Resistance to Drugs

I become resistant to any mood stabilising medication that I take daily

Here’s the typical scenario. I start a new medication, one that says it takes 1-2 weeks to take effect. I start getting a noticeable response to the drugs within hours – sometimes in less than one hour. So that’s good.

But then the drug stops working. This usually happens 3-4 days after I started taking it. Really, the medication stops having much effect, if any. If I respond by taking a higher dose, then I get a boost in its effect, but then that dose also stops having any effect after a few days.

I have done this stepwise increase of the dose with a few of the drugs. Increasing the dose has no long term effect on the effectiveness of the drug, but the side effects get worse and worse.

…but it will work again if I stop taking it for a while

If I stop taking the drug for about three or four days, I lose the resistance and the drug starts working again. But if I start taking it daily again, the whole pattern repeats and I develop the resistance once more.

This has happened to every mood stabilising medication drug that I have tried, including the time I took coffee as if it were an antidepressant medication.


Does this happen to anyone else? Please leave a comment.
Additional Info: I have a consistent pattern of cycling – 7-8 days hypomanic then 7-8 days depressed. The cycles are continuous – there are no periods of normalcy. I’m also supersensitive to mood stabilising drugs – I usually get a strong reaction at less than the stated therapeutic doses.


The three workarounds I can think of – don’t work

One possible solution is to take the mood stabilising drug intermittently – three days on and three days off, or something like that. The problem is that this workaround doesn’t work very well. The cycles of my mood swings continue to run in the background, and if they happen to coincide with a period when the meds aren’t working or when I’m not on meds, then I get depressed.

And once I get depressed, all my plans derail. Usually for a few months.

What about alternating two drugs every few days? I haven’t tried this because the idea of dealing with the side effects of coming off one drug at the same time as dealing with the side effects of starting a new drug kinda gives me pause. Doing this can’t possibly be very safe or pleasant, and I’m suspecting that this is likely to run into the same likelihood of being derailed as the previous idea.

What about not taking the drugs while I am manic (which is well controlled), and taking them just before I start to get depressed? Two problems. The first is timing – if I miscalculate when I am about to get depressed, then I won’t take the drugs in time for them to work against the depression. And my mood cycles are reliable, but not that reliable. The second problem is that the drugs work for 3-4 days, but the depression episodes lasts for 7-8 days. Can you see the problem?

In the last scenario, I should theoretically be able to get a system to work. All I need to do is be more vigilant and responsive to the signs of my changing moods. And I am. But, well..it doesn’t work in the real world. I’ve tried on a few occasions. All I need is a distraction like having to carry the dogs to the vet or my mom inviting me to pass for dinner to derail this system.


Well, there is one exception…that works on mania

The upshot of my resistance to the mood stabilising medications has been that there are no medications that work well for me. Except one.

In a rather happy happenstance, my antimanic drug Tegretol works. But it’s method of action is completely non-standard. I do not take Tegretol daily. Since I have been able to manage my mania quite well, I only take it when I feel that the mania is getting past my ability to handle using non-drug interventions.

So. I only take Tegretol when I am feeling manic. Just like I would take Advil for a headache.

…that doesn’t work if I use it in a standard way

When I take the Tegretol, it stops the mania within 20 minutes and keeps it from reoccurring for about 8-10 hours. Because so much time passes between taking Tegretol and when the effect wears off, the sensation of mania usually drops to a level that can be managed using behaviour modification alone. I usually don’t have to take Tegretol more than once for any manic mood cycle, and usually less frequently even than this.

Interestingly, if I take Tegretol continuously, it stops working, just like all the other drugs and does not stop my mania from happening.

So. I have a drug that I can use effectively against mania because

  1. I’m apparently supersensitive to drugs, so
  2. The drug can make a decisive change in my moods in less than 8-10 hours, and
  3. The decisive change in moods sticks, even after I stop taking the drug,
  4. So I don’t have to take it continuously, and
  5. Because I don’t take it continuously, it works each time I use it.

Wish I had something that worked for depression

I’m pretty sure this runs counter to conventional wisdom about medications for mood swings. But hey, it works. And that’s the important thing.

Unfortunately, I still have no equivalent drug for depression that reliably works.  😦

5 thoughts on “Resistance to Drugs

  1. Pingback: Taking Seroquel: Expect This | LivingManicDepressive

  2. Have you considered a non drug solution? I tried TMS ( transcranial magnetic therapy) for about 4 months. It worked for about 2, then slowly stopped after going on vacation for a week. I never stopped my meds during this time. I am bipolar also. Most of the time depressed. Lithium and lamictal seem to be the only mood stabilizers that work. I have to use Xanax or Ativan to sleep. Lots of vitimans: omega 3, vitiman D3, 5-MTHF, multi vit. I became suicidal again not too long ago and ECT (electroconvulsive therapy)was suggested. Didn’t feel like I had much of choice. So I have had about 8 treatments so far. After about 4, I deceided I would do something really stupid. I took myself all my meds. I was extremely manic for about two weeks and then Hurricane Sandy hit us. Could not get my treatment for almost 2 weeks. Completely crashed to the point my husband had to consider inpatient as I was a threat to myself. Started ECT again about a week and a half since Halloween. been better since then, back on meds too. There is no doubt it, ECT sucks. I can’t think of much else worse. My short term memory is fried. The day of treatment is almost completely shot because you are so tired. Lucky for me I do not have to work and have health insurance.
    Health insurance or I would be fucked.

    • Have not tried TMS – it is not offered in my country and it seems pointless for me to spend the money to try an expensive treatment elsewhere what will fade in time. I haven’t tried ECS either because useful or not, no one is going to run electricity through my brain.

  3. Pingback: Tegretol: Effects and Side Effects | LivingManicDepressive

  4. Do you find that stopping your manic phases dampens your depression? Most of the time since lowering my SSRI dose (and switching from Zoloft to Prozac) I don’t get into as much trouble as I did in years past, but I still wonder if the balancing factor is in there.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s