I’m not OK
Posted on October 20th, 2007 | by Billifer | antipsychotic, bipolar disorder, circadian rhythm, Daniel Johnston, depression, hypomania, Invega, mood, psychiatric medication, psychiatry, sleep, sleep disorderSo when I saw my psychiatrist, she doubled my antipsychotic. It seems counterintuitive, but antipsychotics usually send me into hypomania or close to it. The one I’m taking now (“Invega”:invega) really did it–and sustained it–until she decided that I was getting too hypomanic and she halved my dose (from 3mg per day to 3mg every other day). That started the decline into Shitville, and it snowballed from there.
[invega]http://www.invega.com/
I went back to the original dosage, but it didn’t help at all. I just kept going downhill. On Thursday she bumped it up to 6mg per day, in hopes that it will have some effect.
bq. The recommended dose of Invega(tm) (paliperidone) Extended-Release Tablets is 6 mg once daily, administered in the morning. Initial dose titration is not required. Although it has not been systematically established that doses above 6 mg have additional benefit, there was a general trend for greater effects with higher doses. This must be weighed against the dose-related increase in adverse effects. Thus, some patients may benefit from higher doses, up to 12 mg/day, and for some patients, a lower dose of 3 mg/day may be sufficient. Dose increases above 6 mg/day should be made only after clinical reassessment and generally should occur at intervals of more than 5 days. When dose increases are indicated, small increments of 3 mg/day are recommended. The maximum recommended dose is 12 mg/day[1].
By way of show of hands, how many of you know what it’s like to be on half the maximum dosage (and the dose shown with the most benefit) of an antipsychotic when you’re not even psychotic to begin with? None of you? None? Gee, one more reason for me to feel lonely. I’ve said before that I wouldn’t be surprised to learn of a case study about me in the medical literature; given everything I know now, I’d actively support such a study. At least it would mean intensive treatment by someone with the intention of a positive treatment outcome (so they can publish their case study, if for no other reason). Which is not to say, by contrast, that my practitioners aren’t invested in my care now; just that they have no personal investment in my improvement.
fn1. “Invega Prescribing Information”:http://www.drugs.com/pro/invega.html
