How to tell if a med is working?

Posted by fw8904991 @fw8904991, Aug 23 12:39pm

For a little background I have had mental illness for 10 years and I am currently 24yo male diagnosed with Bipolar 1.

I've been on a dozen or so medications and I continue to have the same problem, often I can't tell whether a medication is helping or not.

Maybe 25% of the time it obviously works and 25% of the time it obviously doesn't work or causes bad side effects. Unfortunately that leaves 50% of the time when I have a hard time telling.

This is likely because I naturally have minor mood changes, so it is hard to know if there is causation. Also with medications that take weeks or months to work it is really hard to determine whether I am doing better or worse due to the medication or just because of the illness itself.

Has anyone else experienced this? Do you know any tricks of the trade?

Interested in more discussions like this? Go to the Mental Health group.

Hello @fw8904991 and welcome to Mayo Clinic Connect. You have certainly articulated your feelings about medication effectiveness well. Being able to articulate feelings such as these can be a tremendous benefit in dealing with mental health issues. Congratulations on this wonderful skill, it should serve you well!

I'm sure many people who take meds for physical and/or mental health disorders wonder, as you do, if they are really working. Often the prescribing physician can provide you with some information as to the time it will take for a med to build up in your bloodstream and become effective. Generally, meds are just one part of the treatment plan for mental health issues. Talk therapy is also necessary.

Are you also involved in therapy? Have you asked your doctor about the length of time needed for your meds to become effective?

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@hopeful33250

Hello @fw8904991 and welcome to Mayo Clinic Connect. You have certainly articulated your feelings about medication effectiveness well. Being able to articulate feelings such as these can be a tremendous benefit in dealing with mental health issues. Congratulations on this wonderful skill, it should serve you well!

I'm sure many people who take meds for physical and/or mental health disorders wonder, as you do, if they are really working. Often the prescribing physician can provide you with some information as to the time it will take for a med to build up in your bloodstream and become effective. Generally, meds are just one part of the treatment plan for mental health issues. Talk therapy is also necessary.

Are you also involved in therapy? Have you asked your doctor about the length of time needed for your meds to become effective?

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I am also involved in therapy, I have spoken with my doctor about these matters. The issue isn't quantitative its qualitative.

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Hello, I have schizoaffective bipolar type and take a large dose of Lamictal to control the bipolar side. We are just now getting it to a therapeutic level, since my bipolar type was just diagnosed in March. Prior to that, my previous practitioner was treating depressive type, which of course does not require nearly the level of mood stabilizer as I actually need. Lamictal can only be raised by 50 mg every two weeks, so it's been a long transition period for me.

The easiest way to explain my answer to your question is that often, it's when you're wondering if it's actually doing anything that you can tell that it really is. I keep a mood tracker, which I recommend if you don't already (Depakote has a great one online that I adapted into Excel). I can see trends where I am either in the steady mood category, or only one level off from steady. Not very or significantly manic or depressed, and thankfully, it's been about two weeks since I had a mixed state episode, which directly coincides with my last med increase.

These meds are there to give us stability. When we have it, we often don't appreciate it for what it is. We just feel like we can't explain how we are doing – and when dealing with bipolar, that's a GOOD thing! It means we're not living in the extremes like we have been. But that's what we're so used to, we start getting sometimes distressed when we're not in the status quo. I know when I first went to Lamictal 250 mg, I started feeling very flat and I briefly went back to 200 because I was so freaked out by not having racing thoughts all the time. I thought it was too much medication, but my psych nurse confirmed that what happened means the meds are actually working. I had become so used to hypomania that I panicked when normal changed. But hypomania is not normal, right? It had been for me for almost two years though.

I know I will have bumps up and down again, but the Lamictal should minimize those and keep them from hitting such big extremes. Those are those times like you said when you know it's not working. No med is going to be perfect though, our brain chemistry won't ever be perfect. But it's those days when I sometimes ask myself what the meds are actually doing, that I know I am on the right track to getting where I need to be. Steady mood check marks on the mood tracker. Isn't it nice to have quiet in your head more often? That's the meds. 🙂

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@rsnsza

Hello, I have schizoaffective bipolar type and take a large dose of Lamictal to control the bipolar side. We are just now getting it to a therapeutic level, since my bipolar type was just diagnosed in March. Prior to that, my previous practitioner was treating depressive type, which of course does not require nearly the level of mood stabilizer as I actually need. Lamictal can only be raised by 50 mg every two weeks, so it's been a long transition period for me.

The easiest way to explain my answer to your question is that often, it's when you're wondering if it's actually doing anything that you can tell that it really is. I keep a mood tracker, which I recommend if you don't already (Depakote has a great one online that I adapted into Excel). I can see trends where I am either in the steady mood category, or only one level off from steady. Not very or significantly manic or depressed, and thankfully, it's been about two weeks since I had a mixed state episode, which directly coincides with my last med increase.

These meds are there to give us stability. When we have it, we often don't appreciate it for what it is. We just feel like we can't explain how we are doing – and when dealing with bipolar, that's a GOOD thing! It means we're not living in the extremes like we have been. But that's what we're so used to, we start getting sometimes distressed when we're not in the status quo. I know when I first went to Lamictal 250 mg, I started feeling very flat and I briefly went back to 200 because I was so freaked out by not having racing thoughts all the time. I thought it was too much medication, but my psych nurse confirmed that what happened means the meds are actually working. I had become so used to hypomania that I panicked when normal changed. But hypomania is not normal, right? It had been for me for almost two years though.

I know I will have bumps up and down again, but the Lamictal should minimize those and keep them from hitting such big extremes. Those are those times like you said when you know it's not working. No med is going to be perfect though, our brain chemistry won't ever be perfect. But it's those days when I sometimes ask myself what the meds are actually doing, that I know I am on the right track to getting where I need to be. Steady mood check marks on the mood tracker. Isn't it nice to have quiet in your head more often? That's the meds. 🙂

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@rsnsza Welcome to Mayo Clinic Connect! Thank you for sharing this to me and many others here. It sounds like you have a great handle on what works for you, and I applaud your diligence.
Ginger

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