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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 Christ_empowered on October 6, 2013, at 8:59:18
Yet another post in which I ask for treatment advice, lol.
So, I'm 29. I've had bouts of psychotic depression since high school. I had a severe psychotic manic episode @ 23. In between episodes, I'm prone to anxiety, agitation, etc. Non-violent, melancholy temperament to some extent. Used to be the most socially phobic hot mess around...that's resolved, largely because of growing up and also Orthomolecular (those massive niacinamide+taurine doses really calm you down).
I take Abillify @ 20mgs/day. This is down from 30mgs/day. I used to be diagnosed as Schizoaffective, Bipolar type. I was on 30/Abilify and 20/Celexa. Thing is...I respond to anticonvulsants in such a way that I guess my doc just went ahead and called it Bipolar. Also, she was trained in Europe (they tend to have a broader view of what constitutes "Bipolar" in Europe, from what I've read). There may also be social class issues involved...my upper middle class, white collar family is behind me, so that lends a degree of "respectability" to me and my "crazy" (minorities and poor people are diagnosed with Schizophrenia and Schizoaffective at a higher rate than middle, upper middle, and upper class people and white people).
OK. So now its 1200/Trileptal, 20/Abillify, and up to 300/Neurontin. My Q is: do I really require a daily antipsychotic forever? Don't get me wrong; Abilify isn't terrible. Especially at 20mgs (although I have 30mgs tablets lying around and I'll take them if I get creepy-crawly feelings or intense agitation) its clean, no EPS, no dysphoria or drug-induced depression (as best I can tell...), and it caused weight gain, but not on the level I'd have gotten from risperdal, seroquel, zyprexa, etc.So...yeah...if you need a full-dose AAP/AP, I recommend Abilify. Gets the job done with fewer side effects, as best I can tell.
My issue is the long haul. I mean, there's Tardive dyskinesia, tardive akathisia, tardive dystonia, and...the one I really dread...."tardive dementia."
One reason I'm doing hardcore Orthomolecular (I use somewhat higher doses than old school Orthomolecular and I threw in additional antioxidants) is to prevent the dreaded TD. So far, so good; I don't even have a stiff gait, which was **always** a problem with **any** AP/AAP at an effective dose before the Orhtomolecular.
I just wonder if I need to take an antipsychotic FOREVER. Some research from Yale on the older APs indicates that, with enough exposure, the majority of patients develop some degree of TD. Of course, that could be because of heavy-handed use of Haldol and other high potency old drugs (Prolixin comes to mind), especially in depot form, but...still....
...also, I read that Abilify isn't the best when it comes to TD. That's perfectly terrifying, honestly. Its tolerable, but it can cause TD that'll sneak up on you. How scary is that?
Posted by Phillipa on October 6, 2013, at 9:53:14
In reply to treating Bipolar w/Psythotic Features, posted by Christ_empowered on October 6, 2013, at 8:59:18
I don't honesty know. Does anyone really know this? I think time will tell. And maybe new treatments? Not necessarily meds. Also a girl I attended high school with her husband is a pdoc and she says he works a lot with nutrition and had suggested that I go to Duke evidently they are working with nutritional supplements also. Have you considered Duke? Phillipa
Posted by sigismund on October 6, 2013, at 14:23:53
In reply to treating Bipolar w/Psythotic Features, posted by Christ_empowered on October 6, 2013, at 8:59:18
>I just wonder if I need to take an antipsychotic FOREVER.
I don't think you should assume so. These things come on people at certain ages, early 20s ususally. Perhaps they pass?
Posted by Zyprexa on October 10, 2013, at 21:34:21
In reply to treating Bipolar w/Psythotic Features, posted by Christ_empowered on October 6, 2013, at 8:59:18
Abilify gave me horrible TD in shaky hands. Seems to be going away now that I've been on perphenazine for the last 6 years. Was only on abilify for 6 months.
I still get shaky sometimes and I'm not sure what causes it. Nerves, Abilify or perphenazine. It seems to be somewhat controlable but not all the time.
Posted by bleauberry on October 13, 2013, at 17:35:36
In reply to treating Bipolar w/Psythotic Features, posted by Christ_empowered on October 6, 2013, at 8:59:18
You might want to take a look at what the psychiatric presentation of lyme disease looks like, how it is described.
I am a chronic treatment resistant depression patient who go mostly better but not from any of the psych meds. It was from antibiotics. Along the journey I became an expert on what various aspects of stealth hidden infections can look like in terms of psychiatric symptoms. And there are patterns. In my case for example Bartonella was the big one, a common co-infection carried by ticks and and similar to cat scratch fever. It really messes with the brain bad, and causes symptoms and histories that pretty much look like yours and mine.
Anyway.
This is the end of the thread.
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