new bipolar depression medication approved by FDA — and into my body it goes

I start a new Crazy Med in the next week or two, depending on when it arrives: Cariprazine, as sold under the brand name Vraylar, to treat bipolar depression.

this is a drug that was only just approved in May 2019 (like, just seven months ago). so there’s limited data out about it. but as always, I’m doing my pre-administration self research. and as follows are my notes.

oh! but first!! I want to point out the ironic hilarity in my spellchecker’s desire to auto-correct “Cariprazine” to “Craziness” (image below) when I was emailing my Mum about it.  XD I’m already a fan of this stuff, lol.

it’s as if you’ve met a potential female mate for the first time and she’s got the smeared lipstick look goin’ on with a name tag reading “Hot Mess”.

anyway, below are the meds I’m currently on are below (for Crazies and brain muckery, not anything else). it’s important to keep track of all this shit.

(name brand)
Dosage & FrequencyReason
0.5 mg, as neededanxiety,
panic attacks
(Wellbutrin XL)
100 mg, once daily;depression
400 mg, twice dailyanxiety
Lithium Carbonate600 mg, twice dailymood stabilizer
Nortriptyline HCL
10 mg, twice dailyfibromyalgia
Pramipexole Dihydrochloride
0.5mg, nightlyrestless leg syndrome
0.50 mg, twice dailybipolar,
yes, that’s 1,200 mg of lithium a day.
are you less surprised now about my constant exhaustion and the complete death of my Creativity?

and again, for my personal reminding, I’m posting below anything I read that was of interest or relevance to me. apologies if my shorthand is unintelligible to others initially; I’ll try to flesh things out once it’s all collected.

  • Purpose & Usage
    • heavy focus on bipolar I (versus II); schizophrenia seems to be in the backseat, too
  • Administration & Consumption
    • advised dosage for depression starts at 1.5 mg daily and settles at 1.5 – 3.0 mg daily
      • for mania, starts at 1.5 mg and settles at 3.0 – 6.0 mg
    • take with or without food
  • Side Effects (for mania & depression): so the normal shit, naturally; plus all this mess…
    • nausea & vomiting
    • dyspepsia (bloated gassiness)
    • restlessness
    • somnolence
    • akathisia (twitchy, full-body RLS; sometimes spazmatic loss of motor control)
    • other extrapyramidal symptoms
      • Parkinsonism (tremors, slower thought processes, slower movements, rigid muscles, difficulty speaking, facial stiffness)
      • tardive dyskinesia (potentially irreversible effects; uncontrollable facial movements, like sucking or chewing, lip-smacking, sticking tongue out, or blinking eyes repeatedly) [so like a gecko?]
      • dystonia (muscles involuntarily contract and contort) [DC’s Ragdoll with a loss of control?]
    • metabolic changes
      • fffff, weight gain D:
      • 3% of folks had >7% weight increase for each mania and depression treatment
      • another viewpoint suggests an average 1.1 lbs of weight gain in the first three weeks for mania. for depression it was 1.5 lbs at 1.5 mg/day within the first 6-8 weeks.
    • okay, y’all, direct quote time from the manufacturer’s distribution sheet:
      • Falls: Antipsychotics, including VRAYLAR, may cause somnolence, postural hypotension, motor and sensory instability, which may lead to falls and, consequently, fractures or other injuries. For patients with diseases, conditions, or medications that could exacerbate these effects, complete fall risk assessments when initiating antipsychotic treatment and recurrently for patients on long-term antipsychotic therapy.”
      • like seriously, though. falls. I mean, that’s just a freakin’ Tuesday for me. XD
    • body temperature dysregulation
    • direction quote number two from official website:
      • Do not become too hot or dehydrated during treatment with VRAYLAR. Do not exercise too much. In hot weather, stay inside in a cool place if possible. Stay out of the sun. Do not wear too much clothing or heavy clothing. Drink plenty of water.
  • Other Random Facts
    • is second-gen (or atypical) anti-psychotic
    • long half-life (Cariprazine 2–4 days; DDCAR 1–3 weeks)
    • side effects may take longer to appear than with other drugs
    • metabolites’ formation and elimination via CYP3A4 (liver-based)
    • looks like it legit can make you more suicidal (hello every anti-psychotic ever), not just the typical level for antidepressants

Things I need to research further include:

  • tardive dyskinesia
  • dystonia
  • Cytochrome P450 3A4
  • ways to counteract weight gain
  • details on potential body temperature dysregulation

An then some potentially useful links:

the all-consuming Darkness

I’ve been on antipsychotics for a while now. lithium, to be precise. lots of it. and it works! my anxiety is lower, my compulsions quieter, my obsessions weaker, and my hypomanias basically non-existent. so yeah, we got the Manic portion of things mostly under control.

but we haven’t figured out my Depression. it’s still all-consuming, a shroud that covers everything, even the things I once loved or enjoyed.

things are not fun anymore, for example. and I don’t even want to try to have fun anymore; it’s exhausting.

I had a lot of free time this past Saturday. so what did I do?– sleep. for ~15hrs. sure, I know part of it was actually needing the sleep for physical reasons. but I know the difference between that and sleep as escapism. and most of that was the latter.

and though it may be psychosomatic and even self-fulfilling, I firmly believe that I will never get better until I GTFO of this fucking tundra.

still Noisy, but less loud

been exactly a month since that last post.  not on purpose.  just how it works sometimes.

things are still Noisy in my Mind.

the Voices are coming back; although they are overall innocent.  they don’t give directions so much as they just talk amongst themselves.  chatty cathys are all they really are; basically harmless.

it’s the Noise that’s the problem.  and yes, that’s different.  Voices that give instructions are part of the Noise.  my own self-hatred and repetitive berating, my high pitch sound that whines in my head, the static that fuzzes over my attempts to escape — that’s all part of the Noise.  sometimes music can contribute to the Noise.

I can’t hardly handle it.  I’m supposed to take medication when it gets too bad. but how often will I admit that?  and many times, it gets really Noisy while I’m at work.  so yeah, let’s see about taking one of my klonopins or such then…


in other news, I am physically ill.  I seem to have a generic winter cold.  the snow up here has been quite beautiful, however.  and we may be going to celebrate Christmas with the same family that offered us a Thanksgiving last year.  truly kind and welcoming people they are.

Christmas cards are going to be very late this year, lol.  I’ll make a post with more details about all that later tonight or tomorrow.  I’ll be collecting addresses there too.  but in the meantime, we’re:  Brian, James, and Zero; 200 Nathan Ln N, Apt 111; Plymouth, MN 55441-6466  😉

that’s all for now.  maybe something more informative later…..



> okay.

> sounds great.

>  perfect plan.


did you disagree?  because I didn’t?

I suspect tomorrow will be fine.

but I’m seriously running out of “bad days” that don’t get logged as “last days”.



the Final Day is ideal,


















please allow it to come soon … or even better ASAP…..

blub blub…

I have 64 words for NaNo so far.  and that’s all just from editing and adding words to older work.  none of it is totally fresh content.  because I have no fresh content in my brain.  I can’t think.  I’m too tired all the time.  I either have something else scheduled at the time, or I don’t have something else scheduled and therein opt to just sleep.

I almost made it to kickboxing this morning.  I got dressed and packed up.  I was fighting off a breakdown the whole time.  then, when it was time to put on shoes and go out the door, I just cracked.  I started bawling.  by the time I gathered myself enough to leave, it was too late and would cause me to be truant.  so I cried all over again.  then Brian eventually coerced me into going to the apartment’s gym and just walking on the treadmill at a stroll for 15 minutes.  and then I tucked my tail between my legs as I shuffled back to the apartment, defeated.  he congratulated and said he was proud of me.  he reiterated that “something is better than nothing”.  but all I could think of is how “a lot is more than something”.

I was legit tardy to work yesterday.  I couldn’t wake up; I couldn’t function.  I was so fatigued, it was beyond words.  and it’s not like I stayed up late on Sunday or anything.  maybe it was the time change Sunday morning.  maybe it’s just my body shutting down.  but it caused me to be late to a point of disciplinary action.  I mean, it’s just earning points towards a larger avoidable balance (think golf).  but hey, any points is more than no points.  and I got some points for being truant yesterday.  ugh.

I’m really falling apart.  I don’t know how to keep above water, much less start actually swimming again.

happy birthday to me

it’s here. happy birthday to me, I suppose. I survived another year of living with myself, of beating myself up and despising who I am and what I haven’t accomplished.

a friend has to postpone birthday hangouts last night. instead, a different friend came over last night and gave me a few gifts. I skipped the gym this morning. I have had a few wishes her at work; I’ve received a few texts from my Louisiana folk too. then there’s an unrelated work hangout this afternoon. in the evening, I’m going to Noodles and Company with a third friend; he will probably pay, knowing him. then tonight I’ll cry myself to sleep. Saturday, Brian will take me to dinner and to see Joseph and the Technicolor Dreamcoat. at some point, I know I’ll get a gift from another friend who always sends something.


I wanted to cry when I woke up this morning. I really hoped that my gift from The-Powers-That-Be would be my not waking up finally. alas.

my sleeping issues have returned. I’m not sure what’s up with that. I mentioned to Brian about going back to a sleep specialist, and he agreed that it was a good idea.

my depression is worse, too; but that typically happens around my birthday.

I haven’t been to therapy in several months. she had a health issue that kept her out of work. she wants to meet Sep 2. I liked what work we were doing when we were actually doing it. but her constantly cancelling and rescheduling appointments was a real pain, and I had decided that I wouldn’t go back. but now, with the state I’m in, maybe I should. for now, at least. …man, I dunno.

I got a UTI last week. haven’t been back to my kickboxing since then. I know that’s not helping my mood any. I also ran out of my fibro and my axiety meds two weeks ago. so that’s taking a toll.


overall things should be great for me. but I’m crazy, and things are not good in my Mind.

so yeah. happy birthday to me.

meh. \shrugs\

I locked the door behind me as I was leaving for work yesterday morning.  a thought flashed through my mind: “I should quit my job today.”

I didn’t.
and I won’t.

but I wanted to.  not for any of the reasons I’ve ever left a job before — which is almost always that the job is slowly killing me on the inside.  instead, I wanted to quit because I just wanted to quit everything.

I had stayed home Tuesday due to have fell ill over the weekend.  I slept all. day. long.  and Wednesday morning, I wondered why I wasn’t doing that everyday.

it’s been a while since I’ve just wanted to Quit.  like, not necessarily or specifically Life itself.  but just Everything.  (recent months, it’s been wanting to very precisely Quit Life.)  but as of the last few days?, weeks?, it’s been just wanting to casually say, “okay, that was fun.  but I’m done now.”

like when you’re playing a game, and you’re just done playing.  time to stop.  nothing drastic like taking your ball home.  nothing like forfeiting the play.  just, time to stop playing.  no remorse, no regret, just Quittin’ time.

part of me is very apathetic about my family coming up here in June.  (another part is OMG, super stoked!)  a large portion of me just doesn’t really care about anything.

will I be fit and prepared for the Tough Mudder?  meh.
will I do something fun this weekend?  meh.
will I enjoy reading my books the next time I pick them up?  meh.
will I eat anything today?  meh.
I just don’t really care about anything.

nothing seems important or matterful.  things are neither easy nor difficult, good nor bad.  I just don’t care.

I’m not sure if this is an improvement or just a side step from crippling depression.  the jury is still out on this one.