTC pain relievers? My mom used those mostly for her pain and they did help her without the side effects she got when they gave her the prescription ones. At least the OTC are a bit cheaper too.

Fish oil helps with inflammation and also mild depression, is good for the nervous system too so maybe that might be something good to try.

I have tried Tylenol, Ibuprofen, Naproxen Sodium, Aspirin, and none help it for very long, unless they are prescription strength. I hate feeling so much pain all of the stinking time. I will definitely be waiting for physical therapy to start any kind of exercise. I want to get better. I am also hoping that as my vitamins get better, the pain will lessen as well. I wish I could find something to help the pain.