Friday, November 18, 2011

Trading your brain for your kidney and other medication conundrums

This is a blog about cutting edge science and bipolar disorder.

And here's the problem with cutting edge science and bipolar disorder: we get the treatments that could kill us or make us feel awful in a different way.

Of all the things I hate about being mentally ill (and there are many), it is the trading off my brain function for liver function, or one kind of brain function for another. Tweak one med and it means more frequent blood tests to make sure that my sanity doesn't kill the rest of me.

If you're like most people with a mental illness, this is the major reason people do not take their medications: side effects. Sometimes it doesn't even  make sense to read the list of likely side effects, never mind the unlikely ones, because not taking psych meds can result in other ugly things happening. So you trade one bad thing for one good thing and hope it all works out in the end.

Lucky for me, I have a combination that works. Very well. But there are times they need an upgrade because the brain is not static. And the pill count gets higher or more complicated and if you have something else wrong with you it eliminates most of the drugs that could help with that problem.

For example, taking lithium means that lots of hypertensive drugs are off the table. If you take olanzapine, you may end up with diabetes (hmmmmm...... sanity or diabetes??). Benzodiazepenes which are used for sleep could make you an addict.

The reason people with mental illness are so bad with their medication compliance is not just that we feel better from taking them (which in any illness this is true) but because the side effects can be so irritating and health threatening. Anyone who takes lithium knows how annoying dry mouth is and the volumes of liquid consumed means that there are many trips to the toilet. And every 3 months you hope the blood tests don't show signs of liver damage or kidney trouble or perhaps one day you wake up and your thyroid no longer works.

Well, there dont seem to be very good answers right now. Perhaps one day science will find a way to target the parts  of our brain causing us trouble and zap.... we're done. Until then, science has brought us some compromises that require us to make tough choices about our lives. So we take them as instructed and keep track of our side effects and if they get too bad, we try something else until if we're lucky we find something that works.

What choice do we have???


  1. That day did JUST come for me--after 7 years of Lithium therapy, I am closely in need of dialysis and just prescribed synthroid--Thank God I found a new doctor who is trying Depakote as a mood stabilizer--it is a never -ending battle, trial and error-that is, medications for mood stabilization. Be informed, be assertive and be questioning. Do not ever give into the RX pad--there ARE other choices. Make your MD listen. It's your health, your life.

  2. I had a cousin who was recently prescribed Cymbalta for ongoing pain issues (not mental health) tell me that she was amazed that I could put up with the side effects of psych meds. I never realized how bad they were until somebody who doesn't need them for mental health reasons pointed it out. Not to mention the cascading effect, as you add one med to treat the side effects of another. I will be happy when they discover that magic pill that fixes bipolar, but I'm not holding my breath.

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