Managing Bipolar Disorder: Medication Effects and Strategies for Relief

Q: Managing Bipolar Disorder: Medication Effects and Strategies for Relief

Hello KK： After taking your medication at noon, you may feel sleepy, possibly due to an increase in blood sugar levels after lunch and a decrease in cerebral blood flow. <br>You are not alone; many people have experienced similar situations. <br>Additionally, the close timing bet

Medication issues

Hello, Doctor.
I was diagnosed with bipolar disorder about a month ago.
The medications I have taken include Liyou, Amberning, Anlif, Xinluying, Andingwen, Lianduomian, and Youleding.
I started taking Andingwen tablets two days ago, along with Xinluying three times a day.
After lunch, I often feel very sleepy and seem to be in a state of half-sleep, even experiencing a hangover-like feeling.
However, I do not have these symptoms in the morning.
Could this be due to the short interval between breakfast and lunch? I usually eat breakfast around 10 AM and lunch around 1 PM, but I have experienced the same situation even when I skip breakfast and go straight to lunch.
Additionally, I would like to ask about the medication.
The doctor mentioned that it is meant to alleviate my anxiety and restlessness, which causes me to walk around a lot.
Currently, I feel a slight reduction in anxiety, but it seems more like I lack the energy to move, while I still feel quite restless inside.
Do you have any suggestions for alleviating this? (The medications I am currently taking are Anlif, Xinluying, Andingwen, and Youleding.)

kk, 20~29 year old female. Ask Date: 2024/07/30

Dr. Lin Mianzhang reply Psychiatry

Hello KK: After taking your medication at noon, you may feel sleepy, possibly due to an increase in blood sugar levels after lunch and a decrease in cerebral blood flow.
You are not alone; many people have experienced similar situations.
Additionally, the close timing between your morning and noon medications may lead to a higher accumulation of drug concentration, which could also contribute to your drowsiness.
To improve this situation, you might try not to eat too much at lunch, especially reducing your intake of starchy foods.
Regarding your medication, you could consider skipping the midday dose of the sedative.
If you still feel restless, you may want to consult your physician to evaluate whether it is appropriate to increase the dosage of your heart rhythm medication or decrease the dosage of your antidepressant.
Wishing you a speedy recovery!

Reply Date: 2024/07/30

More Info

Managing bipolar disorder can be a complex process, especially when it comes to medication management and understanding the effects of various drugs. It’s important to recognize that each individual may respond differently to medications, and side effects can vary widely. Based on your description, it seems you are currently taking several medications, including Lithium (離憂), Amisulpride (安伯寧), Quetiapine (安立復), Propranolol (心律錠), Benzodiazepines (安定文), Melatonin (戀多眠), and Duloxetine (悠樂丁).

Medication Effects
1. Sedation and Drowsiness: The feeling of being in a "half-dream" state and experiencing a "hangover" effect after lunch could be attributed to the sedative effects of the medications you are taking, particularly the benzodiazepines (安定文) and possibly the quetiapine (安立復). These medications are known for their calming effects, which can lead to drowsiness, especially if taken close to meal times.
2. Timing of Doses: The timing of your medication in relation to meals can indeed influence how you feel. If you are taking medications that cause sedation shortly after eating, the combination of food and medication may enhance the sedative effects. It might be beneficial to discuss with your doctor the possibility of adjusting the timing of your doses to see if it alleviates some of the drowsiness.

3. Anxiety and Restlessness: You mentioned feeling less restless but still anxious. This is a common experience in bipolar disorder, especially during mood stabilization. Medications like quetiapine and duloxetine can help, but they may take time to reach their full effect. It’s also important to consider non-pharmacological strategies to manage anxiety.

Strategies for Relief
1. Therapeutic Approaches: Engaging in psychotherapy, such as cognitive-behavioral therapy (CBT), can be very effective in managing anxiety and mood symptoms. Therapy can provide you with tools to cope with feelings of restlessness and anxiety without solely relying on medication.

2. Lifestyle Modifications: Regular physical activity, a balanced diet, and good sleep hygiene can significantly improve mood stability and reduce anxiety. Incorporating mindfulness practices such as meditation or yoga may also help in managing anxiety levels.

3. Monitoring and Communication: It’s crucial to maintain open communication with your healthcare provider about your symptoms and any side effects you are experiencing. Regular follow-ups can help your doctor adjust your medication regimen as needed.
4. Gradual Adjustments: If your doctor decides to adjust your medications, it may be done gradually to minimize withdrawal symptoms or exacerbation of your condition.
5. Support Systems: Building a support network of friends, family, or support groups can provide emotional support and practical advice from others who understand what you’re going through.

Conclusion
Managing bipolar disorder is a journey that often requires patience and collaboration with your healthcare team. It’s essential to address both the pharmacological and non-pharmacological aspects of treatment. If you continue to experience significant side effects or if your anxiety remains high, please consult your doctor for a comprehensive review of your treatment plan. Adjustments may be necessary to find the right balance that allows you to feel more stable and less sedated throughout the day. Remember, you are not alone in this process, and there are many resources available to support you.

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