For many of us who have had bipolar disorder for several years, we may need to undergo a medication change for various reasons. When you are taking medications over the long term, they may stop working as well as they did initially. Or a new drug might come out with less side effects and a promise of higher quality of life.
I am currently undergoing the last steps of a major medication change. This scared me at first because a previous med change years ago triggered mania followed by depression to such a degree that I had to take 6 months off work. So when my psychiatrist suggested we switch meds again, I was very unsure of how this would affect me. But the promise of better control of my anxiety (which had not been controlled at all on the previous medication) seemed to be worth the risk of the disturbance in my mood that could happen with changing meds again. The new medication also has better control of insulin resistance, which had been exacerbating my other medical problems. I have Polycystic Ovarian Syndrome which can cause infertility, all related to insulin levels. Getting pregnant for my daughter took 6 years of trying various fertility treatments and my husband and I wanted another child. I discussed the medication changes with my husband, who has been my best friend and partner in fighting my illness which kicked in right after we married. We decided that changing meds was best for my health and our family as a whole.
Like with any big change in the life of a person with bipolar disorder, planning in advance can really make a difference. For myself, with every big life change I have experienced, such as having my first child, planning ahead and making a commitment to stick to my plan got me through the change without a major relapse of my bipolar symptoms. So I knew that if I planned ahead and committed to doing what I have learned works for me in times of stress and change, that I could handle what was coming.
My psychiatrist knew that previously when changing meds, doing it quickly did not work for me. So we set out a plan to adjust the medication over the course of 4 months by changing from the old one to the new one in small increments. In fact, I am still going through the last few changes and hope to soon be on only the new medication. I would suggest taking this approach if you and your doctor are considering a medication change. Slow and steady seems to be the best way for myself to manage these changes. Although we are all different, I feel that major changes in our lives that happen quickly can trigger relapse for many of us.
The biggest problem I encountered is that this new medication does not have the same sedative effects as the old medication. So I have had to work hard to maintain my sleep schedule. Going to bed at roughly the same time every night has helped, although life gets in the way and sometimes you stay up later than you know you should. Keeping a consistent routine at bedtime can help. Doing the same bedtime ritual each night helps your body and brain shut down for the night. I try to do my best to stick to my tried and tested routine.
Almost four months later, I have already seen major results in making this change. The change came at a risk, to be sure, but in the long term I have seen that this was the right choice. I went from having severe social anxiety to almost none, and I have already noticed better control of my insulin levels. I lost weight, and recently became pregnant with our second baby. I am still working out what to do about losing the sedative effects of the previous medication, but overall this change impacted me in such a positive way that I know it was worth it.
If you are considering making a major medication change, make sure that you plan it out thoroughly with your doctor, and involve that person in your life that you rely on. Take it slow and remember that if you start to relapse, your doctor can help but only if you are honest with your doctor about your symptoms and how you really feel. Remember that what has worked for you in the past to control your symptoms such as a good sleep routine, proper nutrition, and using the supports you have in your community will help you get through this change. Sometimes we cannot control major changes in our lives but this kind of change, if well thought out and taken on slowly, can be a positive one.