Lamictal sudafed

Hello all. I saw a post about this from 7 months ago, but I wanted to touch on my own experiences and share/talk.
I started noticing I'm a HSP to medication about 4-5+ years ago. I've always struggled with anxiety, but in my younger days, I was attuned to external triggers.
This so what I've learned through terrible trial and error AND advocating/trusting my body and instincts:

• Taking pain killer after a surgery made me feel like my heart was going 300mph - like I was going to have a heart attack. Stopped instantly.
  
• Steroids make me feel really weird - stimulated
  
• Birth control was giving me panic attacks and manic depression episodes (original doctor tried increasing the dose LOL)
  
• Pepto gives me major confusion / foggy brain if I take it too many days in a row
  
• Experiences with SSRI/SNRI/Mood Stabilizers during a bad time with postpartum anxiety: I had to take the LOWEST dose available; pediatric sometimes, even lower. Zoloft made me paranoid and depressed, Lamictal made me either energetic or fatigue with panic, Effexor XR made me feel like I was in a constant high/confusion haze. I'm now on Lexapro. The recommended dose? 5mg. I'm taking the LIQUID (didn't know this was a thing) at 1mg 2x a day. Even at the half dose (2.5mg) I was having side effects.** That .5mg makes a big difference for me.
  
• Sudafed or Benadryl - anxiety attack inducing
  
• Caffeine - SMALLLLLL amounts or a panic attack. I used to drink caffeine a lot in college and later in life; not realizing how much havoc it was really causing me until I cut it out.
  

I've learned to really pay attention to what I take and how I feel; trusting my body and not some bs answer of "that's not a typical side effect."
I think the "recommended" dosages for most medications are based on an assumption that everyone's body chemistry reacts the same to meds. It's VERY infuriating considering a lot of medications aren't available in lower doses to even TRY. But for many of us, the side effects can be worse than the symptoms we try to treat.
People who drink several cups of coffee a day, or a few beers with no issues - must be nice lol.

32M, 6'1, white, 235,- blood tests are off- went to hospital recently- no existing issues besides anxiety and occasional chest pain- on lamictal 150 and as need gabapentin- smoke weed 4-5 times a month, occasional drug use but nothing abusive
I went to the hospital for chest pain but I have a cold. I have taken dayquil and sudafed and a weed edible. Some results were returned with slightly out of range tests that mostly indicate liver or kidney related issues. I would like to know if its normal to have out of range kidney or liver tests in the case of being sick and taking meds. Thanks!
Abnormal tests
ANION GAP and ALKALINE PHOSPHATASE - low BUN - a bit high white blood count - low monocytes - high SGPT-ALT - high
​

Age: 32
Weight: 275
Sex: F (he/him)
Ongoing: about a week
Medications: Lo Loestrin, Trintellix, Lamictal, Valtrex
I've had a head cold for about a week. When the congestion got super bad I used Sinex for the three days you're allowed to, 12 or more hours apart. I took my last dose yesterday at 9AM, and it's now 11PM. Last night sleeping was hard, even with Sudafed (the pharmacy stuff not just the stuff on the shelves) because my nose is still all cloggy. It's better, I can kinda breath out my nose, but I know sleepings going to suck again. Since it's been over 24 hours since my last dose can I use a single spray tonight in one nostril just so I can sleep? Or is the risk too great? If it's too much what can I use for a decongestant?

Hello all, I’ve taken 600 mg of Lamictal/lamotrigine every day for 10 years and normally don’t experience any side effects. I learned in college I can’t take adderall or else I get double vision. Okay, nbd.
In the last few years I’ve noticed that when I get sick and take flu medicine (NyQuil, Sudafed, or Coriciden HBP) I’ll experience double vision a few days after.
Has this happened to anyone else? If so, have you found a cold/flu medicine that works for you?
Thank you!! Fellow Epileptic

I (23 F) just got covid for the first time and am having psychotic symptoms again for the first time since first getting medicated for bipolar in 2017. Did covid trigger psychotic symptoms in anyone else? Is it just the stress of the illness, or the fever? Should I seek medical attention for this even though my physical symptoms wouldn’t warrant it?
The symptoms in question: Paranoid delusions, mild audio hallucinations, disorganized thinking, massive memory lapses and forgetting what I’m thinking/doing/saying, brain fog, and catatonia
Edited to add: I’ve had 5 covid shots, I take lithium Zoloft Wellbutrin lamictal trazodone and propranolol (for anxiety + heart palpitations), I have taken Sudafed and Tylenol once each in the past 24 hrs and that’s all. Thank you guys so much :-)

I'ce taken Lamictal for 6-7 weeks and been up to 100 mg for the past three weeks. Ever since reaching this dose I've had a sore throat and congestion most of the time. These are listed as common side effects. I can't keep taking Sudafed and Advil indefinitely so I'm going to have to ask my doctor about coming off of it. It's too bad because it was helping my mood. I also take antidepressants and a lower dose of Geodon but the Geodon doesn't seem to be doing much. When I increased my Geodon dose I got akathesia. Has anyone else had a constant cold while on Lamictal? Any recommendations for a different mood stabilizer without a lot of bad side effects?

This isn’t drug related, I hope this isn’t against the rules because I know nobody else that takes this medication and my psychiatrists office won’t answer the phone or call me back so I can make an appointment, this has been going on for two days. (:
Anyways, I’m on 200mg lamictal daily for a mood disorder, we’re thinking bipolar ( can’t remember if 1 or 2 ) but my psychiatrist can’t properly diagnose me quite yet.
It’s helped a lot with mood stabilization and I love it for that. My issue with this medication is how there’s an interference with nearly every other drug out there. I took DayQuil once for a cold at work, and a few hours later I couldn’t even walk because everything was spinning and I was so off balance. So I’ve steered clear of that, I have another cold and I THOUGHT I could take Sudafed with it, but once again I found out they do interfere with one another and now I’m scared to take Sudafed unless I’m not at work, I work long 12 hour shifts and I’m sick and I don’t know what medication I can take that won’t give me terrible side effects. This is my only issue with the medication is that I can barely take anything with it.
I’m also on Wellbutrin 100 mg daily, and I’m on norethrindrone for birth control ( once again, they interfere with lamictal ) and I just don’t know what to do! The medication works well for me, but I’m tired of not being able to take simple cough syrup or cold medicine without feeling drunk a few hours later. What do you guys suggest? I’ve never had another medication that made me this stable. I’m just lost.
Also, I’ve been on it for quite some months and I can’t say I’ve had too many crazy dreams, then again my dreams have ALWAYS been crazy, so maybe I just haven’t noticed anything because of that haha.

I didn't know that, I took one every four hrs for the last day because I had to work with this awful cold, and then when my heart wouldnt stop and I got hypomanic borderline manic stirrings, idk what to do. I'm due for my lamictal in a few hrs, afraid to take anything to calm down. But I'm fighting the feeling of giving into it and trying to stay awake to follow this rabbit hole because I've missed not feeling numb.
Idk. I'm lost. Scared I'm going to go manic again. Ashamed. Pissed tf off that sudafed doesnt have a bipolar warning

21 f ear 135lbs 5'4" white issues gojng in for two ish months Left ear USA Meds: lamictal, clonidime Smoke weed, minimal drinking, no cigarettes (quit eight months ago after moderate use for two years) No diagnoses at the moment
So my ear has been bothering me for a few months now. I thought it was maybe ear wax but it isn't, I've been to the doctor twice now and they didn't know what was wrong, the first time I wondered if it was just all in my head, the second time I knew it wasn't. No ear wax, no obvious damage, no infection, she just couldn't figure it out. So she told me to go to an ENT- which I plan to do- but I've just moved, started a new job, have a ton going on and probably won't be able to go until January unless the pain gets really bad. She told me to take sudafed in the meantime and I have a few times, and it helps.
It's some pain sometimes, a lot of full feeling, kinda like I have to pop it constantly but that never helps. Slightly muted hearing, and last week what really scared me is I was sitting there and all of the sudden my eardrum started vibrating really hard, for no reason. No loud noise no change in anything, just started vibrating and I could feel it.
A few questions:

1. Can I take sudafed on a near daily basis for a month? Is that unsafe?
2. I drink but only rarely- when I do it's one drink usually two max. Can these be mixed safely? I will probably drink one to two nights a week just since I'm excited to be back in the city and will be going out more than usual as a result.
3. Anyone have any ideas what's going on with it? It couldn't be related to the meds I'm on could it? I think it started well after the lamictal started but before I started the clonidime.
4. Is this something I should be more concerned about? Could my hearing be at risk? If it's anything other than a big risk like that I'd really rather wait till the new year when I have insurance and money.

35 Caucasian/Native American female 5'8" 175lbs Smoking about 1 pack every 3 days, 1 pack daily during exams.
DX History Unrelated to Question:
DSMV Axis 3 (MDD, PTSD, GAD, BP1, ADD: at this point DX is for insurance purposes). Medication compliant. 10yr relationship with psychiatrist.
Unknown Metabolic: All labs ideal (PCOS DX due to sono), rapid weight gain despite intake monitoring to include inpatient monitoring - DS at 476 lbs (gastric sleeve + bilio-pancreatic diversion). Three years post-op, unable to follow post-op diet due to abnormal labs. Resolved with high calorie intake, high salt, high simple carb diet. Gallbladder removed as a precaution. Hypothyroidism, Anemia, etc. onset during adjustment to dietary needs. Resolved. PCOS resolved.
HypOtension and hypoglycemia: controlled by diet and lifestyle.
Degenerative disk disease causing a problem at S1 before it enters the sciatic bundle. Inflammation causes pain of a "pinched nerve": controlled.
DX History Related to Question:
Delayed onset REM and REM duration averaging 15 minutes per cycle with only 4 cycles during 8hr study. No apnea. No restless legs. No other notable incidents in study. Neuro referral (admittedly ignored) 4yrs ago during pre-op screenings.
Delayed sleep phase since adolescence with sleep paralysis and night terrors (PTSD).
New/Worsening SX: onset 9ish weeks ago but progressively worsening. Sleep delay averaging 48hrs. Feel sleep deprived after 36 but unable to sleep. Benzo at bedtime resolved night terrors and sleep paralysis 90%. Sleep aids ineffective. Sleep 4-14hrs after the 48hrs awake. Hands cramp up (gabapentin PRN resolves this - previously attributed to anxiety). Tension headaches (onset 1yr ago but increased frequency coinciding with sleep cycle change).
Current Medication: ** Lamictal 300mg at bedtime *Xanax up to 2mg PRN for anxiety attacks. Up to 1mg at bedtime if anxiety high. *Gabapentin 300mg PRN up to 3 daily. *Prozac 20mg in the morning *Adderall IR (instant due to malabsorption). 20mg up to 3 times daily PRN (10mg wait 15-30 min, additional 10mg if necessary depending on absorption; every 3-4hrs while working) *Bariatric multi vitamins, A, D3, Calcium Citrate, Iron, Biotin, Zinc (all supplements per bariatric surgeon). *OTC: Tylenol normal adult dose for headaches and Sudafed (PSE formula) 1/2 adult dose for periodic cold/allergy SX
With psych history and medications, this looks psych but onset was sudden. Attributed to potential manic episode (first in years) but within 2mos of Prozac increase to 40mg. Prozac decreased to 20mg with no improvement in sleep but lower average mood (of course I chart).
Sleeping pills don't work: e.g., Trazadone causes 3 days continuous sleep at lowest dose. Ambien ineffective due to digestion.
Family HX: Maternal grandmother Parkinson's diagnosis around age 50. Deceased from unrelated cause, so disease progression unknown.
That's a LOT but a neuro consult is financially detrimental as a grad student. My child and I would have to rely on food banks to eat for a month to pay for it but I do research and code to keep us fed in the future and neurological damage is worse than ramen. Dr. Google says neuro, my gut says psych but my gut doesn't like ramen.
ETA: not taking stimulants (other than 3-5 cigarettes) during the first day and taking 2nd Xanax at bedtime did not cause sleepiness. Also edit format.

Update: emailed my phy doc and she thinks I've been having a allergic reaction to the lamictal this whole time, so I'm on my way to er now.
I'm yrs old and 250lbs and I've been sick since early November and I started taking lamictal early November. I just put two and two together and wonder if that's what is making me sick. I had blisters in my throat the doc thought I had a really bad infection so they gave me amoxicillin. I just got worse even had lost my voice for 2weeks so I went back. They gave me strongest antibiotic shot they had and a steroid cocktail shot I was having breathing issues and it seemed to be going into my lungs and I got a lump in my tongue. And my neck and throat was sore. I started feeling better after the shot got my voice back almost immediately. Then I started doing bad again and I noticed I now had a lump in the roof of my mouth too. Went back to the doc they gave me a sulfer drug, 50 mg predazone, streiod for nebulizer and Albuterol for the nebulizer and told me to take Benadryl or Sudafed and the doc thought the lumps we're a start of a canker sore (I've had canker sores they're on the surface and open and hurt to touch but these were lumps under the skin that would swell and the area hurt ) Then again I was feeling better the lumps had even gone down. I finished off the steroids 2days ago. Yesterday my throat started getting sore again then I noticed I could feel lumps in my neck. And I started coughing again and having breathing issues. Then last night I had a small itchy spot on my foot so I scratched it and it was tiny water blisters so now the spot is red and hurting. And anytime I started feeling better I'd stop the Benadryl. Is this a reaction to the lamictal? If so do I have to go to the er or will it be good if I just stop taking it? My phy doc isn't open yet and I go see her on the 19th and also I've been a lot more sore lately and I've got degenerative bone disease so I figured I was just having problems with it cause it's getting colder out. Is this is due to the lamictal if you think the lamictal is causing all this?

Flares suck. I was bedridden for 7 hours today and now I probably won't sleep tonight. I was on an actual schedule too. Getting up at 8 and going to bed at 10. The first few days were pretty good. I was actually able to sit up through the whole day. Then a couple days into it, the midday dizziness started up again. My sleep cycle was inverted for a while. I'd wake up at midnight and then go to bed in the morning. I kept pushing it forward a couple hours every day until I had the schedule I want. I hope what I worked for isn't ruined. I don't think the Sudafed and herbs I use for energy do diddly squat. I start botox later on this month and have my hopes up about that. I'm tired of this illness holding me back. I just want energy and to be able to focus on my music.
I currently take: Latuda 60mg, lamictal 150mg, baclofen 20mg 3x daily, lyrica 150mg twice daily, ambien 10mg and one Sudafed.
(A couple of those meds are for bipolar type 1.)
supplements: magnesium, melatonin, calcium, vitamin c, iron, zinc, and fish oil
herbs: ashwagandha, ginkgo recently added: rhodiola, Asian ginseng
I also drink a lot of yerba mate and ginger water. I ordered some bacopa to try.
I am curious what herbal remedies or nootropic substances everyone has tried. I'm desperate for anything that will work until doctors are able to check out my adrenals and thyroid. My attention span is also terrible. I'm hoping I will eventually get an assessment that will prove I need something like Vyvanse or Ritalin.

I'm 29. I have a lot of mental issues. I'm diagnosed with panic disorder, ptsd, depression, and OCD. I've been playing musical chairs with medication for a decade, unsuccessfully dredging through therapy, trying to find what works with no success. I take prozac, lamictal, clonodine, and klonopin.
I was abused as a child by my mother in extreme ways. I was sexually abused, physically abused, and was forced to kill animals for her amusement. The order was: kill a puppy, or she would kill my father, who was unaware of the abuse because I was too terrified to tell him. She was an insurmountable prison until she died from chronic meth use as I turned 18.
It's difficult to describe some of my symptoms. I despise myself. My self esteem couldn't be lower. I cannot function in society and receive disability. My saint of a Dad that saved me from my monster of a mother and takes care of me. I can't get out of bed in the morning. I have flashback nightmares whenever I close my eyes. I feel nothing but guilt. I hide all of this behind a smile, and when I am social, people can't tell that anything is wrong with me. My father, my doctor, my therapist, and my closest friends were the only ones who knew about my issues.
I would have never submitted this pity party of a post, and remained behind the smile mask. Without this incident, I would have never posted this.
I toyed around with Tinder in the past just to talk to people, but I never swiped right on anyone because I felt unworthy of female companionship. I turn 30 this year and haven't had my first kiss yet.
I caught a bad cold mid December. This lead to my first ever sinus infection. My head felt like it would explode, with pressure pushing on the back of my eyes. After searching online, I discovered that an over the counter called "Sudafed" helped with sinus pressure, so I bought some after showing my ID. I took it as directed by the box. It helped my symptoms, and after two days, I started recovering. Something extraordinary happened. The vast majority of my non ptsd symptoms vanished. The self hatred, doubt, paranoia vanished in an instant. All of those feelings became petty as I began to feel worthy of happiness. I felt near invincible and my focus became crystal clear. I opened Tinder, and started swiping right on anyone that seemed interesting while thinking "why not? The worst thing that will happen is that I won't get liked back, or at worst, rejected." Even thinking those words before the Sudafed would have caused a panic attack, but now I could just shrug them off. I would now be able to make something of myself and stop being a leech on society. I was cured.
When I woke up the next morning, everything was as before. All the benefits vanished overnight, and the miasma returned. I figured I had just had some sort of mental breakdown and that I imagined everything. I got up, took one last dose of the sudifed to relieve the sinus pressure, and I became invincible again. Without a doubt, the variable was the Sudafed. Because my sinus infection was gone, I stopped taking the medication because I didn't want to abuse it for reasons not intended by the pharmacy. I had to be sure.
Coincidentally, I have an appointment in two days to see my psychiatrist. I'm a wreck again, and I will not take the Sudafed again unless directed to. What the fuck happened? Why did an over the counter medication for sinus infections fix my problems? Does anyone have any idea how this is an actual thing?
TL;DR: I'm an emotional wreck. I got sick and took Sudafed. Most of my mental symptoms vanished. I see my doctor in two days. Any idea why this happened?

I was Dx'd as Bipolar 1 in September 2015, but I have a hard time accepting it, and I really don't know what to do. I feel so lost. I can't be happy without getting the right label, and I don't know if "bipolar" is the right label. (Yes, I know the label shouldn't matter, but I can't help but feel concerned about it.)
Maybe I'm overthinking things, but I don't know if I've ever had a hypomanic or manic episode before. My pdoc claims that I became manic after taking 10mg of Lexapro, but I have no idea anymore. I just remember feeling good. I was smiling nonstop, got 3-5 hours of sleep a night, felt hyper, and had extreme distractability... BUT the problem is, I have a diagnosis of ADHD, so the symptoms overlap. It complicates things.
I felt the same way when I took Sudafed, of all things. And apparently I was in a "mixed state" when I first met my therapist... because I guess I was getting 3 hours of sleep a night, feeling energetic, but also feeling horribly depressed at the same time. But is that a combination of ADHD and depression, as opposed to a mixed state?
I just don't see how I could be labeled as "Bipolar 1" without having psychosis. If anything, I'd be Bipolar 2. So, that's partly why I'm leery of the bipolar diagnosis in general.
Now, I do get episodes of severe depression, and they last anywhere from 2 weeks to a couple of months. They don't have any triggers as far as I'm aware, so I know that I either have MDD or bipolar disorder. (My previous diagnosis was MDD, btw.)
I've taken Latuda, and it's done absolutely nothing for me. I just started Lamictal, so who knows how well that's going to work out... But honestly, if I don't have bipolar disorder, then I'd prefer to take a different antidepressant as opposed to taking a mood stabilizer, even if the mood stabilizer happens to work.
Thanks for reading.

There have been some comments about the death of Elisa Lam recently, so I thought I would write up the extensive research I have done on this case. This "mystery" is resolved – the official conclusion that she had a manic episode and accidentally drowned is supported by a breadth of physical evidence as well as established medical opinion, which I have outlined in excruciating detail for your reading pleasure.
There are two main pieces of evidence to review:

• The creepy-ass video of her in the elevator
• The autopsy & toxicology report published by the Department of the Coroner for the City of Los Angeles

I used the Wiki as a jumping off point for my medical research, and much of the information I cite here has also been sourced in the Wiki, if you would like primary sources.
Elisa's family stated that she suffered from bipolar disorder, according to the wiki. Let's go through the list of prescription drugs she was prescribed on p.23-25 of the toxicology report linked above:

• Dextroamphetamine (Dexedrine) - just 2 10mg capsules, loose
  • Stimulant prescribed for ADD/ADHD & narcolepsy
• Lamotrigine (Lamictal) - 100 mg
  • Anti-convulsant and mood stabilizer prescribed for epilepsy & bipolar disorder
• Quetiapine (Seroquel) - 25 mg
  • Atypical anti-psychotic prescribed for schizophrenia, bipolar disorder, and major depressive disorder
• Venlafaxine (Effexor) - 225 mg
  • SNRI Antidepressant prescribed for major depressive disorder, generalised anxiety disorder, panic disorder, and social phobia
• Bupropion (Wellbutrin) - 300 mg
  • Atypical antidepressant prescribed for depression and smoking cessation

There are also two OTC medications on the list: Advil (ibuprofen, pain reliever) & Sinutab, which is essentially Sudafed (a decongestant).
The American Psychiatric Association recommends an anti-depressant in conjunction with a mood stabilizer and anti-psychotic for bipolar disorder treatment. Check, check, and check. Based on the statement from her family and her prescription list, I think it's safe to say without a reasonable doubt that Elisa suffered from bipolar disorder, which entails cycling of manic and depressive moods. Severe mania can include psychotic features, such as hallucinations, delusions, paranoia, catatonia, and lack of insight.
The first primary observable suggestion that Elisa was suffering from a manic episode is the psychomotor agitation she displays in the video, especially with her hands. Psychomotor agitation is defined as: "a series of unintentional and purposeless motions that stem from mental tension and anxiety of an individual. This includes pacing around a room, wringing one's hands, uncontrolled tongue movement, and other similar actions." Psychomotor agitation is a symptom of mania. This piece of evidence alone doesn't prove it, but it does strongly support the results of the toxicology report.
Contrary to popular belief, the toxicology results are unlikely to be affected by Elisa's prolonged stay in the water tank (she was there for 3 weeks). The toxicology report tested the blood in her heart (an internal organ), as well as liver enzymes (also an internal organ) and her bile. It takes significant blood loss (like from a wound) and/or extended decomposition (6+ weeks) to affect toxicology results taken from internal organs. Blood taken from a vein in her arm, for example, would be much more likely to be affected; but that's not the way the tests were performed. There is are tidbits on this topic buried in this article on Medscape authored by a Professor of Pathology at USC Med School, but sadly, all the more specific links I've been able to find are behind a paywall.
Let's compare the toxicology results (p. 26-27) to Elisa's medication list:

• Venlafaxine (antidepressant) was present in the blood in her heart and in her liver enzymes - this suggests Elisa took this medication the day she died
• Bupropion (antidepressant) metabolites were present in the blood in her heart and in her liver enzymes - this suggests Elisa took this medication recently, but not the day she died, as only the metabolites are detected and not Bupropion itself
  • Bupropion can sometimes cause mania in bipolar disorder.
• Quetiapine (anti-psychotic) & its metabolites were not detected in any quantity in the blood from Elisa's heart - this suggests Elisa had not taken this medication recently
• Lamotrigine (mood stablizer) was found in such small amounts in the blood from Elisa's heart that it's debatable it was even there ("quantity not sufficient"); however, Lamotrigine was found in trace amounts in her liver enzymes - this suggests Elisa took this medication recently, but not the day she died
• Bile ethanol (alcohol) results: 0.02 g% (this is a normal amount of ethanol for bile)
• Ethanol (alcohol) was not detected in any quantity in the blood from her heart - Elisa did not drink any alcoholic beverages the day she died
• No obvious illegal drugs were found in Elisa's system – they tested the blood in her heart for for marijuana, cocaine, MDMA, barbiturates, opiates, and amphetamines - all came up "not detected," meaning she hadn't even taken the Dexedrine (prescription amphetamine/stimulant) recently.

To summarize:

• Elisa took at least one antidepressant that day
• She had taken her second antidepressant and mood stabilizer recently, but not that day
• She had not taken her anti-psychotic recently
• She had no alcohol or common illegal drugs in her system

There is a very strong risk of mania associated with taking antidepressants alone (not in conjunction with an antipsychotic or mood stabilizer) for bipolar disorder.
I think it's safe to say that the video combined with the toxicology report proves beyond a reasonable doubt that she was experiencing a manic episode at the time of her death, independent of any other drugs (illegal or otherwise) she may have had in her system.
Although the toxicology report did not test for date rape drugs like Rohypnol (roofies), GHB, or Ketamine, this anomaly is largely a moot point since there was no alcohol (ethanol) found in the blood taken from Elisa's heart. Mixture with alcohol is the most common way these date rape drugs are administered, according to Brown University. I honestly can't think of another way to administer such a drug without Elisa knowing, unless it was slipped into a non-alcoholic beverage. However, the wiki indicates that everyone who saw Elisa that day (hotel staff, the clerk at the book store) asserted she was alone.
Foul play theorists often complain that the police did not investigate enough, or that the police work was below par. According to the wiki, all hotel employees & the book shop keeper who saw her that day were interviewed, and all confirmed Elisa was alone. There was no crime scene (they searched her room and found nothing to indicate foul play) and no possible suspects to pursue.
To be fair, according to the wiki, the rape kit they took from Elisa was never processed – most likely because she was confirmed by eye witness accounts to be alone that night, there was no alcohol in her system, and there is such overwhelming evidence that she was manic. Unfortunately, police resources are scarce, and it makes little sense to run a rape kit on someone for whom all physical evidence points to a more obvious explanation. Although Elisa experienced anal bleeding as a result of prolapse, the autopsy report indicates that this is consistent with water decomposition and not necessarily rape.
Overall, the body of evidence does not point to someone taking advantage of or doing harm to Elisa: she was alone and she wasn't drinking.
Finally, the issue of how she accessed the water tank, got into it, and closed the heavy lid: manic people do crazy shit that often requires exerting absurd amounts of physical strength. According to the National Institute of Mental Health, a couple of the primary symptoms of mania include physical restlessness, strong desire to increase activity, and unrealistic belief in your abilities. The wiki notes that Elisa would have had access to the water tank from the fire escape. The symptoms of her mania - impulsiveness, sense of heightened abilities, hallucinations - would reasonably lead to her to climb in the tank and shut the lid. God knows what she might have been hallucinating that motivated her to climb in that tank and shut it.
Though this case is resolved, I will admit that it's very interesting and unusual – to be fair, according to the wiki, the medical examiners had classified her cause of death as “undetermined” up until three days before the autopsy report was published, when they changed it to “accidental.” While I had a lot of fun researching the whole thing, the case of Elisa Lam is not a mystery - it's a tragedy.
EDIT: I didn't want to bring this up, but I have seen a lot of posts here regarding personal experiences with mental health issues, psychiatry, bipolar disorder, etc. I just want to say that I experienced a psychotic break 5 years ago, was hospitalized three times for 6+ weeks at a time each, and was at one point diagnosed as bipolar I (misdiagnosis, turns out I'm just mildly depressed and Adderall does bad things to me). I understand mental health issues from a patient's perspective and I tried to portray the disorder as accurately as possible without delving into too much detail. I'm sorry if my portrayal has offended anyone.

I'm on Lexapro 20mg and Lamictal 100mg for my bipolar 2. I've been taking Sudafed for a couple days due to a cold and after my most recent dose I feel all jittery, restless, rapid pressured speech, etc. Could it be the Sudafed, or should I call my p-doc? I'm also coming off a serious bout of depression brought on by life events. Thanks.