Crazy People! What antipsychotics work for you with training?

Triathlon Forum
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So…after I got my medical alert bracelet in case I had a Ziprasidone-induced heart arrythmia, it turns out I may be having an allergic reaction to it, that or muscle rigidity of the throat/mouth (I’m having one of the ‘unlikely but serious side effects’ that you have to contact your doctor about), so I will likely be shopping for a new antipsychotic.

My current meds are Ziprasidone, Seroquel (staying on low dose of 200mg as going down any further triggered me up some), and Lyrica (for use as an anti-anxiety med, though I do have compressed nerves at the moment and it’s doing double duty as a result).

For the crazy people, what medications have worked for you with training, and what haven’t? Feel free to PM me as well! Thanks!

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bumping for the evening crowd…

hoping for an AP/AAP with minimal metabolic side effects, that don’t cause things if you become dehydrated and in general work well with endurance training. also minimal sedation. obviously side effects are indivudual to some extent but are still interested - i asked on a crazy person forum but can’t say the answers there are helpful thus far.

ideally a med with low muscle rigidity too.

willing to accept diabetes risk and some organ stuff as don’t think can be avoided in these meds.

thanks!

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All I have to say is that I noticed a couple of things a few months back, neither of which have to do with your issue directly.

First, serotonin reuptake inhibitors were shown to decrease performance in one ex phys journal article I was looking at.

Second was that a study looking into wellbutrin showed it improved performance but only in people who were new to using it. I think wellbutrin was on the watch list with WADA for a year.

And also, good luck with finding something that works for you.

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Thanks Kevin!

I hadn’t thought of that…I’m pretty sure antipsychotics would NOT be considered performance enhancing, but I’ll check into it. Luckily I’m not in danger of placing in races :slight_smile:

I can’t take SSRIs actually - I’m bipolar, so they don’t go well with me. Right now I’m on 2 atypical antipsychotics (ziprasidone and seroquel) and one neuropathic (lyrica).

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Teags,

I don’t know much about the different meds and their side effects. I know that they can have different types of effects and/or different intensities of effects for individuals. You probably knew that though.

My best to you on this. I have some family members who are bi-polar and know how challenging it can be for the affected person and his/her loved ones. Balancing the meds and reducing side effects is so important.

Good luck.

Bernie

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Thanks Bernie!

It is hard to balance everything, and I’d really like something that’s okay for training. I got lithium toxicity following a trail race, though it also made me hypothyroid and didn’t actually work that well, but it was a bad training med, and Ziprasidone is a bit scary b/c it can cause long QT syndrome, which dehydration raises the risk factor of as well. So with doing long training work for my ultra next year, that’s a bit unnerving. I was starting to work on my hydration and electrolytes (and a very nice ST member has helped!) coming back from the neuroma, but now I don’t even know if I’ll be staying on Ziprasidone, b/c I’ve been having what I think is muscle rigidity of my throat/mouth - it was just occasional and I didn’t think much about it, but last night I had an attack that lasted over half an hour. Trying to swallow and not being able feels very suffocating even when you can breathe fine. I couldn’t even swallow my own saliva for most of it (except when I drank water, which oddly I could swallow, I did not have a dry throat either). I see my psychopharmacologist Monday (they moved up my appointment) and in the meantime if something bad happens I’m supposed to go to emerg. Typical to happen the weekend before I do a backcountry trip with one 45k day! Plus I have limited time to train for my first tri! It’s just, you find something you think works and you want to stick with it, but the side effects - yikes.

You sound supportive, so your family members are lucky to have you!

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No advice… but as a fellow crazy person (different brand of crazy, though), I just want to say THANK YOU for your positive attitude, and your openness in talking about stuff. A lot of folks have no problem talking about cancer, or kidney stones, or a broken leg…but mental illness talk makes people run for the hills. So kudos to you :slight_smile:

Have you checked out the Crazymeds site? They have not only some very informative (but human) stuff on pretty much every drug going. And the forums can really be helpful. Someone over there might be able to help you.

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I am assuming you have a good psychopharm to work with…

lamictal seems to have less metabolic effects than some of the others. Zyprexa has the weight gain thing (ergo diabetes risk) but you will know within in a couple of weeks if that is going to happen to you.

neurontin would seem a good choice as it might also get you off the lyrica (I always like prescribing twofers…)

good luck!

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Never forget the advise of a very wise Rick James

Cocaine is a hell of a drug!

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So…after I got my medical alert bracelet in case I had a Ziprasidone-induced heart arrythmia, it turns out I may be having an allergic reaction to it, that or muscle rigidity of the throat/mouth (I’m having one of the ‘unlikely but serious side effects’ that you have to contact your doctor about), so I will likely be shopping for a new antipsychotic.

My current meds are Ziprasidone, Seroquel (staying on low dose of 200mg as going down any further triggered me up some), and Lyrica (for use as an anti-anxiety med, though I do have compressed nerves at the moment and it’s doing double duty as a result).

For the crazy people, what medications have worked for you with training, and what haven’t? Feel free to PM me as well! Thanks!

I have OCD (anxiety disorder - a lot of people don’t know that!) and mild depression and take Lexapro for it (SSRI) and have always wondered how it affects my performance. I reduced my dose of it recently and I actually noticed an increase in performance - I have an easier time getting my HR up during workouts and I can go harder during races. Oddly enough, I also feel calmer during swims - I was worried I would be more succeptible to panic attacks while swimming as a result, but for some reason the lower dose made me feel more relaxed, which was a big surprise.

Anxiety medications in general lower one’s sense of urgency, which can be a good thing. But I found that now on the lower dose, my sense of urgency about “gotta catch that mofo ahead of me, gotta have a good race, gotta make my splits” is a little more intense and makes me push myself a little harder.

11

No advice… but as a fellow crazy person (different brand of crazy, though), I just want to say THANK YOU for your positive attitude, and your openness in talking about stuff. A lot of folks have no problem talking about cancer, or kidney stones, or a broken leg…but mental illness talk makes people run for the hills. So kudos to you :slight_smile:

Have you checked out the Crazymeds site? They have not only some very informative (but human) stuff on pretty much every drug going. And the forums can really be helpful. Someone over there might be able to help you.

x2 - people are still way too ashamed about discussing this sort of stuff. It’s changing drastically though - I am 25 and have no trouble at all discussing it with people my age and have never encountered any negative attitudes or “judgmentalness” over the fact that I take OCD meds. I also live in Manhattan though, and here you are more or less considered a complete freak if you don’t have a shrink.

I think a lot of older people still have a hard time accepting it though (my dad is one of them - he has always been supportive but he just doesn’t understand why anyone other than a crazed axe murderer would want or need to see a shrink). But by the time I am middle-aged I think psychiatric disorders will be seen as no different from anything else.

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Thanks mmrocker13! (I actually might be schizoaffective, not bipolar, but who knows. It’s a thin line w/my brand of bipolar anyways.) I used to be really private about this but I’ve come to terms w/being diagnosed now and am a lot more comfortable with it myself, which makes it easy to be open about it in general. bachorb, I think it depends - most people I tell are fine with it, but I have had friends (close friends, I thought) who stopped talking to me when I was diagnosed.

I have checked out crazymeds - great! And I am actually on Crazyboards, which I find helpful.

Tritoy, my psychopharmacologist is excellent - heads up the unit, prof at University of Toronto, publishes regularly - and I just like him to deal with.

Lamtictal isn’t an antipsychotic but I have been on it - it was my first bipolar med. I got a rash at my first titer up and even though there’s no way it was the fatal rash I was taken off it and it’s off the list of possibles.

I thought of Zyprexa but I’m trying to lose weight, and I’ve heard that it has a weight gain rate of up to 90%, plus it causes increased deposits in the adipocyte (did I spell that right?) tissues. So I’ve sort of crossed it off the list. I find antipsychotics work well for my brain though both for my mood symptoms and my psychotic features (I’m not sure if I cross into psychosis or not, I know the difference but find there is a grey area in real life).

I like the sound of Clozapine but 5 black box warnings (agranulocytosis sounds scary) plus weekly blood testing put me off a bit.

Neurontin is Gapapentin, right? And Lyrica is Pregabalin. Isn’t Lyrica a more recent iteration of Neurontin? I know they both work on anxiety, I chose Lyrica over Neurontin b/c initially I was prescribed it to try to act as mood stabilizer (off-label) with Seroquel (@ 500mg, I used to take 800mg of Seroquel but it was too sedating). Everything I’d read said recent studies showed Neurontin wasn’t actually good as a mood stabilizer. Lyrica didn’t totally work for it either so it’s been left on for me as an anti-anxiety medication as sometimes with my mood swings I get feelings of dread.

The biggest problem with Lyrica for me is I developed a neuroma in my foot while on it and the doctors all agree that as it’s a neuropathic it masked the pain (I’m on 100mg 3X/day) and I ran on it longer than I would have otherwise.

What would be the positives of switching from Lyrica to Neurontin?

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…Ziprasidone is a bit scary b/c it can cause long QT syndrome, which dehydration raises the risk factor of as well. So with doing long training work for my ultra next year, that’s a bit unnerving.
I suffer from mild depression, but currently not on any meds (have been on Prozac and Lexapro in the past). I’m actually really interested in your comment regarding meds that can cause LQT. I passed out at the end of a race a few years ago and the doc said I had a long TQ interval. After months worth of tests they ruled it out and just said I was dehydrated. I wonder if it could have happened because of my depression. I guess I am confused because LQT Syndrome is a genetic disease, but do the symptoms of it (LGT interval) occur from some meds and dehydration?

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My understanding is that dehydration cannot cause long QT syndrome by itself but if you have long QT syndrome dehydration can screw up the QT interval and make you symptomatic.

There are 2 types of long QT syndrome: congenital (genetic) and acquired: http://en.wikipedia.org/...red_Long_QT_Syndrome

Maybe it was the meds you were on at the time, or maybe you are one of those people who has mild long QT syndrome and is, for the most part, entirely symptom free.

Edit: Or, as per the Wiki, you could be one of the people who gets long QT syndrome but has a normal QT interval - maybe dehydration alone is enough to cause it.

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Edit: Or, as per the Wiki, you could be one of the people who gets long QT syndrome but has a normal QT interval - maybe dehydration alone is enough to cause it.
Thanks for responding! After being in the hospital for a week(undergoing various tests, wearing a heart rate monitor for months, and getting genetics testing) the docs ruled out congenital LQTS. They think my LQT interval was temporarily caused by severe dehydration and very low potassium but don’t know for sure.

As for your OP - I have competed on Lexapro and Zoloft and seemed OK (this was when I was only swimming competitively). Good luck!