Tuesday, 15 May 2012

Methadone, Heroin and Mood Swings

I HAVE YET ANOTHER DRUG WORKER ~ my fourth in less than a year , if you include the titration nurse (who never titrated me at all, as I came there from another clinic, already on methadone). Anyway, I'm to come in next week when my methadone, which is currently 30mg a day, should be coming down to 25.

 The detox unit idea hasn't gone out the window, by the way, we just barely had any time to discuss it. My one problem with such units is that they tend to take you off too quickly ~ 5mg every 2 days, instead of 5mg every 2 weeks, as I was doing until up to a few weeks ago, when I messed it up by taking too much heroin. If anything is going to disturb my mood, a too-rapid detox will do. I have never managed to drastically reduce, or come off, or switch to Subutex (which involves going through some withdrawal) without depressive or manic symptoms or both.

 I emailed one of the top rehabs in the country, which I'd only get into if they made an exception and let me in free ~ which I was told unofficially WAS a possibility, if I could prove my motivation. I told them I was diagnosed "bipolar schizoaffective". They warned me by email that the methadone might be acting as a mood stabilizer. If this is true, it would explain why I've always had such trouble coming off. My worst withdrawal symptoms were always psychiatric, not physical.

 If methadone does have a mood-stabilizing effect, it's markedly weaker (on me*) than heroin, which in the early days pressed my constantly undulating mood to a near-flat line. years later it was still acting as a potent antidepressant. The days when I didn't take it, and relied on methadone instead , I was so low I barely did anything at all. Then the Great UK Heroin Drought hit in 2010. I decided I had had enough of the "gear" anyway. And 24 hours after my last hit of heroin (but on easily enough methadone to eliminate physical withdrawals) I was floridly manic!

 I am NOT suggesting anyone use heroin or any other opiate to treat mental problems of any sort. If you need a mood-stabilizer, take lithium, valproate, carbamazepine (Tegretol) or lamotrigine (Lamictal), or use an antipsychotic. Get your pills on prescription from a doctor. All heroin did in the long term was make my problems far wrose , to the point where I was completely held hostage by the drug. For years I fantasized about being able to get by on just methadone and live a normal life, but it wasn't to be. I went weeks on just methadone but had so many episodes of high and low mood in a year, I literally lost count. In bipolar terms that makes me a "rapid cycler".

 The meds the doctors gave me seemed to cut out the highs better than the lows. I have tried 2 antipsychotics in the year and a bit since getting diagnosed. I had to stop both thanks to undue side-effects . Risperidone (Risperdal) seemed to cause anxiety and panic (on and off, not all the time) and might well be responsible for the lump of breast tissue that grew on one side. (I have a scan regarding that tomorrow.) Seroquel (quetiapine) made me so faint, dizzy and exhausted (amongst other things) it was like having Chronic Fatigue Syndrome all over again. Risperidone seemed to do a better job of keeping mood swings and voices at bay . No medication has ever helped me feel more motivated. The tiniest things feel like massive chores. Somehow the illness, the drugs, or both, seem to have knocked the stuffing out of me.

 So I'm now on the look-out for a third medication. Olanzopine (Zyprexa) may be the one. It is very commonly prescribed over here. I've met loads of people on that and no-one ever complained of side-effects. Whatever I take must not be too sedating, must not cause anxiety or insomnia and would ideally not make me pile on the weight . Which is probably all too much to ask. To anyone with knowledge or experience on the subject ~ please, some advice!

*Everybody is different. Anna Grace in Wisconsin, who is diagnosed bipolar, says methadone actually makes her feel better than heroin and helps her depression more. "I find Methadone the perfect fix for my addiction,"  she says. I only wish I could feel the same, but I don't. My plan is to get off methadone as quick as I can, which may well take weeks or months, but I'm determined to do it!


James Claims said...

This is the first time blogger seems to allow me to comment. This is James, just in case it doesn't show. I was also on risperidone and seroquel. And both did nothing for me except for side effects. Seroquel was insanely fatiguing for me. Not just throughout the day, but two hours after taking it, I had trouble walking I was so knocked out. And it didn't prevent the hypnotic psychosis that I can get from time to time (e.g. I believe things like music are talking to me and giving me instructions).

Abilify (aripiprazole) lengthened my mood cycle from around 10 days to 20 odd days. It also made the swings less intense. I had difficulty going on it, the side effects were very strange and kept changing on me. But after 3 weeks, I was feeling more like myself.

I'm currently on Zyprexa (olanzapine) and have had amazing success with it. It's very fast acting and I use it for depression, mania, and psychosis. The only downfall of it is that at higher doses, it removes all my emotions and completely flattens me out. But the lower dose that I'm at keeps me stable. And even though my mood cycle is fast, it's very manageable.

Both of those drugs are uppers in antipsychotic terms, meaning that they can cause agitation. There can be a calming effect for when I'm in a mood swing or psychotic state, but normal day life, it perks me up. Abilify used to be more powerful than a pot of coffee.

Also, abilify is rather new, it's not going generic until 2014. So it is quite expensive. However, zyprexa went generic about 6 months ago, and is much much cheaper ($30 a month for me with my insurance, but that's different for everyone too). I've also been told by my psychiatrist that zyprexa is used in our hospitals in triage and emergency situations because of its strength and rapid response. Those are my thoughts on zyprexa as a drug, I have a love hate relationship with it, but we get along nice enough and I don't have brain fog at the lowest dose.

Hope that helps.

matmc71 said...

Hey Gleds,
I've been following your progress for over a year now. I have been on the same meds, same "street" drugs, been on and off, up and down, in and out, now i think I've found a balance! We will see.
I stopped taking serequel and things got better. You seem like a very intelligent and kind human being. All power to you bro. Keep the faith! Be gentle with yourself. Much love.

Merle said...

Hi Gleds ~~ Love the new blog
Very nice and you seem to be more determined to get off all that stuff, I sure hope you can as it is such a waste of time and a good man.
Take good care my friend, Love, Merle.

Gledwood said...

JAMES: many thanks for that. I don't know whether to give Seroquel one last try or not. Basically all the time on it, I felt like I was coming down with some illness, like the flu. I was exhausted and felt crap. And that was only 200mg! Which wasn't enough to act as a psychic insulator. So I got the worst of both worlds. Not that a lot of the more cuckoo symptoms I get truly bother me anyway. I hate anxiety most of all, then depression, then paranoia. Maybe I say that because I've never had ultra-extreme paranoia!

Anyway thanks again. I'm going to look into olanzopine a bit further...

MATMC71: do you not take any psychiatric drugs at all now, or did you swap Seroquel for something else? I found it kept me moody and I had mood swings but the top was cut off, which was annoying because I don't think they'd have gone that extremely high anyway. As an antipsychotic it was nowhere near as good as risperidone, but risperidone gave me anxiety which I hate so much I just had to stop it. I want OFF the street drugs all together. Heroin is so weak here it's not worth wasting the money on! Good luck :-)

MERLE: yes heroin is a waste of a life. I want to try something else now (like being clean) ;-)
Great to hear from you.

Syd said...

Gleds, I hope that you will do the detox and stay clean. A lot of your mental problems could be coming from the drugs, including heroin. Try getting clean and seeing how it goes then.

Gledwood said...

If it turns out the mental problems were down to methadone I'm suing the clinics I've been to.

The psychiatrist who diagnosed me was an expert in dual diagnosis. The mood swings and weird experiences started years before heroin addiction, unfortunately.

I really wish I could pin everything on drugs. It would make it so much easier to explain. Not to mention more socially acceptable. Nobody likes a schizo, well most people don't. But most will tolerate a reformed junkie!

claire said...


Interesting blog, its right what you say about methadone been a mood stabilizer, I never evrn knew I had a mental health prob until I did a rapid methadone detox, 5ml a day from 30ml in the community ( on my own) It send me into a pyschosis that ruined my life- if u go for detox, just be aware that all your feelings will come back - and hit you like a ton of bricks. I'm supposedly bi- polar type 2, and like you say the mania is the only happiness I get, on meds just flatline and feel blue. I'm on Seroquel... it did make me dizzy @ 1st but after time ur body adjusts n u can handle it. Ive been on olanzapine- it made me pile on weight, was good for a while, but when the pyschosis comes it did sweet f.a to stop it. Everybodys different though - it might work for you. Interestin blog neways - keep it up

Gledwood said...

I know someone who has schizoaffective, depressive subtype, who has been on antipsychotics for years and they seem not to do that much for her.

I can't believe those meds will stop you going hypomanic and yet not stop you being depressed. I'd rather be hypomanic all the time. Like any other sane person would... (including a psychiatrist...)

Anna Young said...

Zyprexa, i've herd many good things about this drug. My doc is thinking of potting me on this medication.

Gledwood said...

The only thing against Zyprexa/olanzopine is that it seems to make lots of people put on weight... then again so do most other of those pills... the biggest turn-off from what I remember about that particular one is that it can cause pre-diabetes which does NOT sound good...

Lucky1 said...

Yeah good point. hypermania = happiness. Weed also helps a lot - doc sed thts y neva new i had b. p - cos it puts on a level when a smoke it evryday. dnt no bt ne1 else bt it wks 4 me

Gledwood said...

Hypomania is the nearest I've ever been to happy. But it's definitely not the same thing. I tend to see happiness as a peaceful, contented state which no (hypo)manic episode has ever been...

James Claims said...

As for gaining weight, I did gain weight on zyprexa. But it was only about 15lbs. Which is very manageable and easy to lose over a summer of biking. The real difficulty came from lithium adding about another 15lbs of water weight because I take so much and it's a salt (so it retains water). As a result, I'm a little chubby, but compared to other people in my weight class, I look about 20lbs less.

I'm also a big fan of abilify and zyprexa because they are not sedating for me at all. Abilify was quite the opposite and at medium doses of zyprexa, all I do is lift weights and move around. And even combined with lithium, I still get my hypomanias only my thoughts are even more organized than before. So not only am I really productive, I can lock into things I want to do and not get distracted. It's the best harmony of both normal and bipolar worlds.

Plus, it stops my psychosis dead within hours at even 2.5mg, which is half the dose of the smallest pill available. I'm a huge fan of those two drugs, and from what I hear, geodon is also good. They don't sedate as much as risperidone/seroquel/haldol and they act fast and can be very potent. It's just a matter of what your brain chemistry is that decides which one works.

Mike Bishop7 said...

First of all thank you for sharing the article Gledwood. I found your blog while researching Methadone Detox online because I have a family member having their own personal battles. Your story is a good one and so many people go through the same struggles as you but a lot of America is ignorant to this. I hope that Olanzopine works for you and that you get better. I am definitely going to subscribe to your blog, thanks again for sharing.

Rodney Knight said...

Still in many places, methadone is a popular choice for treating patients suffering from heroin or morphine addictions. I am aware of the fact that methadone does not make the patient suffer from mood swings and also prevents him from having withdrawal symptoms. Read More

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