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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by uncouth on August 6, 2011, at 12:07:18
hi friends,
so after talking to my psychiatrist, we have decided to try discontinuing the antipsychotic I have been on for the past 6 months, Saphris. I tried d/c a few months ago but sleep was affected and my mood worsened. However, I believe that I'm probably on too much medication for my bipolar 2, and I'm still depressed (maybe "empty, lonely, afraid, hopeless" is more precise), so I'd like to try and see what living without an antipsychotic feels like.This will be the first time I've been completely off of an antipsychotic in jeez at least two years. I'm also on Tegretol so that will hopefully provide enough mood stabilization.
What I want to know is, what can I expect from discontinuing the antipsychotic? It's hard for me to say exactly what each drug I'm on does by itself, depression is so multifaceted. SO far I've decreased from 10mg to 5mg over the past week and I feel like my mood has already worsened a bit, but i'm hoping that in the long run my mind will feel more clearer and more natural without the Saphris.
What have been people's experiences, subjectively, how it feels, etc. when they have discontinued an antipsychotic? Rebound mania, depression, etc.? Since antipsychotics affect thinking and cognition, did your cognition improve or worsen going off? Attention, motivaiton, etc.? Addictions and compulsions and obsessions improve or worsen?
i"m very torn because I'm pretty sure I have an organic, biologically based brain disfunction, and if an antipsychotic can treat that, then perhaps I should be on it. But on the other hand, i've been on one along with other meds for years and I still feel the way I feel. Who knows, maybe I would have felt worse if I hadn't been on it? ALl the research I do brings up articles showing the positive effects these things have in the brain. On the other hand, it's yet one more chemical i'm adding to my brain, and it could be having some profound negative effects I can't really notice until I'm off. It's antagonizing dopamine, so maybe the antipsychotic is causing my anhedonia and low motivation. Maybe it's the reason why I don't seem to care about sex or being in a relationship. Maybe it's the reason I'm in my head too much. Maybe it's numbing my emotions so I don't get a chance to fully process my experience. I just don't know who I am anymore, with or without the drugs. I'm tired of playing God and will follow my psychiatrists instructions, but I am very torn about this decision. I hope some of you can understand my concerns, and can speak to your experience with antipsychotics.
I just want to have the capacity to enjoy life again, to not feel so empty and dulled by life, to feel the positives AND even the negatives, and most importantly, to love. I feel like the illness or my nature or nurture somewhere along the line took away my capacity for love. For a girlfriend, for people, for God. I feel that part of my brain is broken and it makes me really sad, because i know how much love would help me.
So yeah sorry for the stream of consciousness, but please tell me your experience of how you felt going off of an antipsychotic. Did it improve things or make things worse? Could you tease out the other effects it had on you besides just on general "mood"? I'm expecting some tough weeks, and won't be shy about asking to go on it again if things get really bad, but damnit there has to be more to life than just reliance on chemicals right? I am starting to go to AA for my medication obsession and other addictions so that is helping, i'm just on step 1, but I'm starting to realize that a big part of my depression is a spiritual malady that can only be solved by a right relationship with God. I'm trying hard and have been trying for years but i'm still getting stuck in old patterns, sin, self-pity, self-obsession. I want to get out of myself and am hoping that reducing my medication burden will help that, somehow.
I don't know. Someone help me, i'm very anxious lonely and depressed right now. I keep hoping that med changes (either additions or removals) will be the answer, but they never seem to be. And yet I can't ignore the real effect changes do have on my mood. But maybe life is more than mood, etc.?
So we'll see. LAst night was my last night on saphris. Please pray for me and share your experience.
Uncouth
Posted by Phillipa on August 6, 2011, at 12:43:16
In reply to Discontinuing Antipsychotics - What to expect etc?, posted by uncouth on August 6, 2011, at 12:07:18
Uncouth no experience but will be thinking of you. So the antipsychotics has the same or similar withdrawal as SSRI's, benzos etc? Didn't know that. Good luck. Phillipa
Posted by Christ_empowered on August 6, 2011, at 13:10:26
In reply to Discontinuing Antipsychotics - What to expect etc?, posted by uncouth on August 6, 2011, at 12:07:18
I have been diagnosed with Bipolar I w/ Psychotic Features, so my problems are different from yours.
When I went off an antipsychotic (Abilify), I felt great for a while, then crashed into a hyperkinetic, mildly psychotic, agitated depression. I had to go back on a Abilify at a higher dose to make the symptoms go away.
For Bipolar II with no psychosis, I don't think you'll be having those problems. Long-term use of high doses of antipsychotics, at least the older ones, can worsen a psychotic condition or even create a psychotic condition in patients who hadn't before experienced psychosis. I think this tardive psychosis is fairly rare, though.
Just try to take it slow. In "Mad in America", the author writes about how some data seems to indicate that rapid withdrawal of a neuroleptic can lead to a deterioration, which will lead to more neuroleptic use. More gradual withdrawal gives your brain time to adjust the absence of the tranquilizer. If you're taking a sedating neuroleptic, you might want to consider a benzo or something for sleep. Even non-sedating, high-potency neuroleptics can cause withdrawal problems, so I would think that a day time anti-anxiety medication might be a good idea to keep agitation at bay while you taper.
Good luck to you.
Posted by bleauberry on August 6, 2011, at 16:09:25
In reply to Discontinuing Antipsychotics - What to expect etc?, posted by uncouth on August 6, 2011, at 12:07:18
Well, whatever other meds you are on, many of them have the common effect of dulling emotions. While on the meds, it is hard to tell if that is part of the disease or a direct effect of the meds. The only way to find out is to get off the meds and weather the storm for a couple months to see how things settle out. Sometimes people feel better fairly quick and there isn't even a storm to worry about. Others the suffering can be hard.
My experience in withdrawing from antipsychotics has been with zyprexa 8 years, seroquel 1 week, and amisulpride 1 month. Seroquel had a nasty rebound anxiety/insomnia thing that was short lived. Amisulpride had a depression rebound that improved to baseline in a few days. Zyprexa was hard. I had to wean in tiny steps over a couple months. The primary difficulties were anxiety, inner restlessness, and sleep.
Whatever you do, doing it in tiny steps will help make it as smooth as possible.
Posted by floatingbridge on August 6, 2011, at 19:32:31
In reply to Discontinuing Antipsychotics - What to expect etc?, posted by uncouth on August 6, 2011, at 12:07:18
Uncouth, I am sorry this is such a difficult time for you.
I don't know about saphris. I took longer than you are to discontinue abilify. I was up to 10mg. I had no untoward, noticeable discontinuance effect, but, I think I took maybe a month to reduce to zero.
This is a good place to have a stream of conciousness, IMO. You are in my thoughts.
> hi friends,
> so after talking to my psychiatrist, we have decided to try discontinuing the antipsychotic I have been on for the past 6 months, Saphris. I tried d/c a few months ago but sleep was affected and my mood worsened. However, I believe that I'm probably on too much medication for my bipolar 2, and I'm still depressed (maybe "empty, lonely, afraid, hopeless" is more precise), so I'd like to try and see what living without an antipsychotic feels like.
>
> This will be the first time I've been completely off of an antipsychotic in jeez at least two years. I'm also on Tegretol so that will hopefully provide enough mood stabilization.
>
> What I want to know is, what can I expect from discontinuing the antipsychotic? It's hard for me to say exactly what each drug I'm on does by itself, depression is so multifaceted. SO far I've decreased from 10mg to 5mg over the past week and I feel like my mood has already worsened a bit, but i'm hoping that in the long run my mind will feel more clearer and more natural without the Saphris.
>
> What have been people's experiences, subjectively, how it feels, etc. when they have discontinued an antipsychotic? Rebound mania, depression, etc.? Since antipsychotics affect thinking and cognition, did your cognition improve or worsen going off? Attention, motivaiton, etc.? Addictions and compulsions and obsessions improve or worsen?
>
> i"m very torn because I'm pretty sure I have an organic, biologically based brain disfunction, and if an antipsychotic can treat that, then perhaps I should be on it. But on the other hand, i've been on one along with other meds for years and I still feel the way I feel. Who knows, maybe I would have felt worse if I hadn't been on it? ALl the research I do brings up articles showing the positive effects these things have in the brain. On the other hand, it's yet one more chemical i'm adding to my brain, and it could be having some profound negative effects I can't really notice until I'm off. It's antagonizing dopamine, so maybe the antipsychotic is causing my anhedonia and low motivation. Maybe it's the reason why I don't seem to care about sex or being in a relationship. Maybe it's the reason I'm in my head too much. Maybe it's numbing my emotions so I don't get a chance to fully process my experience. I just don't know who I am anymore, with or without the drugs. I'm tired of playing God and will follow my psychiatrists instructions, but I am very torn about this decision. I hope some of you can understand my concerns, and can speak to your experience with antipsychotics.
>
> I just want to have the capacity to enjoy life again, to not feel so empty and dulled by life, to feel the positives AND even the negatives, and most importantly, to love. I feel like the illness or my nature or nurture somewhere along the line took away my capacity for love. For a girlfriend, for people, for God. I feel that part of my brain is broken and it makes me really sad, because i know how much love would help me.
>
> So yeah sorry for the stream of consciousness, but please tell me your experience of how you felt going off of an antipsychotic. Did it improve things or make things worse? Could you tease out the other effects it had on you besides just on general "mood"? I'm expecting some tough weeks, and won't be shy about asking to go on it again if things get really bad, but damnit there has to be more to life than just reliance on chemicals right? I am starting to go to AA for my medication obsession and other addictions so that is helping, i'm just on step 1, but I'm starting to realize that a big part of my depression is a spiritual malady that can only be solved by a right relationship with God. I'm trying hard and have been trying for years but i'm still getting stuck in old patterns, sin, self-pity, self-obsession. I want to get out of myself and am hoping that reducing my medication burden will help that, somehow.
>
> I don't know. Someone help me, i'm very anxious lonely and depressed right now. I keep hoping that med changes (either additions or removals) will be the answer, but they never seem to be. And yet I can't ignore the real effect changes do have on my mood. But maybe life is more than mood, etc.?
>
> So we'll see. LAst night was my last night on saphris. Please pray for me and share your experience.
> Uncouth
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