I have diagnoses of both anorexia nervosa and bipolar disorder, though I would have considered myself in remission from both of these in recent months and years.

Recently, I had to stop my antipsychotic (lurasidone), which I have been stable on for four years, because it went non-formulary in my CCG and I was told I wasn’t able to be prescribed it anymore. It’s the only antipsychotic of five that I’ve tolerated well and it helped my mood immeasurably. I am prescribed an antipsychotic, along with a mood stabiliser, to help manage my bipolar disorder, which I was diagnosed with in 2015. Due to having already tried a few different antipsychotics and it being advised I take one with a lower weight gain profile, I was changed over to amisulpride, an antipsychotic that I had not yet tried.

The reason it’s advised I am not prescribed anything with a high chance of weight gain is due to my recovery from anorexia, which I have been managing independently since being discharged from eating disorder services in 2021.

I am doing well in recovery but I absolutely do not profess to be recovered and I’m very much a work in progress. It would not take a huge amount to destabilise that I don’t think, and weight gain as a result of antipsychotic use was a previous cause of a significant relapse so I am anxious about it. I gave amisulpride a chance despite my anxieties and lo and behold, I have gained weight.

I feel so miserable about it all. My mood has also nosedived since changing medication irrespective of gaining weight – it just isn’t helping me stave off depression like my previous medication was. I am so frustrated about the whole situation. Trying to balance having bipolar disorder and staying well and having anorexia staying well is a minefield and I am honestly, incredibly tired of it at the moment.

How do you try to stay well in one area while knowing it will make another worse? I feel like that’s the choice services have left me with, and instead what has happened is I’ve now deteriorated in both. I am undeniably depressed and have been for weeks now, and my body image is now rock bottom after doing well to manage this for months. I feel in full panic mode about everything. If I don’t stop taking it, what if I gain more weight? If I do stop taking it what if I get more depressed, or possibly even manic again? What an awful choice to have to make. And worse, all this decision making was done with a GP, a pharmacist and a psychiatrist, none of whom have ever met me or discussed it with me.

So, I have decided that of both those choices, the sacrifice to my eating disorder recovery feels too high, and I am now stopping my antipsychotic. I am prepared to have a further relapse with my bipolar disorder and will cross that bridge when I come to it. In the meantime, the mental health nurse at my surgery is asking for them to appeal and re-prescribe me lurasidone, which was completely life changing in terms of the quality of life it gave me and impact it had on my stability.

I know a lot of you have asked about how I am around all of this at the moment and it’s too big of an update to share on socials, so this is where we are at.

Please keep your fingers crossed for me that something changes soon!