Pharmacological drugs for psychiatric disorders are a crap shoot. Any doctor who tells you otherwise is full of shit. Trial and error is apparently the only way we can figure out what works best on an individual level, and that is why in-patient treatment works so well; giving the doctors time to guess and then check.
Although I’ve been told bipolar disorder is often misdiagnosed, they definitely got it right with me. I break the mold when it comes to bipolar 1, or bipolar I as they call it in my book here. I just now put together that Bipolar I and Bipolar II are marked in the same manner as WWI and WWII.
This is a war and we are soldiers. Death can come for us at any time, in any place. -Morpheus from The Matrix Reloaded
So enlisting myself in this mental and spiritual war, I bought the “Nursing 2021 Drug Handbook” back in July 2020. While I do make plenty of poor decisions when it comes to nebulous purchases during MANIC episodes, this $70 book purchase was anything but frivolous. It has in fact become something of a prized possession of mine after helping me and several others during my last in-treatment stay at Emory’s psych hospital.
Anyway, without photocopying each page from the book here is what I could pull on the drugs I’m currently taking and some I have taken in the past.
Here is the format I’ll be using for transcription…
Official Name, sometimes these are printed strangely. (Name I know the drug as)
(Pronunciation)
Therapeutic class: These are all different and need deeper research.
Pharmacologic class: Not going to pretend I understand these either.
Highlighted or emboldened points made by my book.
Some of these points I have highlighted as specific passages in my book, and I’ll share those here too.
I’m skipping over a lot of information in the book here. - indicates dosage
In these bulleted sections, I’m just bolding points that stood out to me.
Some necessary vocab…
Acute medicine: a specialty within internal medicine concerned with the immediate and early specialist management of adult patients with a wide range of medical conditions who present in hospitals as emergencies.
From my understanding “acute” at least in the sense of the book means “you’ve got it right now.”
CNS: Central Nervous System
Monotherapy: Therapy that uses one type of treatment, such as radiation therapy or surgery alone, to treat a certain disease or condition. In drug therapy, monotherapy refers to the use of a single drug to treat a disease or condition.
Adjunctive therapy: Another treatment used together with the primary treatment. Its purpose is to assist the primary treatment. Also called adjunct therapy.
Lithium Carbonate (Lithium)
(LITH-ee-um)
Therapeutic class: Antimanics
Pharmacologic class: Alkali metals
Acute mania in bipolar disorder - indicates dosage
Long-term control in bipolar disorder - indicates dosage
adults and children age 12 and older usual dose, 600mg
Action - Probably alters chemical transmitters in the CNS (Central Nervous System), possibly by interfering with ionic pump mechanisms in brain cells, and may compete with or replace sodium ions.
ADVERSE REACTIONS - CNS: fatigue, lethargy, coma, seizures, tremors, drowsiness, yada yada…
Mike’s notes: Currently taking and I’ve never had a problem with lithium, in fact, on a good day I can’t even tell if I’ve taken my 1500mg or not. Probably, possibly, and may: This is from the experts, top science folks! They don't know how or why this stuff works, nor do I. All I know is that when I feel the “pressure” on my mind, this drug subsides said pressure. When I’m stressing it can feel like my brain itches, lithium scratches my itch. It removes the splinter from my mind.
ARIPiprazole (Abilify)
(air-eh-PIP-rah-zole)
Therapeutic class: Antipsychotics
Pharmacologic class: Quinolinone derivates
Schizophrenia (oral, IM [abilify Maintenal]) - indicates dosage
Schizophrenia (Aristada, Aristada Initio) - indicates dosage
Bipolar mania, including manic and mixed episodes, with or without psychotic features; adjunctive therapy with either lithium or valproate for treatment of manic and mixed episodes associated with bipolar I disorder with or without psychotic features.
Bipolar I disorder maintenance monotherapy - indicates dosage
Adjunctive treatment of major depressive disorder - indicates dosage
Irritability associated with autistic disorder - indicates dosage
Tourette disorder - indicates dosage
Action - Thought to exert partial agonist activity at dopamine 2 and 5HT1a receptors and antagonist activity at 5-HT2a receptors
ADVERSE REACTIONS - numerous
Mike’s notes: Abilify makes me a little drowsy but not compared to Saphris or Seroquel. It’s kinda scary how many different “illnesses” this one drug can treat. With that said I remained stable for three years taking Abilify with my lithium. That action explanation might as well be voodoo magic written in Chinese.
asenapine (Saphris)
(a-SEN-a-peen)
Schizophrenia (acute and maintenance therapy)
Acute manic or mixed episodes associated with bipolar I disorder as monotherapy or as adjunctive therapy with either lithium or valproate.
Maintenance treatment for bipolar I disorder as monotherapy - indicates dosage
Acute manic or mixed episodes associated with bipolar I disorder as monotherapy
Action - Unknown. May block dopamine and 5-HT receptors.
ADVERSE REACTIONS - numerous
Mike’s notes: Currently taking (from doctor’s sample.) Once again, ACTION UNKOWN. So far Saphris has been working on me, but apparently, it’s hard to get in the States… So my doctor and I made a plan to go to Risperdal if my network of pharmacies can’t get Saphris. Mom calls this one “your MANIC silver bullet.”
risperiDONE (Risperdal)
(ris-PEER-i-dohn)
Therapeutic class: Antipsychotics
Pharmacologic class: Benzisoxazole derivatives
Parenteral maintenance therapy for schizophrenia or bipolar I disorder (as monotherapy or as combination therapy with lithium or valproate.)
Give injectable into buttock every 2 weeks, alternating injections between the two buttocks. lol
monotherapy or combination therapy with lithium or valproate for 3-week treatment of acute manic or mixed episodes from bipolar I disorder.
Irritability, including aggression, self-injury, and temper tantrums, associated with an autistic disorder.
Action - Blocks dopamine, 5-HT2a alpha1 and alpha2 adrenergic, and H1 histaminergic receptors in the brain.
ADVERSE REACTIONS - numerous
Mike’s notes: I haven’t taken this one in a few years and looks like I’m getting back to it tonight (04/27/23). I remember in-treatment saying risperiDONE like I’m DONE for the night, as in this drug makes me sleepy quick. From what I understand (and this is just causal speculation) is that Abilify helps more with depressive episodes while Risperdal helps me more with mania.
valproate sodium (Depakote)
(val-Proh-ayt)
Therapeutic class: Anticonvulsants
Pharmacologic class: Carboxylic acid derivatives
Simple and complex absence seizures mixed seizure types (including absence seizures). - indicates dosage
Complex partial seizures - indicates dosage
Mania - indicates dosage
To prevent migraine headache - indicates dosage
Action - Hasn’t been established. Activity in epilepsy is thought to be related to increased brain concentration of GABA.
ADVERSE REACTIONS - numerous
Mike’s notes: Depakote did NOT work on me nor bring me down from my MANIA. I had an in-patient program try it on me for a month with no positive results. I’ve understood for some time that the best long-term maintenance of bipolar I is to pair a “mood stabilizer” with an “antipsychotic.” From this research, it would appear there are two different major camps when it comes to prescribing mood stabilizers. Those patients that match up with Depakote, and those that process Lithium best. I fall into the latter camp. With this information out there, it amazes me that a doctor would continue to try and fail at prescribing me Depakote while in treatment. If that recipe aint working how about trying the other one eh doc?
OLANZapine (Zyprexa)
(oh-LAN-za-peen)
Therapeutic class: Antipsychotics
Pharmacologic class: Thienobenzodiazepines
Schizophrenia - indicates dosage
Short-term treatment of acute manic episodes linked to bipolar I disorder - indicates dosage
Short-term treatment, with lithium or valproate, of acute mixed or manic episodes linked to bipolar I disorder. - indicates dosage
Long-term treatment of bipolar I disorder - indicates dosage
Agitation caused by schizophrenia and bipolar I mania. - indicates dosage
Depressive episodes associated with bipolar I disorder. - indicates dosage
Treatment-resistant depression - indicates dosage
Preventing chemotherapy-associated acute and delayed nausea or vomiting. - indicates dosage
Chemotherapy-associated breakthrough nausea or vomiting. - indicates dosage -
Action: May block dopamine and 5-HT2 receptors.
ADVERSE REACTIONS - CNS: somnolence, insomnia, parkinsonism, dizziness, NMS, suicide attempt, yada yada…
Mike’s notes: Zyprexa is my chill pill. My bottle states “Take 1 pill by mouth every 6 hours as needed (for) agitation. While I don’t take Zyprexa every day, I definitely take it every day I see my parents.
QUEtiapine fumarate (Seroquel)
(kwe-TYE-a-peen)
Therapeutic class: Antipsychotics
Pharmacologic class: Dibenzothiazepine derivatives
Schizophrenia - indicates dosage
Monotherapy and adjunctive therapy with lithium or divalproex for the short-term treatment of acute manic episodes associated with bipolar I disorder; adjunctive maintenance therapy with lithium or divalproex. - indicates dosage
Bipolar I disorder, acute manic episodes. - indicates dosage
Bipolar depression - indicates dosage
Major depressive disorder, adjunctive therapy with antidepressants - indicates dosage )
Action - Blocks dopamine type 2 (D2) and serotonin type 2A (5-HT2A) receptors. Its action may be mediated through this antagonism.
ADVERSE REACTIONS - CNS: dizziness, headache, drowsiness, somnolence, NMS, seizures, yada yada…
Mike’s notes: Before I knew this drug as Seroquel I used to pronounce the generic version QUIET-time. This medicine knocks me out for at least a solid 6-8 hours. The only downside is I wake up with a drowsiness hangover that takes a few hours to kick. Taken over a period of time the drowsiness begins to subside but not the best drug if you have to get out of bed and get ready for work in the morning.
Writing this piece took a lot out of me. Some stuff we just don’t want to know. My hope is that this list is something that can add to and help your Google search for these drugs. As of tonight, I’ll be taking 1500mg of Lithium (5 pills), 4mg of Risperdal (1 pill), and if for some reason I get pissed off I’ll take 5mg of Zyprexa (1 pill).
These are just the drugs I remember taking and I’m sure I’ve missed a few. Let me know what I missed in the comments if you’re feeling brave.
Please drop a like if any of this information was useful.
Goodnight to all and to all a good night!
You officially deserve a vacation after this... Seriously, I hope you do something fun for yourself! That was a lot of work and incredibly brave. I am very familiar with many of these meds and their side effects 😩😴😜😢😎. Lithium for one, has been helping save my life and keep me stable for quite some time. I am very grateful.
Thank you for sharing!