Why I Stayed On Meds, Or The Mysteries Of Monotherapy

It was a gut hunch. Except that it's never that simple. So here's how the more complicated part went. It involves the word monotherapy.

I have been on Lamictal alone since last August, when I walked away from atypicals as an adjunctive med. That blue pill has been in my mix of meds since the spring of 2004. And it's been the best monotherapy for bipolar disorder for me since, well, since I don't know when. And monotherapy is a whole lot better than polypharmacy. I'd rather take 1 pill a day than 4 or 5. My body likes it better and so does my head.

Of course, I am a lot better now--more experienced with this shit really--than I was during my early days with Lithium (1989-90) and Depakote (1997). Both of those worked okay as monotherapies, but then I needed to add other meds in the mix to address depression and scattered psychoses. My body didn't like that and neither did my head.

Going Lamictal-only last summer was a move born of frustration and disgust with the poor performance and wicked side effects of Seroquel and Geodon. I have ranted about Seroquel's effects on my self elsewhere--suffice to say it dumbed me down and there was still sporadic symptom breakthrough (nothing major, we are talking fine points here). When I went off Seroquel last July, I switched to Geodon, searching for a way to bite off that edge that comes with bipolar disorder--for some of us--that you'd rather not have around. Geodon made me crazy. It was like taking speed.

So I dropped the Geodon one day last August. I didn't even consult my doc on that. I'd told him previously that if Geodon didn't work, I'd ditch it faster than a phone call from a publicist. And I did. When I went to see him about 10 days later, he asked what I wanted to do. I always had the option of trying something else, after all. I told him I was doing well enough where I wanted to roll with Lamictal and see what happened.

Excepting a few bumpy patches, things have been very good. Yesterday, I went to a press conference following a police shooting the night before where the cops killed a young man--early indications are that this guy was plum crazy--who'd run along the sidewalk with a .38. He raised the gun at the cops and two cops unloaded on him. After the television crews packed up and left, I stood around and talked with a deputy police chief about the uptick of cops running up against folks with behavioral health issues. Last evening, I went and covered a commission probing the sheriff's department and, later, followed the sheriff out onto the sidewalk and asked her annoying questions.

I ain't broke, so there's nothing to fix. And that's the story of my gut hunch.

I hope everyone else can get this lucky. I hope my luck holds for me.