Tag Archives: medication

The Tegretol Verdict

Next up on my (short) list of medications left to try was tegretol (carbamazepine). I started taking it about two months ago, starting at 50 mg and moving up gradually to 250 mg last week.

I want to take a minute to make my normal note that I have treatment-resistant bipolar disorder, and I don’t react the way most people do to medications. I wouldn’t consider this the average response to tegretol, if you tried it things would probably quite different for you. This is simply an account of how I reacted to it, and why (spoiler alert) it isn’t for me.

At a very low dosage, my side effects were minimal. Diziness and nausea in the evening after taking Tegretol with food, but nothing more. You can believe there was much rejoicing at that fact!

Moving up to around 200 mg was a bigger issue. I began having headaches lasting  75-100% of the day. My nausea would creep in between meals, and was especially bad in the afternoon. Despite loading up on things like tums (and slices of pizza) the nausea would go away for about ten minutes and then return with a vengeance (I had better luck with about a 30 minute relief after each slice of pizza, though the pizza does have the added side effect of weight gain). The dizziness in the evenings (after taking the medication) became overwhelming, to the point where I could barely stand within three hours after taking the tegretol. The dizziness was on par with a night of binge drinking as a 21 year old (without the fun), so much swirling and whirling upon closing one’s eyes that vomiting was almost inevitable.

All of this I took with a grain of salt, despite the nausea and headaches becoming quite intense this week.

What finally made me pull the plug on tegretol was a painful swelling in my neck that started around 100 mg. It started on one side, and was so painful I had trouble sleeping (I actually thought, at first, I might be having some kind of trouble with the firmness of my pillow!). After showing my psychiatrist I went to my general doctor who made sure I had no reason for my lymph-nodes to be swelling. He wanted to wait and see if the swelling would go away before trying to take me off any medication.

Well, that was a week ago, and yesterday I woke up with the swelling on both sides of my neck instead of on just one side. My neck is covered in painful swollen lumps, not unlike the Cardassians on Star Trek. Apart from not looking particularly attractive, it definitely doesn’t feel good.

So, uh… no more tegretol for me. I’m tapering off it as fast as I possibly can.

I find this to be a bit of a sad story, because (though I don’t have any proof) I was beginning to think it might be helping my moods. There were several situations where I expected to feel overwhelmed or depressed, but the feelings didn’t seem to show up or last as long as they might normally. Mind you, this is really speculation (and I’ve been so anxious lately I can’t expect my observations to be spot on) but I wasn’t willing to let the other lymph nodes on my body start to swell up painfully while I waited to find out if I was right.

Disaster Preparedness

Do you have enough medication to get by in the event of an earthquake or other natural disaster?

Not a day goes by living in Seattle that I’m not reminded on the street or on local tv channels that a natural disaster is imminent! Since a potentially city-flattening earthquake is just around the corner, locals are urged to create an emergency kit to keep handy with canned food, blankets, water, and more. The thing that always grabs my attention is including at least a month’s supply of your prescription medications. 

Can you imagine? An emergency takes place, and you lose access to your medications? For many this is as good an excuse as ever not to even begin taking them, but for anyone who has concluded that medications are helping their situation, would you want that help suddenly taken away?

That said, having a month’s worth of medications in your emergency kit is probably a great idea if you can get them. Unfortunately, that is where the tricky part comes in, because most insurance companies will not allow filling extra quantities, and most pharmacies (even if you are paying cash) wont let you fill a prescription twice in one sitting.

So where is this extra month’s worth of my prescription coming from, and can I even afford it?

Some doctors are more willing than others to write up prescriptions in such a way  that you can get what you need. My doctor has been quite lax about this (which I’m not sure if I feel good about or slightly troubled), and has provided me with two prescriptions before, one to fill immediately (for my “emergency” amount) and then a second prescription (usually the dosage is tweaked a little, or the new prescription is written for 90 days, or has different directions) that I can go back to the pharmacy a few days later, have filled, and then stay on for the next couple months.

Another method is to fill your prescription at the moment it becomes fillable (at most pharmacies it is about a week before your final dosage) and after doing this a few months you can get an entire month ahead of what you need. As long as you keep filling your prescription on the early schedule (three weeks after getting it filled each time you fill it), you should always have an extra month’s supply. I used this method while on insurance so that when my insurance stopped, I still had a month (or more) medication to take that I only paid a co-pay for.

Having extra medication for emergencies can go beyond the “natural disaster” sorts of emergencies as well. It can be easy for even the best of us to fall into an episode and forget to refill our prescription, only to find that the pharmacy is closed for the weekend or holiday! Having even one or two days of extra medication to use in an emergency situation can mean the difference between continued stability or an episode, or even withdrawals (which are not fun at all, trust me).

Keeping extra medication is something that I know is a good idea, but at the same time there are some drawbacks.

Remembering to swap out the emergency bottle for a freshly filled bottle every once in a while is a big one, otherwise you can run the risk of having your emergency stash expire! If this is an issue for you, I’d recommend setting an alarm on your phone/device (or writing on your calendar) to make a reminder for yourself in a couple months to swap it out. Try making the alarm as soon as you put the emergency medication away, so you don’t have to think about it again until it comes up.

Also, I don’t know if anyone else feels this way, but I get concerned about having hoards of pills lying around my apartment. As someone who periodically experiences intense moments of suicidally, I like to believe I have pretty good willpower but I also don’t want to make suicide easy for myself, you know? I don’t keep guns sitting around, and I try not to keep oodles of pharmaceuticals lying around either. It is important for me to know where this emergency medication is, but at the same time there are moments where I really don’t want to know. 

My solution? First, keeping them out of sight helps keep them out of mind for me. If they’re in an emergency bag in the closet, I am likely to forget they are there (until my reminder alarm goes off) and it wont be an issue. If I am doubly paranoid about it, it is ok to give the medication to someone I trust (a close friend, my boyfriend) and let them hold onto it.

Finally, I discussed this a little in In Case of Emergency, but keeping a laminated card or a sheet that lists all of your current medical information (medical history, hospitalizations, medications, etc.) with your emergency medication is a really great idea. Stress (like, say, a destructive natural disaster) can trigger episodes, so having this information close at hand if you are injured (and need to avoid specific medication interactions) or having an episode that requires medical attention can be a huge benefit to the medical team attempting to treat you.

Taking the time in a moment of stability (or something like it) to prepare for emergencies has made a huge difference in my peace of mind, on top of that I know that this preparation can make a huge physical difference if an emergency does ever come up.