Bipolar Me

I see a lot of posts in the bipolar/mental health Facebook groups that I belong to asking what medications people take and advice on which ones they should take. “Has Caplyta worked for you?” “What side effects have you had from Lamictal?” “Can I take both Zoloft and Ativan?” “Can I take an antipsychotic with Nyquil?”

Fortunately, I have a quick and easy answer to all these questions—I don’t know.

The main reason I can’t answer those questions is that I’m not a doctor. All the questions should be directed to your prescribing physician (usually your psychiatrist). The other reason is that every person reacts differently to different medications.

Think about it. Every drug comes with a whole, long list of possible side effects, and there’s no telling which ones you might get. It’s impossible to know for certain how the various drugs will interact with one another. I might get a rash, while you might get an upset stomach. Each of us has to decide for ourselves which side effects we can live with and which are intolerable.

I’ve drawn the line at drugs that gave me terrible nightmares, ones that made my hands tremble, and one that affected my memory. (I told my doctor about that one, and he said, “Yes, that drug can have that effect. Stop taking it.”) The point is that memory problems were one possible side effect, but he didn’t know that I would have that effect until I did. If I got a question about what reaction I had to that drug, I’d have to say, it affected me one way, but it may affect you another way. I got what I considered a deal-breaker reaction. You could get that same side effect, of course, but you could also get a more tolerable one or none at all.

When you get into the area of multiple medications, it’s even more difficult to give a sensible answer. Maybe an SSRI combined with an anti-anxiety med will make you sleepy. Or not. A lot of us take more than one med—with all the different ones out there, the combinations are virtually endless. Your doctor may be able to tell you that one combination is likely to increase sleepiness or make you anxious, but some people tolerate them better than others do.

When people ask me what meds I take, I never tell them the specifics. I respond with categories. I take an SSRI, an anticonvulsant, an anti-anxiety, an antipsychotic, and occasionally a sleeping pill. (Plus non-psychiatric medications for high blood pressure, cholesterol, and so on.) I have pills I take in the morning and ones I take at night. I have tolerable side effects.

Does it sound to you like I’m over-medicated? That’s between me and my psychiatrist, and he doesn’t think so. We review my medications regularly, adjusting them as needed, but my basic meds haven’t changed in years. I have a “cocktail” that works for me and no desire to change. Not even for the newest medications I hear about on all those commercials.

So, no, I can’t tell you how a certain drug will work for you or what side effects you’ll have. You can find out about possible side effects online if you want to, but they may only scare you. (My doctor told me not to look up one side effect online. “It’s gross,” he said. So, of course, I did. He was right. It was gross.) Not everyone gets a particular side effect. In fact, the likelihood of getting any specific one is low. I will say that mixing prescribed meds with over-the-counter ones isn’t a good idea. How they will interact can be a problem. But that’s true of any combination of drugs.

And weed? I have no idea how that reacts with any psychiatric medication or any combination of them. I’d avoid it while I was on psych meds. You don’t know the strength of what you’re getting, possible additives, or your own reactions (which can differ from person to person—euphoria, sleepiness, paranoia, relaxation, excitation, etc. I wouldn’t even offer a guess about that.