keepingupwithlife

Having bipolar disorder can be very hard to manage sometimes. Even if you’re on medication that keeps you fairly stable, if you don’t know what to watch out for, you can accidentally trigger a manic or hypomanic episode. There are many possible triggers; such as prescription medications, herbs and supplements,  over-the-counter (OTC) medications, essential oils, lack of sleep or an irregular sleep schedule, stress, and illegal drugs can all trigger mania or hypomania.

For example: You get a severe case of bronchitis and have to go to the doctor for treatment. The doctor is unfamiliar with bipolar disorder, and prescribes an antibiotic, a decongestant, and cortisone for you. Not knowing the dangers, you fill the prescriptions and start taking them, triggering a manic episode. (Both cortisone and decongestants can cause mania.)

Prescription medications and illegal drugs are a HUGE risk for those with bipolar disorder. Medical doctors are unlikely to know which prescription medications are unsafe for patients with bipolar disorder, since this is outside their area of expertise. A bipolar patient should never fill a prescription before researching the possible interactions and side effects, because once the prescription has been picked up, you’re stuck with it. It’s illegal for a pharmacy to accept a return on a prescription, and if you fill the prescription before making sure it’s safe for you to take, you’ve spent money on something you can’t use.

My method is to have the doctor spell out the medication name for me if it’s not printed out (if you’ve ever tried to read a doctor’s handwriting, I’m sure you understand why,) then come home and research it before taking the script to the pharmacy. My favorite website for medication research is RxList, but I also use Google to do a search on the medication for additional resources that may be helpful. If I don’t see any dangerous interactions with meds and supplements/herbs I’m already taking, it’s not listed as a stimulant, and there are no indications that it could cause mania, I have it filled. If there are dangerous interactions, or other contraindications, I call the prescribing doctor and request a different medication be prescribed (asking for a list of possibilities to research,) and call my psychiatrist for advice on which would be the safest option.

Prescriptions aren’t the only danger, however. OTC medications, herbs, and supplements can be just as dangerous. Your psychiatrist will be familiar with OTC meds that you shouldn’t take, and can most likely provide you with a list, but if not, the information is easily found online with a little bit of searching. Herbs are mostly safe in the amounts used in cooking, but if you eat large amounts of foods with stimulant herbs, it could cause an issue, so being aware of which ones can be a problem is important. The situation is similar with supplements, since vitamins and minerals are necessary for good health, and quite safe in the amounts recommended; however, megadoses can be dangerous.

Herbs that can trigger mania: St. Johns Wort, nutmeg, licorice, ginger, purslane, rosemary, ginko biloba, and ginseng

Essential oils that could cause mania:  allspice, ambrette, lemon balm, Canadian balsam, French basil, bergamot, cassie, grapefruit, helichrysum, jasmine, true lavender, orange blossom, rose, clary sage, sandalwood, hemlock spruce, vetiver, and ylang ylang

Supplements that can cause mania:  5-HTP, SAMe, DHEA, and selenium

All of these (except SAMe and St. John’s Wort, which should NEVER be taken by someone with bipolar disorder,) are relatively safe when used in small to moderate amounts, but some individuals have higher sensitivity to certain substances. I watch carefully when using any of these, and if I (or my family) notice any indications of extreme mood change I discontinue use immediately.