Archive for the ‘Seroquel’ Tag



The other day I finally went to the urologist.  I wanted to find out why at fifty years of age I started wetting the bed three nights a week.  As I walked into my sparse HMO Plan’s Doctor’s Office, I was prepared for news of a cancerous growth in my manhood, a renegade testicle or an untreated progressive tropical sexual disease I picked up eating Cuban Food in San Francisco’s Mission District.  But I got even worse news… There was nothing physically wrong with me.  The emotionless managed care physician even managed to look at my prostate, which apparently gave him the “OK” sign as well.  I wonder if it was a “thumbs up” or it just “winked”at him like a Cheshire cat?


 If my member is not sick, that means my night-time urinary incontinence must be in my head.  Or at least that was my first conclusion.  After all these years in therapy trying to keep my Bipolar mind afloat, now I had sprung a leak down below.  And, the treatment was as vague as the apparent cause.  So the vanilla urologist gave the tasteless advice not to drink fluids three hours before bedtime and see what happens.  He also emphasized no alcohol.  I knew this was implausible. My Bipolar medications make my mouth extremely dry.  I have to keep drinking liquids or suffer from such bad cotton mouth my lips stick together when I speak, causing annoying suction sounds.  Plus, the thought of restricting the flow of alcohol prematurely during an evening on the town is out of the question.  I prefer to drink with wanton abandon.  Why should I once again have to add another limitation to my already restricted existence?


And then it hit me… This was just one more annoying annotation to my treatment schedule I will have to endure due to my Bipolar Disorder.  Just like the cadre of pills I have to take twice a day, now I must regulate my liquid intake.  Another hurdle to clear, inconvenience to negotiate and regiment to be saddled with in order to remain ready for prime time.  I feel like I am in an 1800’s horse-drawn wagon, piled high with pills and their side-effects, barely inching across the baron plains of the old west.  Hi-Ho Effexor, Lamictal and Topamax! Git!


However the thing the Managed Healthcare Professional said that bothered me most is he felt the assortment of Bipolar medications I take are probably the cause of my night-time incontinence.  I’m well aware they cause dry mouth, nausea, severe constipation and weight gain, among other things.   But because my nightly dose of the anti-depressant Seroquel makes me sleep quite deeply, I may not be waking up when I have the urge to urinate.  Consequently, I go in my sleep.  And, the doctor made it clear he did not think I should discontinue any of my medications.  So in essence, he was saying it was best to continue wetting my bed.  That way “at least I have my sanity.”  I call this Managed Medical Incontinence.


One time a friend who I met in a Bipolar Chat Room came to visit me in San Francisco. When I helped her get settled in her hotel room, she pulled out an identical Zip Lock Baggie to mine filled with pill bottles containing her personal mixture of Bipolar elixirs and poultices.  I suddenly felt a strong commonality with her. I realized all Bipolar sufferers carry their own “baggie” full of unique prescriptions and medication induced limitations like mine, everywhere they go in life. I take a handful of assorted pills twice a day. Some people take theirs three times daily. Some have to take meds with food. Mine make me too nauseous to eat right away.  A number of people can drink alcohol with them, but others get violently sick or depressed and can not combine the two.  Each baggie contains a mixed bag of burdens specially formulated for that individual.  But we all bear the same baggie of burden.


Wetting the bed is a pretty heavy burden for a baggie to bear.  You can learn to keep your shaky hands in your pockets, and take your midday dose of medication out of sight from your co-workers.  But if you are ever going to have an intimate relationship, you can’t hide the fact that you are irrigating the bed.  Or, you can wear a diaper to sleep at night and call it an “undergarment,” so it sounds more like Mormon underwear. However I’ve come to the realization that everyone’s baggie seems equally big in their own eyes.  Different people with Bipolar Illness have different medication regiments.  It’s not as simple as just popping a Prozac.  And consequently, we all have our own set of annoying side-effects. Moreover, if they are your annoying side-effects, they are bigger than anyone else’s.  When I first started taking a once daily dose of the anti-depressant Elavil in the mid-1980’s to treat my Bipolar, I didn’t even need a baggie. Conversely,  I thought taking that single pill at night would be a massive intrusion on the rest of my life.  Now I carry a heavy duty Zip Lock Baggie, and yearn for the days of simplicity that came with only needing one pill bottle.  These were the days when my side-effects could be counted on one hand, not amplified to a roar and punctuated by constantly having to change my bed sheets.


Now that the cat is out of the baggie, do I accept my predicament or search for a solution? If you suffer from Bipolar Disorder, you are forever trying to do one thing to compensate for another.   Am I willing to discontinue the Seroquel, become sleepless, depressed and dehydrated, so I can awaken dry just in time for another miserable day of suicidal ideations? Personally I am not ready to accept the Meaningless Managed Medical Memorandum on my nocturnal incontinence. So I will go forth seeking solutions that may or may not materialize.  Will I end up adding to my baggie or shrinking it?  I don’t know. But I do know I am not alone. Because Bipolar babies all have baggies.  No matter how big or small, they are enormous to the bearer.  And all of us in the Bipolar Community anticipate with bated breath a cure for their individual intolerable side-effects just around the corner.  Side-effects are the price we pay for being alive and sane.  However they can also drive you insane.


I thought the only way I could write about this was if I were “half in the baggie.”  It’s an embarrassing thing to do sober.  And nobody except the person “sleeping on my bottom bunk” really has to know.  But so rarely can you showcase a Bipolar medication related side-effect that makes the non-afflicted truly realize how gruesome this business can be.  There is no free ride.  Moreover, in most cases Bipolar medication only works to a point.  It does not completely wipe out deep depression, anxiety or mania.  Just enough to get by.  But the side-effects are full strength and show no mercy.



Cocktails and Indian Food: When is Enough Too Much?   2 comments

Friday was a really rough day.  The company for which I work is in the process of merging with another and changing identity.  People are coming and going, new faces are telling me what to do and I’m not sure I’m doing everything right.   We had a department lunch to say goodbye to a very talented woman who decided to resign, and I was planning dinner and drinks with a good friend who was in town from LA.

It turned out to be a really late night.  We went from bar to bar indulging in the new cocktail craze which has consumed the city of San Francisco.  Frankly, I think cocktails are a pretentious trend and for non-drinkers who don’t really like the taste of alcohol.   Finally these people can brag at the office that they got hammered the night before…. on Lemon Drops and Mint Juleps.  BMOC.

And as I am prone to do, I over did it.  Having taken a cab that night, I didn’t have to worry about drinking and driving.  So I took full advantage of it and filled myself to the bipolar brim with those ridiculous libations.  They didn’t taste strong and were served up in these tiny glasses.  Cocktails are sneaky little bastards.  With beer, wine and hard liquor you know what you’re getting.

Anyway, when I got my badly inebriated body home, I peeled off my clothes and flopped into bed, instantly falling asleep…. Without having the only cocktail I can’t live without… My cocktail of bipolar medications.  Usually I can not sleep without at least my 600mg of Seroquel.  Seroquel is also used off label as an antidepressant.  If I don’t take it I’ll start having nightmares and getting the shakes, wake up around 3am and realize I didn’t take my pills.  But the alcohol simply put me out.

I woke up around 12 noon.  I didn’t feel right and it wasn’t from drinking.  I panicked when I realized I didn’t take my medication the night before nor my morning dose.  I almost fell on my face jumping out of bed racing into the bathroom to take my morning dose.  “Now I should be fine,” I thought.  “Missing one evening can’t hurt me.”  Boy was I wrong.  All my bones ached and I felt like I constantly had to throw up.  My hands were shaking and I had hot flashes like I was going through menopause.  I wasn’t depressed, but I had no interest in doing anything except laying on the couch and being miserable.  My brain was bobbling around in my head like it was made of Jello.

I have withdrawn from medication before.  I knew the symptoms and these were those.  And the only way to get back “on the clock” was suffer until bedtime and then take my nighttime medications, of course including the usual 600mg of Seroquel, and hopefully feel right in the morning.  It actually took me until Monday afternoon to fully feel back to myself,  because I ate Indian take out food the night before and came down with a case of the “New Delhi Darts.”  I call them the “Darts” because about an hour after you eat the Indian food, you’re darting to the bathroom for the rest of the night.

I think it was a good thing this happened to me, except for the Indian food.  I don’t know what I was thinking when I ate that schmutz.  But sometimes we take it for granted that our medication is doing it’s job.  We even get complacent enough that we think we don’t even need our medications.  Then you have a situation like mine where you do not take you medication, even for 24 hours, and you start the withdraw process.  Like me, you get a rude reminder of just how dependent you are on those colorful little pills.

The other thing I got out of this is how foolish I was to consume that much alcohol while on these powerful psychotropics.  I knew I was getting drunk and kept going.  I was aware of the consequences of consuming large amounts of alcohol with the amount of medication I take.  But I was too comfortable in this area as well.  I’ve always been able to drink a few glasses of wine or beer with no problem whatsoever.  So I decided I was like everybody else and jumped in the deep end.

Even more frightening is if I had remembered to take my pills that night.  With the amount of alcohol I consumed, ingesting 600mg of Seroquel among other things could have killed me.  And there is no lesson to be learned when you accidentally overdose and die.  Who do you tell you learned your lesson to when they are lowering your coffin into the ground, as relatives are fighting over your 5.0 Mustang and CD collection?

It’s one thing when we feel bad and are looking for the right balance of bipolar medications.  We tend to become very vigilant and do everything right when we find the correct drug(s) and dosage amount(s).  But when we feel well and are getting complacent, we tend to take our positive mental status as a given and start letting our guard down.  And that is when we start getting in trouble.  “Sure I can drink a few more beers.  I only had nine-teen shots of tequila.”

I am not telling anyone whether or not or how much to drink, smoke or eat Indian food.  Just like with bipolar medications, everyone has a different tolerance when mixing.  Use my lack in judgement as a lesson learned;  It’s an excellent idea to always keep your head when dealing with alcohol so you can read the signs of excess and avoid losing your head.  The last thing I want on my epitaph is that I met my fate at the hands of a Roy Rogers.

Computer Dating with OCD: Desperately Seeking Seroquel   2 comments

The minute I officially ruined my marriage and drove my wife to ask for a divorce, I stood on the precipice of an imaginary barrier in my mind that kept me from seeing other women through 15 years of commitment, held my arms up over my head and exclaimed, “Divorce Court of California, tare that wall down!”   I was now free to roam the greener grass on the other side.  It was time to start dating and making up for lost time with the opposite sex.

As a bipolar II, I have always had issues with Obsessive Compulsive Disorder.  And this was going to follow me into my new life as a single man.  Suddenly I felt it imperative to make up for lost time while married.  In a matter of hours after moving into my new apartment, I joined two different dating sites and was frantically filling out profiles, uploading photos of myself I took with my i-Phone in the bathroom mirror and sending out “winks” and messages to as many women as possible in an attempt to fill up my calendar.

I was relentless.  Communicating with possible matches at work, in stalls at public restrooms, at home into the wee hours of the morning and any other time I could sneak a look at my laptop.  If I did not have plans for every night of the week, I was frantic.  I looked for women whose profiles I didn’t even like that much to see if I could fill empty slots.  And if I couldn’t, I go out to bars that evening hoping to pick someone up.  Redoing my profile, updating my pictures and trying to get to new site members before anyone else became my full time obsession.  At 43 I was sure I only had a few good years left of virility and a flat stomach, so I had to make up for lost time.

Throughout this period I lowered my standards, risked disease and basically put my life in danger in a couple of situations.  My online dating was completely out of control.  But I couldn’t stop.  I felt if I didn’t keep dating that “someone special” would slip by without me ever knowing it.  I could not let that happen.  Even if it killed me.

Obsessive Compulsive Disorder does not just show up in the form of counting footsteps, always having to sit facing west,  checking that the stove is off 50 times before you leave the house or ritualistic hand-washing.  OCD is actually the minds way of trying to take control of a life that may feel is out of control.  For instance, a bipolar with compulsive hand-washing might feel that they can not control their bipolar issues, but by washing the skin off their hands they can at least control not getting a disease.

OCD dating is like compulsively wearing the skin off your fingertips by constantly working the keyboard on dating sites.  Like I did, people get a number in their head for how many responses they should be getting a week, how many turn into dates and how many progress beyond that.  When they don’t hit their number they feel unattractive and unwanted.  This can make them work the dating sites at an even more feverish rate.  Eventually it becomes full blown OCD.

As any bipolar suffered knows with the OCD cherry on top, you can’t just “stop it.”  That’s like telling someone who is clinically depressed to “just snap out of it.”  But here are a few tips for slowing down the online dating frenzy;

First, limit the amount of time you will spend a day working the sites.  Then fill the time with something constructive, like working out or starting a project you haven’t had time for until now.  This way you are not just slowing down, but you are doing something to build yourself up.

Second, get involved with some extracurricular activities or volunteer work.  Not only does it add another positive dimension to your life making you a more interesting person, but you will meet people instead of staring at embellished profiles on a computer screen.  You can interact with them one on one and actually form friendships.

Third, raise your standards online.  Only  message women or men that really interest you, not just for something to do.  This means the time you do spend on line is quality.  And the people you date are more likely to turn into healthy relationships.

Finally, try and get out of the mindset that everyone you meet is going to be “the one.”  Enter all communications with the attitude that you are making a new friend and if it goes any further, wonderful.  But if not, you were not expecting a torrid love affair.  You’ll be a lot more relaxed when going out and probably exude more confidence.

Of course some cases of OCD have to be quelled by drugs.  I take a drug called Clomipramine which takes the edge off of my OCD making it a little more bearable.   But I still have to constantly fight the urge to turn every day things into ODC rituals.  I still can’t walk away from my car without beeping the remote alarm to hear it chirp at least five times while the parking lights flash.

I’ve also often thought of going on a dating site and posting my profile with the caption: “Bipolar Man with OCD: Desperately Seeking Seroquel.”  My guess is I’d meet the girl of my dreams.