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    Staying on your prescribed medications,for good or ill.

    Asked Nov 7, 2007, 07:53 PM 237 Answers
    How do we,who need to take medications daily,stay compliant,(take them as prescribed) and why do we go off them, knowing the results if we do.

    Last edited by KBC; Nov 7, 2007 at 08:01 PM.
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    KBC's Avatar
    KBC Posts: 2,550, Reputation: 487
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    #2

    Nov 7, 2007, 08:03 PM
    I for one, remember the times when I went off, even for a few weeks, knowing the outcome might not be to my liking,but justified it saying the side effects are too much and I deserve to live better.
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    J_9's Avatar
    J_9 Posts: 40,137, Reputation: 5631
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    #3

    Nov 7, 2007, 08:07 PM


    Ken, this is a good thread, and I may make it a sticky for the medications board.

    Staying compliant is very hard for the individual as well as the health care worker. This pertains to all medications, not just those that deal with mental health aspects.

    You see, the meds, whether it be for high blood pressure, hypo/hyperthyroidism, bipolar, schizophrenia, etc... make people feel better than their pre-medicated state. So, once a patient feels better many think they are "cured" and this is just not so.

    To remain compliant on medications it is up to the health care provider, whether it be the doctor, but usually the nurse, to educate the patient on their particular malady so that they understand that the medications need to be taken EXACTLY as prescribed.

    Many people who have an infection, for instance, take their medications until the symptoms are gone... so they think that they are healthy again, even if they only took the antibiotic for 3 days instead of the prescribed 10 days. This is one reason we have developed superbugs like MRSA. The bacteria becomes dormant rather than killed completely and then they mutate and become resistant to drugs.

    People with schizophrenia, as another instance, begin to feel better symptoms seem to disappear, so they think they are "better" when in fact it is the medication balancing out the neurotransmitters that are not working correctly in the brain. When they quit their meds the psychosis comes back full force, and many times worse than in the beginning. When this happens there is no way to turn back the hands of time, the schizophrenia has gotten worse and will not regress, so different meds are needed.

    Again, it is all about education of the particular illness involved. I, as a health care worker, am responsible for educating patients regarding their illness... what to expect regarding side-effects of medications... how long to take the meds, etc.
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    #4

    Nov 7, 2007, 09:00 PM


    KBC agrees: You mean I get my first 'sticky'?? Thanks J-9
    Yes, you have your own personal sticky and I think it is very well warranted.

    Good thought here Ken, this was much needed. I am all about education and medicine... Well, here we go. I hope the thread grows and grows.
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    N0help4u's Avatar
    N0help4u Posts: 19,825, Reputation: 2035
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    #5

    Nov 7, 2007, 10:09 PM
    As J_9 said
    Again, it is all about education of the particular illness involved. What to expect regarding side-effects of medications... how long to take the meds, etc.


    There are things you can do but it depends on what you are taking what medicines for and
    So forth. Many people try alternative herbs, vitamins and minerals but you have to know what ones work with your meds and what ones work against them and what ones accelerate the effect. So you should ask your doc to work with you if you want to go the alternative route.

    For example, some people can take chromium picolinate for diabetes but they need to keep their levels monitored all the more cause you usually need less insolin.

    When you take statin drugs for cholestrol you should take omega and Q 10.
    If you look that up on the internet you will see that many doctors are saying it is important.

    Also as J_9 said you have to take the whole script for antibiotics, but once you are through with it it is important to take probiotics or eat yogurt to replace healthy bacteria that your body needs.

    I have been doing the alternative supplements and nutrition for preventative measures. Many people my age are already getting put on so many meds they look like a walking pharmacy. I spent the past 10 years teaching myself the alternative stuff and I am healthier than I was in my 20's (30 years ago!)
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    KBC's Avatar
    KBC Posts: 2,550, Reputation: 487
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    #6

    Nov 9, 2007, 10:07 AM
    I am currently on prescribed Depakote and Celexa.

    The medications are only effective for a short time,outside stimulus has been eliminated to a few needful things,stresses are very low.

    For the past month, I have been going through many multi-cycling episodes,manic to the point of sleep losses,often up for 14 hours,sleeping for 2-3 and up for another 14 or so.

    No depression as of yet.

    My mind is cloudy, but I can still function,just not at full capacity when I get too tired.(cabinet making requires some clearheadedness to operate the power tools)

    My appointments with a psychiatrist is every 3 months, due to the lack of Dr's in the remote area I live in.(closest clinic is 50 miles round trip) closest private Dr is 80 miles round trip.

    I am lacking sleep, serenity falls off during these times also. My cravings for food, especially sweet foods, rises by 5 fold, impulsiveness is erratic,sometimes overwhelming, I fall prey to them, going on spending sprees and excessive activities( don't need sleep, can do just about anything, got a lot of time on my hands)

    Working in the shop becomes second in line to far fetched ideas, useless pursuits ending in some shame, because I didn't get anything done (at least what I thought I should do that day)

    Focus can be done through concentration,although it brings headaches on if I do it for too long.

    Does this sound familiar to anyone? It is the first signs of bi-polar relapse. My signal flairs are going off, and I am clearly needing help.

    My post here will hopefully help others as to what to do when this kind of thing happens to you. All answers are appreciated.

    Ken
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    J_9's Avatar
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    #7

    Nov 9, 2007, 10:16 AM


    Ken, this sounds very familiar. It is rapid cycling bipolar, if my memory serves me correctly (I'm not where I can get a hold of my textbook at the moment).

    Let me ask how long you have been on the Depakote and Celexa and what the dosage is. Many people with bipolar disorder learn to adjust the dosage of their medications according to the symptoms. What other meds have you tried?

    Now, the drive that you mention (50 miles round trip and 80 miles round trip) is nothing really, especially when you are in need of some help. I drive 95 miles round trip 3 or 4 days a week. LOL

    How long have you been going through this current manic phase?
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    KBC's Avatar
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    #8

    Nov 9, 2007, 10:26 AM
    Been on these meds for over 6 months.

    DepakoteER 1500 mg daily.

    Celexa 20 mg daily, just got lowered for manic behavior 2 weeks ago)

    I have been on almost every medication on the market today,

    Paxil
    Prozac
    Zoloft
    Trileptal
    Lamictal

    Probably a few I can't remember right now also.

    Depakote
    Lithium

    Again a few I can't remember.

    Zyprexa

    Adivan(sp?) during hospital visits,that one really helps.

    Many for the shakes, all low dosages.

    Length of time in this phase,1 month or so.
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    KBC's Avatar
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    #9

    Nov 9, 2007, 10:32 AM
    And I need to amend that 'drive' thing (clear thought prevailing after the fact)

    It's not the drive so much(that just makes me feel better,to see someone face to face)its the contacting of the doctor for changes.The 'system' is falling short of thorough help,lack of funds play a huge part in this.

    These came on suddenly and are very upsetting( you saw some of my harsh statements on here lately)
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    J_9's Avatar
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    #10

    Nov 9, 2007, 10:33 AM
    1500mg Depakote? Can I ask how much you weigh? The dosage is dependent on your weight. This may be too little or too much, which, either way could be causing this episode.
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    J_9's Avatar
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    #11

    Nov 9, 2007, 10:34 AM
    Are you involved with NAMI?
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    KBC's Avatar
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    #12

    Nov 9, 2007, 10:46 AM
    Had a meeting yesterday with them, yes.
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    J_9's Avatar
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    #13

    Nov 9, 2007, 11:01 AM
    Good, I found one in your area, I was going to give you the #, but if you met with them, then you are on the right track.

    Now, your weight? I would like to calculate your dosage to see if you are in the correct therapeutic range.
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    KBC's Avatar
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    #14

    Nov 9, 2007, 11:04 AM
    Just had my valporic acid level tested 2 weeks ago, I am within the therapeutic range(don't remember the actual numbers, but it was somewhere in the middle of the scale.)
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    #15

    Nov 9, 2007, 11:04 AM
    Any way, I am 6'1" 230 lbs
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    J_9's Avatar
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    #16

    Nov 9, 2007, 11:08 AM
    Thanks. You are indeed on the max dosage. Are you taking it all at once or twice a day? You should be taking 750mg twice a day.

    You say the Celexa was decreased due to mania. Has your mania gotten better or worse since the decrease?
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    KBC's Avatar
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    #17

    Nov 9, 2007, 11:12 AM
    Actually the mania is close to the same, maybe a little less.

    The depakote is once nightly,being ER tabs, it does take time to disburse and testing was 12 hours after last dosage.
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    J_9's Avatar
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    #18

    Nov 9, 2007, 11:17 AM
    Sorry, I forgot it was the ER. Although my text says that Divalproex sodium (depakote, Depakote ER, Epival) should be given by mouth 750 mg in divided doses.

    It may do you good to call your pharmacy and have a consultation with the pharmacist to get his opinion on your particular symptoms and dosage.
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    KBC's Avatar
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    #19

    Nov 9, 2007, 11:19 AM
    Pharmacist,not the psyche?

    Ok, I have never done that.

    Thanks J :)
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    #20

    Nov 9, 2007, 11:21 AM
    The pharmacist is a GREAT resource for drug information. It was the pharmacist who taught my father how to recognize his symptoms, whether being manic or depressed, and how to alter his medication dosage and times of day in which it was to be taken.

    While the psych docs are pretty good with meds, meds are the ONLY things the pharmacists do.
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