Bipolar medication?

Okay say I know this person who i s taking Topamax for their Bipolar disorder. They seem to be doing better after a month and a half, but are getting more aggressive at times. they don't have typical bipolar symptoms, manic/depressive episodes, more manic/normal/ manic/MANIC episodes. They don't have insurance, are seeing a mental health professional, but not of much help with the medications.
Does anyone out there know much about these meds, something that could be added to the Topamax for a better outcome maybe?
Also this person is very bright student, to be a nurse practioner.
Studies are difficult and medication "trials" make mind too cloudy for school.
Can anyone offer advice?

Answers:
Topomax was originally created for other purposes, but has been found to be useful for bipolar disorder. I took it and hated it. I had an extreme reaction within the first couple days and became much more aggressive. What a lot of people either don't know or don't want to acknowledge, is that aggression/hostility/irritabil. are all signs of mania.

I can sympathize with you about taking a few pills and then switching to something else. The prescribing doctor (and I certainly hope it's a psychiatrist who is more knowledgable about psycotropic drugs) could prescribe just a small number at one time. Unfortunately, the higher the quantity the cheaper the overall prescription is. Why isn't the mental health professional offering your friend samples to try until the right mix is found? They get bombarded by drug salespeople all the time who leave samples with them.

I hate to say this, but from experience I know that sometimes it takes awhile to find the right combination. I just realized that you didn't say your friend is taking Lithium. Usually that's the first drug of choice and often another drug such as an anti-depressant doesn't need to be added. Lithium is relatively inexpensive. You do have to keep a close eye for changes while you're taking it because there's a fine line between therapeutic range and toxicity. The patient could be started off with as little as 150-300 mg. a day. Routine blood work would be necessary and I have no idea how much that would cost. There may be a free or low-cost clinic in your area that could do the testing.

Your friend will feel cloudy-headed until the right combination is put into place. I hope your friend doesn't give up on the studies. Perhaps a discreet explanation to the professors about the problem and that medications are being tried would give your friend a break. If they're teaching others to be nurse practitioners, they should be sympathetic and show some compassion.

If you don't think that mental health professional is helping, find someone else. There are some doctors who will accept a patient on a sliding fee scale. Is there any organization in your area that could help with medical expenses? Your friend would have to apply and it may take time, but it would be better than all of the out-of-pocket expenses. Check your phone book. Most of the ones I've seen in different towns have "blue pages" (my area) that have government listings. You might find something there. Or, ask the pharmacist for advice.

Best of luck.

We know it's you. Get a regular job and sleep normally. Then you won't need all that medication. Lithium is for batteries, not people.
The kind of specifics you are asking for would kind of be like practicing medicine without a license. Your friend really needs to be under the care of a psychiatrist. These drugs are mind altering, they don't necessarily react the way you want them to.
Your friend definitely needs to be seeing a psychiatrist. They specialize in mental disorders, therefore they can prescribe the correct medication. Sometimes, a person has to try a lot of different medications and combination of medications to find the ones that work the best for them. If your friend has been diagnosed with bipolar disorder, they should be prescribed an anti-depressant and a mood stabilizer.
Topomax is a medication that is used to control epileptic seizures, but is also used as a mood stabilizer and to prevent migraines. Though, I have been on Topomax and hated it. It does not have the same effect as other mood stabilizers.
Aggression is a symptom of mania, so your friend may need to try something different.
If the mental health professional that he/she is seeing is not helping with medication, then your friend should probably see someone else.
I've worked in mental health in the past and I've seen patients get worse on psychotropic meds. It really depends on the person. I've even seen a slightly depressed school teacher take an antidepressant for 3 months only to become seriously mental ill and ruin her life. She ended up in a psych ward diagnosed with paranoid schizophrenia.
I'm sure that is not common but drug companies are in a business and most of the drugs for mental illness act differently in each patient.
Nursing school is SO stressful and that amount of stress overtime can cause mental imbalance, but nursing school is temp. and she will be a lot better once done. If i were her I would avoid psychotropic meds as much as possible, and just try different stress relief activities that work for her, along with a balanced diet & exercise.
Also, Bipolar is really being over diagnosed.in reality we probably all could be diagnosed with a mental illness, unless she is a real threat to herself or others trash the drugs, seek psychotherapy and relaxation.
Now, this is my experience, just *my* experience.

Topomax made me more manic. Horribly so. I've found relief w/ Carbamazepine (Tegretol), which has been around longer than Topomax. Added to the Tegretol is Lexapro, an anti-depressant, & Lamictal, another mood-stabilizer.

There are waaaay too many options out there now for your friend to still have so many problems. Check out www.crazymeds.org , too.

Y'all *please* get some more medical advice/assistance. Life's too short to let Bipolar ruin it. Trust me, I know. From the hard way.

Best of luck.
Depakote helps with the rage and aggressive behaviors. It comes in a generic which will make it more affordable. Try to find out which pharmaceutical company makes topamax and see if they can help with the medication costs.
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