Bipolar Medications Can Be Dangerous

Here is the sad truth and reality about taking medications for a mental illness. I think any long use on the exact same medication can become problematic because they wreak havoc on your entire body and most importantly your brain.

I have now taken two medications that have nearly killed me for two different reasons. The first medication that nearly killed me last year was called Trileptal, used to treat bipolar. I was on the highest dose of that medication usually prescribed for approximately eight years.

The other medication that most recently almost killed me is Clonazepam (generic name). Well known as Klonopin (brand name). I have taken Klonopin for over 20 years to help control my anxiety, hypomania and mania symptoms.

I most recently learned of the severe, possible lethal complications for using Klonipin as long and as much as I did. I learned of the dangers of Klonipin use after researching Klonopin more extensively due to my overdose. I will write that information in another post, as this post already has a lot of information.

Last year, I developed two syndromes from taking Trileptal (brand name) or Oxcarbazepine (generic name). I developed two syndromes from taking this medication. One syndrome is called Hyponatremia and the other is called Syndrome of Inappropriate Secretion of Antidiuretic Hormone (SIADH). I was unaware of these conditions and that it was possible for me to get them, while taking Trileptal.

Hyponatremia can be life threatening and I got it from taking my bipolar medication, Trileptal, as prescribed for eight years. If you are on this medication for bipolar or other reasons, please be aware of the symptoms and make sure you get your blood levels checked often.

Many other medications should be added to this list, because Trileptal didn’t make the list of medications that cause this condition, as listed in the next article. However, Carbamazepine (generic name) or Tegretol (brand name) is often used to treat bipolar and it made the list. Many other bipolar medications are in the same class of medications, so I thought it was very important for me to help make you aware of this condition.

I had to stop taking Trileptal immediately and was never given another bipolar medication, as that was the last medication used to treat bipolar that I could take. I have taken them all and seem to be medication resistant or intolerant of the side effects. Some medications caused adverse reactions.

In May, of last year, I started taking only Klonipin to treat my symptoms of bipolar. After my overdose I realized that was when my decline began and my symptoms became severe.  I became angrier easier and more often, my isolation increased, I became depressed more often and my suicidal ideations increased requiring me to fight suicidal thoughts nearly every day for the last three months, before my suicide attempt. Actually, I had all the signs that I needed to get help, but will explain why I didn’t get it in another post.

I am talking about my situation to help you and hope no one makes the same mistakes as I did. Please do not do as I do or did.

Please let me be an example of what not to do and prayerfully an example and inspiration that we can overcome any obstacle in front of us.

Sometimes we cannot step over that obstacle in time, but we can catch up and eventually jump over anything in our way.

We can rise above, climb to the highest peak possible and conquer any obstacle that gets in our way of reaching for the stars and becoming a bright shining star of our own. I am on my way…

God and prayer and beautiful people are necessary and essential components to add to the recipe of survival, as well.

Thank you again to all of my wonderful, caring, loving, beautiful, fabulous blogger, Twitter and Facebook friends. You are all simply the BEST!

Oops. Sorry. I do digress at times. Now back to the topic for this post…

I never knew sodium played such an important role in regulating our entire body.

Sodium is one of the body’s electrolytes, which are minerals that the body needs in relatively large amounts. Electrolytes carry an electric charge when dissolved in body fluids such as blood.

Most of the body’s sodium is located in blood and in the fluid around cells. Sodium helps the body keep fluids in a normal balance. Sodium plays a key role in normal nerve and muscle function.

The body obtains sodium through food and drink and loses it primarily in sweat and urine. Healthy kidneys maintain a consistent level of sodium in the body by adjusting the amount excreted in the urine. When sodium consumption and loss are not in balance, the total amount of sodium in the body is affected.

Hyponatremia – Low Level of Sodium in the Blood

written by James L. Lewis, III, MD, Attending Physician, Brookwood Baptist Health and Saint Vincent’s Ascension Health, Birmingham

In Hyponatremia, the level of sodium in blood is too low.

  • A low sodium level has many causes, including consumption of too many fluids, kidney failure, heart failure, cirrhosis, and use of diuretics.
  • Symptoms result from brain dysfunction.
  • At first, people become sluggish and confused, and if hyponatremia worsens, they may have muscle twitches and seizures and become progressively unresponsive.
  • The diagnosis is based on blood tests to measure the sodium level.
  • Restricting fluids and stopping use of diuretics can help, but severe hyponatremia is an emergency requiring use of drugs, intravenous fluids, or both.
Causes of Hyponatremia

Hyponatremia occurs when the body contains too little sodium for the amount of fluid it contains. The body may have too much, too little, or a normal amount of fluid. In all cases, however, sodium is diluted. For example, people with severe vomiting or diarrhea lose sodium. If they replace their fluid losses with water, sodium is diluted. Disorders, such as kidney disease, cirrhosis, and heart failure, can cause the body to retain sodium and fluid. Often the body retains more fluid than sodium, which means the sodium is diluted. Certain conditions may cause people to drink too much water (polydipsia), which can contribute to the development of hyponatremia.

Role of Vasopressin

Vasopressin (also called antidiuretic hormone) helps regulate the amount of water in the body by controlling how much water is excreted by the kidneys. Vasopressin decreases water excretion by the kidneys, which retains more water in the body and dilutes the sodium. The pituitary gland produces and releases vasopressin when the blood volume (amount of fluid in the blood vessels) or blood pressure goes down or when levels of electrolytes (such as sodium) become too high.Pain, stress, exercise, a low blood sugar level, and certain disorders of the heart, thyroid gland, kidneys, or adrenal glands can stimulate the release of vasopressin from the pituitary gland. The following drugs also stimulate the release of vasopressin or enhance its action at the kidney:

  • Chlorpropamide (which lowers the blood sugar level)
  • Carbamazepine (an anticonvulsant)

  • Vincristine (a chemotherapy drug)

  • Clofibrate (which lowers cholesterol levels)

  • Antipsychotic and antidepressant drugs

  • Aspirinibuprofen, and many other nonprescription pain relievers (analgesics)

  • Ecstasy (methylenedioxymethamphetamine)

  • Vasopressin (synthetic antidiuretic hormone)

  • Oxytocin (used to induce labor)

A frequent cause of hyponatremia is the syndrome of inappropriate secretion of antidiuretic hormone(SIADH), which is the syndrome I had and occurs when vasopressin is inappropriately secreted in a variety of other situations (such as certain cancers, infections, and brain disorders).

Causes of Hyponatremia

  • Addison disease (underactive adrenal glands)Blockage of the small intestine
  • Burns if severe
  • Cirrhosis (formation of scar tissue in the liver)
  • Consumption of too much water, as occurs in some psychiatric disorders
  • Diarrhea
  • Drugs such as barbiturates, carbamazepinechlorpropamide, clofibrate, diuretics (most common), opioids, tolbutamide, and vincristine
  • Heart failure
  • Hypothyroidism (underactive thyroid gland)
  • Kidney disorders
  • Pancreatitis
  • Peritonitis (inflammation of the abdominal cavity)
  • Syndrome of inappropriate secretion of antidiuretic hormone (SIADH)
  • Vomiting
Symptoms of HyponatremiaThe brain is particularly sensitive to changes in the sodium level in blood. Therefore, symptoms of brain dysfunction, such as sluggishness or lethargy (which I had severely and could barely walk) and confusion, occur first. If the sodium level in blood falls quickly, symptoms tend to develop rapidly and be more severe. Older people are more likely to have severe symptoms (thankfully, I am not really that old… just a little though).As hyponatremia becomes more severe, muscle twitching (my eye started twitching) and seizures may occur. People may become unresponsive, aroused only by vigorous stimulation (stupor), and eventually cannot be aroused (coma). Death may follow.

Besides my eye twitching and extreme lethargy, my body swelled up significantly and rapidly with fluid retention. My face was so puffy that my eyes were nearly shut and I looked like I was eleven months pregnant. I also had an irregular heart rhythm and my blood pressure was high, when I typically have a normal blood pressure.

Diagnosis of Hyponatremia

  • Measurement of sodium level in the blood
Hyponatremia is diagnosed by measuring the sodium level in blood. Determining the cause is more complex. Doctors consider the person’s circumstances, including other disorders present and drugs taken. Blood and urine tests are done to evaluate the amount of fluid in the body, the concentration of blood, and content of urine.
Treatment of Hyponatremia
  • Restricting fluid intake

Mild hyponatremia can be treated by restricting fluid intake to less than 1 quart (about 1 liter) per day. If a diuretic or other drug is the cause, the dose is reduced or the drug is stopped. If the cause is a disorder, it is treated.

Occasionally, people are given a sodium solution intravenously, a diuretic to increase excretion of fluid, or both, usually slowly, over several days. These treatments can correct the sodium level.

Severe hyponatremia is an emergency. To treat it, doctors slowly increase the level of sodium in the blood with intravenous fluids and sometimes with a diuretic. Newer drugs, called vaptans, are sometimes needed. Increasing the sodium level too rapidly can result in severe and often permanent brain damage.

© 2018 Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA

Syndrome of Inappropriate Secretion of Antidiuretic Hormone (SIADH)

Written by James L. Lewis, III, MD, Attending Physician, Brookwood Baptist Health and Saint Vincent’s Ascension Health, Birmingham

The syndrome of inappropriate secretion of antidiuretic hormone (SIADH) develops when too much antidiuretic hormone (vasopressin) is released by the pituitary gland under certain inappropriate conditions, causing the body to retain fluid and lower the blood sodium level by dilution.

Vasopressin (also called antidiuretic hormone) helps regulate the amount of water in the body by controlling how much water is excreted by the kidneys. Vasopressin decreases water excretion by the kidneys. As a result, more water is retained in the body, which dilutes the level of sodium in the body. A low-level of sodium is called hyponatremia.

The pituitary gland appropriately produces and releases vasopressin when the blood volume (amount of fluid in the blood vessels) or blood pressure goes down or when levels of electrolytes (such as sodium) become too high.

Secretion of vasopressin is termed inappropriate if it occurs when:

When vasopressin is released in these situations, the body retains too much fluid, and the sodium level in blood decreases.

Causes of SIADH

Many conditions increase the risk of developing SIADH. SIADH may result when vasopressin is produced outside the pituitary gland, as occurs in some lung and other cancers. SIADH is common among older people and is fairly common among people who are hospitalized.

SIADH has a long list of possible causes that typically require additional tests to uncover.

Causes of SIADH

  • Abscesses in the brain
  • Bleeding (hemorrhage) within the layers of tissue covering the brain
  • Encephalitis (inflammation of the brain)
  • Guillain-Barré syndrome
  • Head injury
  • Hypothalamus disorders, including tumors (rare)
  • Meningitis
  • Strokes
  • Tumors
  • Acute respiratory failure
  • Pneumonia
  • Tuberculosis
  • Brain cancer
  • Lung cancer
  • Lymphoma
  • Pancreatic cancer
  • Cancer of the small intestine
  • Surgery
  • Undernutrition

Symptoms and treatment of SIADH tend to be those of the low sodium level in blood (hyponatremia) that accompanies it. Symptoms include sluggishness and confusion.

© 2018 Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA