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SheltieUnderdog

Utterly intolerant to Antipsychotics, Strongly considering Lithium or Lamictal as Monotherapy for Schizoaffective Disorder.

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I've been on and off antipsychotics sporadically for the last 7 years since age 22 (since 2011). I'm extremely sensitive to them and have a very high response to every one I've been on. I've gained 145lbs from an increase in appetite and metabolic changes, have severe akathisia that is utterly insane and makes me want to cut my own legs off, I developed severe gynecomastia from Risperdal and Invega respectively (Won the Risperdal lawsuit, but no surgeon will touch me because of my weight), experience anxiety (The most on Abilify), fatigue, drowsiness, impotence (On Fanapt), anhedonia (From aggravated depression on Haldol), blurred vision (On Fanapt), lack of concentration, mild tardive dyskenesia (In combination with TMJ syndrome, I think it's permanent), dry eyes (Can't secrete my own tears), nasal congestion (aggravated, because I have it anyway without taking APs) , disorganized speech (Literally developed a speech impediment from a combination of Fanapt and Topamax), GI issues, etc

I've experienced almost every common recorded side effect from this category / class of drugs. The lack of control over my weight and appearance and the akathisia are the worst (that's why they're listed first and reiterated). These drugs have destroyed the relatively abysmal life I had before I developed this illness and presently cut it down to absolutely nothing. I have no life. I spend the majority of my life either going to multiple doctor's appointments for my medical issues or otherwise eating uncontrollably, and pacing back and forth and smoking cigarettes occasionally. I browse the internet with my thoughts racing. I might try to watch a TV show or play video games or play bass guitar like I used to but I can barely hold concentration or focus long enough. I want this to end, I really want out. I want to experience a fraction of life again.

I was previously diagnosed Bipolar 1 With Psychotic Features before my 2nd and most recent episode. As I said, I haven't taken APs consistently for 7 years. I've gone off of them twice for pretty significant periods of time before I relapsed. I usually last about 10 or 11 months (almost a year) without symptoms and perform consistently better in life in general with everything gradually going back in my life to when before I was 22. The side effects and depression usually disappear within a week. At 5 to 8 months I'm very stable, but in just under 11 months I start feeling like I'm on top of the world, become severely manic and delusional, hallucinate, experience an episode, and get into legal trouble. The 1st time around, I resisted arrest during a welfare check called in by my parents and went to the hospital and the 2nd time I successfully eluded the cops by motor vehicle on the highway and got caught hours later and went to county jail.

I understand I could be facing harsh consequences but I've never been on a heavy mood-stabilizer before. All they do is overload me with APs. After the 1st episode I stopped taking psych meds completely because of how much I despised how I felt except for Zoloft and resisted almost all treatment. I avoid SSRIs now and will this time because I think it may have been responsible for raising my mood too much before the 2nd incident took place.

The key to preventing future incidents for me, I believe, is to make the hallucinations and mania more tolerable to where I won't feel the need to act on them. The delusions are a joke, I can easily handle them. I'm currently taking Latuda 20mg and I'm requesting that my psychiatrist allow me to keep 2 or 3 bottles stored in my cabinet or 1 on me at all times in case any symptoms were to occur while taking Lithium. During the last episode, I was frantically searching for antipsychotics or any appropriate psych medication but didn't have them because I threw all of my former meds away after the first episode had taken place. This time I will have them to back me up and if it turns out that I need to suffer immeasurably on Latuda 20mg or another AP for the remainder of my life then so be it but I deserve a chance on a mood stabilizer simply because of what I've gone through and what I'm experiencing on APs.

Has anyone ever tried Lithium as monotherapy for schizoaffective disorder or bipolar 1 with psychotic features? I hear it still has some side effects (would like to know what all of those are) but that it's immeasurably more tolerable than antipsychotics. I realize many people use it in combination with an antipsychotic but this is not in reference to that. Is there anything better than those two that's not an AP? This post is simply to inquire about anyone's thoughts or experiences about using Lithium or Lamictal as monotherapy for schizoaffective mania. A dosage and frequency recommendation would also be appreciated from those that have taken it, although I realize that I will ultimately need my psychiatrist to determine that.

I found 1 study on this subject from the early to mid 1980's here: https://watermark.silverchair.com/10-1-30.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAAcYwggHCBgkqhkiG9w0BBwagggGzMIIBrwIBADCCAagGCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQMAypxqSBIPHx7kbXfAgEQgIIBeTskilYIIUxtfy4i-FH7a6BQ4SrsYxqZG44q7kWx1rVJdLbZ4PMxE33_FUje8rDj4FoUYJI27hYGzv-06pCL6xPDrbVg7n-g9QzqTwoPiRxgDv2VnqzwifudoudTuskAGEKItv5TfD1_V9opXCFF7vJXJln8ij8NeNkMLUpe_n-Xbp6TtkU7rXYdPCZ9dObhTfmQ4PEHkwKfcJcOVAjXzelMWD1EPzWPxCK5zu1l1d2w8ojnqH68mbvgaDuvBxyPTY-EEdADh9N0NIUPQCWHXZKWE2gEBsG_AbWS-bkPdgjxtXcn8Y_5KljQbU2Geb_ERYYWuWFMEk6CRs7FYte_16TOiCQVlahMabKxw0BdjlqvdGaPYZTKBoBWb9Poswigg8jbF1whmlo7WWRyCLCLdbKt4xkmZCU0qmv_j5FTFzeXsq05ptOFY10M3jpUft1xV75pMsPtVJ8U7d42OYqMksXhZyrA8B5k9XNhfJGS0XgmTTSLHNOdcTY2

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Posted (edited)

I know your scared of APs. I can understand. Haldol gave me the most severe EPS the hospital pdoc had ever seen and Abilify made me manic, which resulted in hospitalization. But you haven't tried EVERY AAP. I don't see seroquel,, clozapine, sahpris, valvyar. It's hard to imagine treatment of psychosis outside an AP? As for the mood stabilizers, if you have schizoaffective bipolar disorder, you should definitely be on one. 

Edited by CeremonyNewOrder

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Lithium and Lamictal might stabilize your moods, but they will do nothing for psychosis and will not affect delusions, hallucinations, etc. So being on lithium or Lamictal is like being on nothing with regard to psychosis.

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Posted (edited)
On 3/12/2018 at 6:01 PM, CeremonyNewOrder said:

I know your scared of APs. I can understand. Haldol gave me the most severe EPS the hospital pdoc had ever seen and Abilify made me manic, which resulted in hospitalization. But you haven't tried EVERY AAP. I don't see seroquel,, clozapine, sahpris, valvyar. It's hard to imagine treatment of psychosis outside an AP? As for the mood stabilizers, if you have schizoaffective bipolar disorder, you should definitely be on one. 

It's not that I'm scared of antipsychotics, more just sick and tired of their bull****. I see the whole guessing game thing as a waste of time because they're all basically a similar poison for me and a poison at that. I've heard of all the one's you mentioned except Valvyar. Still have you ever read the drugs.com reviews for all of these? There's not one of them that's not acknowledged for destroying multiple people's lives and people just discontinuing them abruptly because of the chemical torture. The only one I would even consider is Seroquel because that seems like somewhat of a compromise as it's used as a mood-stabilizer in the lower ranges and allegedly has less EPS side effects as an antipsychotic but I'm barely open to it because of the negative things I've heard about it including but not limited to extreme sedation. I certainly won't lose weight on it. I want to be one of the lucky few that can successfully manage schizoaffective disorder with Lithium alone. And if I'm taking an antipsychotic, I see little incentive to take a mood-stabilizer on top of it. For me, the less medicine I'm taking, the better I seem to function.

Edited by SheltieUnderdog
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15 minutes ago, jt07 said:

Lithium and Lamictal might stabilize your moods, but they will do nothing for psychosis and will not affect delusions, hallucinations, etc. So being on lithium or Lamictal is like being on nothing with regard to psychosis.

There's people throughout the internet and even on this forum stating it can effectively manage rage and mania and make hallucinations more tolerable if not practically non-existant for some. So from that aspect it has some type of alleged effect on psychosis. Furthermore I am not someone who believes that all drug types and diseases are "cookie cutter" like you're describing. Mental illness in general overlaps and is definitely gray shades rather than just a black and white interpretation like an incompetant psychiatrist would see it.

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1 hour ago, SheltieUnderdog said:

There's people throughout the internet and even on this forum stating it can effectively manage rage and mania and make hallucinations more tolerable if not practically non-existant for some. 

That's because they are likely bipolar I and not schizoaffective. If you are bipolar I, control the mania then you control the psychosis. It does not work for schizoaffective. I challenge you to find any post on this board that says you can control schizoaffective disorder with either lithium or Lamictal. You can't really even control bipolar I with just Lamictal. But I predict that you will ignore my warning and learn the hard way. It's your life. I certainly wouldn't want to get myself into any more trouble than I've already been in if I were you.

Furthermore, I take serious exception to describing a class of meds as "poison." That is an anti-med stance and is an attitude that we do not tolerate here. AAPs are life savers for many people on  this board, myself included. So I'm telling you now to watch how you characterize meds because you could be putting doubt into the minds of people whose meds do work for them.

Finally, be aware that you can find anything to support your position on the internet. The internet is far from a bastion of science.

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Posted (edited)
2 hours ago, jt07 said:

That's because they are likely bipolar I and not schizoaffective. If you are bipolar I, control the mania then you control the psychosis. It does not work for schizoaffective. I challenge you to find any post on this board that says you can control schizoaffective disorder with either lithium or Lamictal. You can't really even control bipolar I with just Lamictal. But I predict that you will ignore my warning and learn the hard way. It's your life. I certainly wouldn't want to get myself into any more trouble than I've already been in if I were you.

Furthermore, I take serious exception to describing a class of meds as "poison." That is an anti-med stance and is an attitude that we do not tolerate here. AAPs are life savers for many people on  this board, myself included. So I'm telling you now to watch how you characterize meds because you could be putting doubt into the minds of people whose meds do work for them.

Finally, be aware that you can find anything to support your position on the internet. The internet is far from a bastion of science.

Perhaps not regarding its effects on schizoaffective disorder, but here is a thread with someone, I believe Bipolar 1 With Psychotic Features eventually admitting that she could no longer tolerate APs to where she "was permitted a trial of anticonvulsants only" (not Lithium) and it being relatively effective at treating the psychotic aspects of her illness thus far. Like myself, she said that she would keep a bottle of antipsychotics nearby in the instance of a relapse.

Then there is my last topic which you had commented on and had ultimately provided me with inaccurate information as to why I was likely experiencing issues with extremely disorganized speech which was ultimately discovered to be caused by the drugs Fanapt, Topamax, and Gabapentin combined. I did formerly possess some basic issues with speaking but my condition had become far worse than it had ever been at the time of my post and you suggested that it was likely being caused by my illness with possible slight aggravation from Fanapt. The deterioration of my ability to speak clearly at that point was not just mild from what it had been previously. You refused to acknowledge this and listening to you would have ultimately led to a complete failure in resolving the issue I was experiencing. My psychiatrist (who took notice of my mental deterioration at the time on this combination of drugs) failed to identify the Topamax as the core of the problem itself. It was however, prescribed by my neurologist. 

Later on a user (who ultimately resolved my problem by suggesting the speech deterioration could be triggered by the drug Topamax) suggested that I had an intolerance to APs and upon asking him if Lamictal alone could be effective at treating psychosis, the user responded that Lamictal could possibly reduce my psychotic symptoms based on his own experience. He said there was a clinical study done which showed promise with Lamictal and schizoaffective disorder when the dosage reached 400 mg or higher, reaching considerable mood stability and complete remission from paranoid symptoms. He provided this reference. https://www.karger.com/Article/Abstract/26540

Edited by SheltieUnderdog

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Posted (edited)
12 hours ago, jt07 said:

Furthermore, I take serious exception to describing a class of meds as "poison." That is an anti-med stance and is an attitude that we do not tolerate here. AAPs are life savers for many people on  this board, myself included. So I'm telling you now to watch how you characterize meds because you could be putting doubt into the minds of people whose meds do work for them.

And for the record, I was only referring to antipsychotics as poison from my point of view and my own experiences only. I wasn't speaking for everyone. If someone wants to trial and error all 30 or 40 antipsychotics currently on the market and experience the same amount of torture I have thus far while taking them and they still feel that the positives outweigh the negatives and choose to tolerate it, then more power to them. I can support that. I'm not trying to discourage anyone from taking the entire class of antipsychotics except myself. If you would prefer that I sugarcoat and put gloss on my words even when making individualized statements like the prior one, then I will comply with that. That's all I would really need to do in order to not be seemingly "anti-med" considering the minor circumstances of what I said. Just remember, they are basically former tranquilizers, like Thorazine, one of the originals, which killed about 15 dogs in the testing process, yet got approved for the market, made the chemist famous and resulted in the "miracle drug" era of the 1960's and 70's which essentially introduced us to akathisia and the famous shuffle which the psychiatric professionals still cannot circumvent with any of the more current antipsychotic medication or counteract effectively over half a century in the future. It is true that I do not see this as one of the greatest advances in psychiatric history but at the same time I'm not anti-meds. If someone sees value in Thorazine, I would advise against it, but ultimately leave the decision up to themselves and their psychiatrist to prescribe and consume the drug. If Thorazine worked for them resoundingly well, I would applaud it. Just wanted to clarify that. 

Edited by SheltieUnderdog
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7 hours ago, SheltieUnderdog said:

And for the record, I was only referring to antipsychotics as poison from my point of view and my own experiences only. I wasn't speaking for everyone. If someone wants to trial and error all 30 or 40 antipsychotics currently on the market and experience the same amount of torture I have thus far while taking them and they still feel that the positives outweigh the negatives and choose to tolerate it, then more power to them. 

This is not a purely personal statement. You are assuming that everyone will experience the same "torture" you have. Then you go on to talk about killing dogs?

I don't think anyone here sugarcoats things. Trialling meds is a miserable process and side effects suck. But one of the reasons I come to these forums is so I don't have to read shit like this when I'm in a vulnerable state of mind. I need support staying ON my meds, not more reasons to go off them.

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1 hour ago, Juniper29 said:

This is not a purely personal statement. You are assuming that everyone will experience the same "torture" you have. Then you go on to talk about killing dogs?

I don't think anyone here sugarcoats things. Trialling meds is a miserable process and side effects suck. But one of the reasons I come to these forums is so I don't have to read shit like this when I'm in a vulnerable state of mind. I need support staying ON my meds, not more reasons to go off them.

I really wasn't assuming anything for anyone but myself. This is not a response to someone else, it is my own.

The mental health community should be entirely informed about all the positive aspects, negatives, and failures of any drug. We are adults, not infantile children. The internet should be as accurate as possible, not just a place to promote and sell miracle drugs, this is not a business.

It is a fact that Thorazine killed multiple dogs in the testing process and still got approved for the market out of desperation for a quick solution and I'm sure that you're aware that the elderly (about 65 and older) aren't even permitted to take antipsychotics at all because they could face potential death, severe deathly fatigue, and seizures themselves. These are known facts, any forthright psychiatrist or neurologist would tell you this.

I'm still not telling anyone not to take the drug (antipsychotics) if its working for them. I'm simply explaining its history as accurately as I can and reveal how it originated and evolved. It has a horrific beginning and the past is over and a known fact. I pretty much answered my own topic as to why myself, not you, am experiencing so much torture on a particular class of drugs and why I should try something different that could potentially work effectively at treating my illness to the point where I can avoid a future episode.

Popular definition of insanity is repeating the same thing over again and expecting different results. That is essentially what I was doing with antipsychotics. Their composition is too similar across the board for me to care about them anymore, for myself. For others, I have a different perspective, as I never would discourage safe trial and error or exploration in any way for someone else. 

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Thorazine wasn't created to be an antipsychotic. That was an accident. It's original use was an antihistamine. Many antipsychotics have antihistamine properties. Anyways, thorazine is rarely used anymore because of the side effects. It was also used IV as surgical anesthetic. It also stops hiccups if they go on long enough, for some reason..

But ending psychosurgery, lifetime institutionalization and whatnot, how horrible of antipsychotics!

And before I get bullshit this and bullshit that.Ya, thorazine sucks. It was the first, it obviously wasn't perfect. But it was a major breakthrough.

And yes, it sucks taking meds. It sucks having side effects. Akathasia is hell, and I know that from experience.  Cogentin is intolerable to me, its worse than EPS and akathasia, I take Artane. I take an older antipsychotic right now, fortunately no huge side effects. But I've had terrifying psychotic episodes where I've almost accidentally ended up dead because I was that out of touch with reality (running through my town in socks, jeans, t-shirt in the snow in -20 C weather until help came.. not my finest hour).

The thought of that is worse than any medication.

Quote

The potential use of CPZ in psychiatry was first recognized by Henri Laborit (1952), a surgeon and physiologist in the French army, in the course of his research with artificial hibernation in the prevention of surgical shock. In collaboration with Huguenard and Alluaume, he employed the drug as an adjunct to surgical anesthetics (“anesthetic cocktail,” “lytic cocktail”) because of its body temperature lowering effect. He found that CPZ, in the dosage of 50 to 100 mg given intravenously, produced disinterest without loss of consciousness and with only a slight tendency to sleep

History of Thorazine, peer reviewed

Chlorpromazine was synthesized in 1950 by the French pharmaceutical company Rhône-Poulenc, but was not originally planned to be a psychiatric drug.  The company was developing antihistaminergic drugs for use in a range of conditions including nausea and allergies.  A French surgeon and researcher, Henri Laborit, encouraged Rhône-Poulenc to develop an antihistamine with effects on the central nervous system as he believed this would be useful as a pre-anaesthetic agent given prior to surgery

History, easier to read

 

 

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Lithium is classified as an antipsychotic, BTW. Lamictal as an anticonvulsant. I am suspicious of people who say they are intolerant to whole classes of meds, meds that are not chemically related.

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2 hours ago, notloki said:

Lithium is classified as an antipsychotic, BTW.

While this is technically true and there are historical reasons for it, I don't believe and you don't see people with schizoaffective disorder or schizophrenia being treated with lithium as monotherapy. It just doesn't work for those illnesses. Yes, lithium can level the mood of someone with schizoaffective disorder bipolar type and it can reduce suicidality, but it will do little or nothing for psychoses that occur outside of extreme mood states.

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Maybe a dumb question - but I am assuming that in Schizoaffective disorder, psychosis occurs independent of mood?

On the other hand, I could see if someone had Bipolar-type schizoaffective (where psychosis develops from manic states) then Lithium could possibly prevent Mania and then the psychosis, right? Then you could also have an emergency PRN available.

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Posted (edited)
13 hours ago, San said:

Thorazine wasn't created to be an antipsychotic. That was an accident. It's original use was an antihistamine. Many antipsychotics have antihistamine properties. Anyways, thorazine is rarely used anymore because of the side effects. It was also used IV as surgical anesthetic. It also stops hiccups if they go on long enough, for some reason..

But ending psychosurgery, lifetime institutionalization and whatnot, how horrible of antipsychotics!

And before I get bullshit this and bullshit that.Ya, thorazine sucks. It was the first, it obviously wasn't perfect. But it was a major breakthrough.

And yes, it sucks taking meds. It sucks having side effects. Akathasia is hell, and I know that from experience.  Cogentin is intolerable to me, its worse than EPS and akathasia, I take Artane. I take an older antipsychotic right now, fortunately no huge side effects. But I've had terrifying psychotic episodes where I've almost accidentally ended up dead because I was that out of touch with reality (running through my town in socks, jeans, t-shirt in the snow in -20 C weather until help came.. not my finest hour).

The thought of that is worse than any medication.

 

 

The breakthrough could have been better than that, my god. Thorazine for myself, would be like a chemical lobotomy. I guarantee you that. The only praise I'll give to its creation is that it essentially made the chemical lobotomy only temporary and the effects can be reversed. It's not permanent anymore. Still, what difference does it make if you have to take them for a lifetime and feel borderline lobotomized for the rest of your life?

It killed domesticated animals in the testing stages. Also an accident. It's funny you mention the antihistamine properties. Whatever traces of that is in antipsychotics from when it was originally created must be residual ancient science because the majority of them have made my chronic allergies worse. No current allergist or otolaryngologist would use them for anything. Dry throat, inability to secrete tears, aggravated post-nasal drip, and endless violent sneezing to name a few of the things they have caused for me. And this is while on the newer atypical drugs. Further reinforces my argument that their basic composition is similar and they haven't come a long way in almost 70 years of evolution. Hiccups and acid-reflux are both worse for me on all of the antipsychotics I've tried. In my experience, the most effective remedy for hiccups is drinking water and not breathing for at least 15 seconds. 

The majority of the time, the side-effects from antipsychotics are so agonizing for me that I wish I could just be institutionalized without having to take medicine at all. Confinement would work for me if I were unmedicated the entire time. It did, as a matter of fact, when I was incarcerated and not taking the antipsychotics at all for a significant period. The psychiatrist on staff at the first jail I entered claimed my condition was a severe case of Bipolar 1 Mania With Psychotic Features, suggested a mood-stabilizer, and told me they reserved the use of antipsychotics in their facility for only "extreme cases" because the effects it would have on the inmates, primarily akathisia, would get inmates into fights over space and boundaries because of the constant movement. I only had some delusions over the course of this period, never hallucinated, and could tolerate my environment much better than if I were taking antipsychotics, so I was to find out later on.

It wasn't until I got extradited (it was a police chase spanning multiple counties) that another facility offered me a position in their mental health unit under the condition that I take my prescribed medication which turned out to be none other than low-dose antipsychotics. It was from that point which I developed the askathisia, became depressed, and started gaining weight again. I couldn't wake up in the morning (an effect of Zyprexa) to the screaming voices which were previously tolerable. The environment which was once a walk in the park for me became intolerable and I became scared of things that didn't phase me when I was unmedicated at the previous facilities. I wouldn't have done it if it didn't make my situation look better for my parole hearing, which was quickly approaching. Antipyschotics also seem to deter confidence and destroy courage and conviction for me, something that is essential to surviving jail and prison. They destroyed affect, making things completely flat.

And all the counteractive meds which I kind of believe they prescribe much more than anything else to benefit the drug companies than the patients, because they either don't work, or they're like placebo, and the patient just believes the condition has improved when it hasn't. Point is, they don't work for me and I'm aware they don't work. Been on Cogentin and Artane, they don't work. I'm not going to be conned into taking more incessant useless drugs. They either have no effect on me or knock me cold out and once I awaken, I have akathisia again and want to stuff my face. If they work for someone else, which I hear is usually minimal improvement of akathisia at most, then like I said, great for them. They don't work for me, the antipsychotics are simply too powerful to be overtaken by the counteractives.

You see, I already had metabolic problems to begin with before I developed my illness but I was able to fend off the weight gain until they started medicating me in 2011 at age 22. I used to be thin, in relatively good shape, I loved 80's music and aspired to become a professional bass guitarist. Now I'm seeing a Bariatric Surgeon to discuss Gastric Sleeve Surgery? Yes, damn right it's bull****. The illness "and" the antipsychotics destroyed everything. 145lb is a lot of weight for anyone on this earth. I pace all day and I'm morbidly obese on top of it.

I fear that I will become like Manuel Uribe, the worlds fattest man until his death in 2014, who weighed 1316lb at his peak weight as it appears I have no weight set-point on this class of drugs.     

Edited by SheltieUnderdog

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6 hours ago, notloki said:

Lithium is classified as an antipsychotic, BTW. Lamictal as an anticonvulsant. I am suspicious of people who say they are intolerant to whole classes of meds, meds that are not chemically related.

Look, I've tried almost all of them, enough to claim suspected intolerance to the entire classification. I don't even want to bother with Seroquel in the schizophrenic range because my intuition knows I'm just going to suffer through another trial period before I see my psychiatrist again. There must be some type of similar composition or chemical in every antipsychotic that is doing this to me. Every single ******* pill, which is allegedly different from the other one, as according to my psychiatrist, seems to have akathisia and severe weight gain as a side effect. Maybe it's the Dopamine Antagonism, who the **** knows? I don't care enough anymore to figure it out.

Are you suggesting Lithium over Lamictal? I haven't fully decided yet, but I was currently going to choose Lamictal because it reportedly causes notable weight loss in obese patients. I need some of that without an antipsychotic added to the concoction. The antipsychotic (if still present) would probably prevent weight loss from Lamictal which is why I must take a drug like Lamictal alone to get the desired effects.

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1 hour ago, Blahblah said:

Maybe a dumb question - but I am assuming that in Schizoaffective disorder, psychosis occurs independent of mood?

On the other hand, I could see if someone had Bipolar-type schizoaffective (where psychosis develops from manic states) then Lithium could possibly prevent Mania and then the psychosis, right? Then you could also have an emergency PRN available.

All I can say is that my psychosis has always occurred after days of mania and grandeur. I have no idea what classification I should actually have because I've received so many different labels from multiple so-called professionals over a short period of time. Like someone who's changed their hair color so many times and they forget the natural one. I think the assumption that it's plain schizoaffective at this point and treating it with antipsychotics is just them playing it safe and being unwilling to take a risk because of how much trouble I've gotten into. I mentioned the emergency PRN already. The last time I became psychotic, without the use of a mood-stabilizer, I was desperately searching for one.

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5 minutes ago, SheltieUnderdog said:

All I can say is that my psychosis has always occurred after days of mania and grandeur. I have no idea what classification I should actually have because I've received so many different labels from multiple so-called professionals over a short period of time. Like someone who's changed their hair color so many times and they forget the natural one. I think the assumption that it's plain schizoaffective at this point and treating it with antipsychotics is just them playing it safe and being unwilling to take a risk because of how much trouble I've gotten into. I mentioned the emergency PRN already. The last time I became psychotic, without the use of a mood-stabilizer, I was desperately searching for one.

Schizoaffective disorder requires psychosis to be present even in the absence of significant mood symptoms. That's my understanding anyway.

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Posted (edited)
24 minutes ago, Juniper29 said:

Schizoaffective disorder requires psychosis to be present even in the absence of significant mood symptoms. That's my understanding anyway.

I can't be anymore honest when I say that my psychosis has always occurred with mania. I experience the depression and suicidal thoughts when I'm on the antipsychotics and the opposite occurs when I'm not taking them, usually for almost a year. It's a revolving door and cyclical for me but I've never been on a heavy mood-stabilizer alone. The last time I was manic, and enjoying the feeling of it, screening came to my apartment (at the request of my mother) and suggested mood-stabilizers. They showed up too early (by a few days) and too late in a way as well to intervene successfully if a mood-stabilizer could have prevented what I had done that night. The day I began hallucinating, I was searching the apartment for Zyprexa out of desperation to make it stop, but I had unfortunately thrown it away months prior out of frustration and never wanting to take it again. I was going to drive myself to the hospital but my car wouldn't start because of the frigid temperatures (it was the middle of winter). I wound up walking over to my mother's townhouse and took her car and fleed, then she called the police and they were already waiting for me at the nearest hospital with knowledge that I was likely heading there (I spotted them from afar). So I chose to keep going until I reached a hospital where there was no police presence, by the time I did, 3 counties away, the cops caught up with me on the street before I could admit myself to that hospital and apprehended me. The story made the nighttime news.

Another thing I will mention about my psychosis, is that along with preceding mania, it also only seems to occur in extreme temperatures. When I resisted arrest before that in 2012, it was during a massive heat wave in July. If that sheds light on anything. I live in a temperate climate zone with noticeable change of seasons. Extreme temperatures in the winter and summer seem to be detrimental to me when I'm off the medication or it could have just been the timing.

Edited by SheltieUnderdog

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Sheltie, you’re treading very close to one of CB’s no-no’s, which is the categoric condemnation of an entire class of medications. You’re equivocating just enough that I’m going to give you a moment to take a deep breath, stop being combative, and redirect to your original question. You’ve had the chance to vent about APs. OK? So let’s talk about lithium, and lamotrigine.

I have bipolar l. It’s arguable whether I’ve ever been psychotic; I have been manic and sleepless long enough to hallucinate. Blows. If you’d care to read my signature and my list of current meds, you will see that I have earned my stripes on the med-go-round. In the course of doing so, I’ve discovered that sometimes it takes combos to make a med that was previously intolerable work for you.

If you’re any flavor of bipolar, then yes, you need a mood stabilizer. Lithium is the gold standard. It’s the first thing practically everyone with a new bipolar diagnosis gets prescribed. It’s cheap, there are decades of research on it. You need the occasional blood serum level test. Not a big deal. It’s very good for mania. Very good. If becoming psychotic after mania is a problem for you, then I think you might want to start there. 

You could try Depakote (divalproex sodium). It’s also an anti-seizure med. Good for mania.

Lamotrigine is a trickier medication. The titration is complicated. It can be very activating. You might even feel worse before you feel better. It’s the gold standard for bipolar ll, because that activating-y sort of feeling can have an antidepressant action, and bipolar ll has more depression than high-end mania.

I’ve not had great luck with APs. I take a small dose of Seroquel at night to help me sleep. As a day-to-day med I don’t need them; I’m not schizophrenic and don’t have SZA. But when I have a manic episode coming on, I eat APs by the handful until the symptoms stop, as PRNs, as per my pnurse’s directions. It’s what I have to do to keep myself from going nuts. 

You might find that with a mood stabilizer, you can manage without any APs, or that the quantity of them that you need is small enough that you can manage. So I encourage you to continue researching mood stabilizers. Ask questions about them. Ease up on the ranting. 

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13 minutes ago, Gearhead said:

Sheltie, you’re treading very close to one of CB’s no-no’s, which is the categoric condemnation of an entire class of medications. You’re equivocating just enough that I’m going to give you a moment to take a deep breath, stop being combative, and redirect to your original question. You’ve had the chance to vent about APs. OK? So let’s talk about lithium, and lamotrigine.

I have bipolar l. It’s arguable whether I’ve ever been psychotic; I have been manic and sleepless long enough to hallucinate. Blows. If you’d care to read my signature and my list of current meds, you will see that I have earned my stripes on the med-go-round. In the course of doing so, I’ve discovered that sometimes it takes combos to make a med that was previously intolerable work for you.

If you’re any flavor of bipolar, then yes, you need a mood stabilizer. Lithium is the gold standard. It’s the first thing practically everyone with a new bipolar diagnosis gets prescribed. It’s cheap, there are decades of research on it. You need the occasional blood serum level test. Not a big deal. It’s very good for mania. Very good. If becoming psychotic after mania is a problem for you, then I think you might want to start there. 

Lamotrigine is a trickier medication. The titration is complicated. It can be very activating. You might even feel worse before you feel better. It’s the gold standard for bipolar ll, because that activating-y sort of feeling can have an antidepressant action, and bipolar ll has more depression than high-end mania. 

You might also consider Depakote (divalproex sodium). It’s also an anti-seizure medication. Good for mania

I’ve not had great luck with APs. I take a small dose of Seroquel at night to help me sleep. As a day-to-day med I don’t need them; I’m not schizophrenic and don’t have SZA. But when I have a manic episode coming on, I eat APs by the handful until the symptoms stop, as PRNs, as per my pnurse’s directions. It’s what I have to do to keep myself from going nuts. 

You might find that with a mood stabilizer, you can manage without any APs, or that the quantity of them that you need is small enough that you can manage. So I encourage you to continue researching mood stabilizers. Ask questions about them. Ease up on the ranting. 

 

Hi, Thank You for answering my question directly.  I've been waiting patiently for that. How is Depakote in terms of weight gain, is it at least weight-neutral? I'm being cautious of Lithium because of the explosive weight gain I hear it can potentially cause. I've been prone to all weight gain from any medication I've taken that list it as a side effect. If Lamictal is the gold-standard for Bipolar 2, than it may fail for me despite the clinical studies I've posted claiming its effectiveness in treating psychosis at dosages reaching 400mg or higher. This was observed in 3 female schizoaffective patients it apparently worked on and caused remission of paranoid symptoms. I also have heard about it and witness it causing weight loss for the morbidly obese.

Depression is basically non-existant for me as I'm gradually building up to a psychotic episode. I simply become increasingly manic until the point I'm feeling pleasure from a lot of things to a point it's semi-euphoric. I can relate to your lack of sleep while enduring mania, I want to stay awake and just keep going through the night. My senses are more acute and my reflexes sharpen. I can read and recite things so fast. I'm so focused. Then I start becoming delusional and begin thinking my life was more complicated than it actually is in reality and start thinking the world or a large amount of people might revolve around me. Then I start thinking about acting on it and my mind starts racing and subsequently I develop some paranoia and the pleasantry starts dying away and is replaced by potentially terrifying hallucinations (mostly auditory). I found a way to tolerate this the last time by reducing ambient noise like TV's and the heater and going outside to try starting my car to drive to the hospital (car wouldn't start). As I said, the last time this happened I was sprawling for an AP (which usually goes into sufficient effect within an hour for me),  just didn't have any around because I threw them all out. My psychiatrist should have suggested a mood-stabilizer then and I would have had an answer to this dilemma by now as to whether a consistent AP is necessary. At that point he was just begging me to remain on the Haldol, I declined and dumped all my Zyprexa in the trash. My alternative plan to consistently taking antipsychotics could not be anymore cautious and preemptive than it is now. I just need to settle on a mood-stabilizer as a first choice, like I said I've been sequestered from them due to misfortune and bad timing and decisions. Now I'm planning to give it a full shot.

Thank you again for being informative and direct. Simple as that.   

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The problem is that you are trying to convince us now that you have bipolar disorder when the title of this (your) thread says quite clearly schizoaffective. I answered your question directly that neither lithium nor lamotrigine are treatments for schizoaffective and you will surely develop psychoses if you use only mood stabilizers to treat schizoaffective.

Finally, I do not believe your doctors are idiots, and therefore there must be a reason they diagnosed you as schizoaffective and noit bipolar i.

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Posted (edited)

I wanted to add though... Mania can really flip out your brain. Especially if the psychosis always occurs AFTER peak of intense Mania (and insomnia which can cause hallucinations). I had a somewhat similar experience to the OP. I will describe a personal experience regarding this. The first time I was hospitalized as a teen was after I had started my first psych medication (Zoloft). I had a bad reaction - became anxious, distressed, restless and couldn't sleep. (didn't tell the doc because I was told that it takes 2 weeks for you to "get used" to the medication and that it could cause side effects, sleep disturbance.)

Anyhow, after 5 nights of no sleep, I became manic/mixed and started having symptoms of psychosis/paranoia. After I was hospitalized, the doctors threw like 4 different diagnosis (from schizophrenic to schizoaffective, Bipolar etc...(I only had a history of anxiety & depression, never any mania before). They threw antipsychotics at it (and made me stay on them way long after the episode has subsided) but I reacted like the OP, sedated, depressed, flat. Over time, my diagnosis was changed. Other doctors confirmed that this episode was in fact, Med-induced.

My doctors in the hospital (including my initial psychiatrist) all told me that Zoloft NEVER causes psychosis. When if you read the side effects - it says that this is possible, especially in teens! So sometimes doctors can give you the incorrect diagnosis - they make mistakes and they've never probably tried any of these meds, they can't memorize every possible side effect. Especially if you've only seen 1 doctor, its always good to get several opinions! And let someone get to know you over time before slapping a lifelong diagnosis on you.

I think OP would be worth trying Lithium to prevent mania - I hear that Depakote can cause more weight gain. Lamictal is more helpful for depression (less for stopping mania)..

Edited by Blahblah
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4 hours ago, jt07 said:

The problem is that you are trying to convince us now that you have bipolar disorder when the title of this (your) thread says quite clearly schizoaffective. I answered your question directly that neither lithium nor lamotrigine are treatments for schizoaffective and you will surely develop psychoses if you use only mood stabilizers to treat schizoaffective.

Finally, I do not believe your doctors are idiots, and therefore there must be a reason they diagnosed you as schizoaffective and noit bipolar i.

I'm not trying to convince you or anyone else of anything, I'm trying to get additional opinions based on the most accurate reenactment of my symptoms that I'm capable of giving. The reason I chose this thread is because it matches the most recent diagnosis I was given (although questioned by my current psychiatrist, as he's not entirely certain) and I thought I would face more discrimination posting an identical topic within the Bipolar Disorder Thread because potential Schizoaffective Disorder is simply a different animal. I wanted to encounter more individuals who were diagnosed with both disorders actually and render an answer based on everyone's responses, not just yours. You have the right to answer my question, but I also have the right to respond with skepticism. I was using more caution by posting here but made it clear from my original post that I was formerly diagnoses as Bipolar 1 With Psychotic Features by multiple professionals, instructed to take mood-stabilizers alone by professionals, and was unsure about my exact mental disorder myself. I was under the assumption that I was safer posting my question in here and if anyone diagnosed with Bipolar 1 or Schizoaffective Bipolar Type were to catch eye of this and possessed any knowledge that could help me, they would post here and try to help me. I also thought they would at least acknowledge the clinical studies and references I posted about how mood-stabilizers alone "can" treat Schizoaffective Bipolar Type when they reached certain dosages. You seem to be nearly oblivious to anything I have said, and continue to give the same black and white answer. I personally think that's why were conflicting here. I see everything including mental illness in multiple shades and you are simply more black and white, bar none.

Furthermore, I don't recall ever saying that my doctors were idiots within this thread or even alluding to it. I've admittedly done it in the past on here but I was careful not to vent on them this time around. If you can show me evidence of me directly calling any of my doctors idiots, it was done completely by accident and in error of how I actually feel about my current doctors. I'm frustrated with them but I don't exactly see them as  complete idiots.

And it's funny that you mention my doctors in the plural value rather than just single out my current psychiatrist or neurologist. I'm sure yourself, like almost all others on CB Forums do not intend for your medical opinion to be placed over a professional one. As I said, there were several "doctors" in the jail system who were observing me directly after my incident took place who said it was Bipolar 1 With Psychosis Aggravated By Severe Mania. I said this from the beginning. They had seen and heard of the incident that took place on the nighttime news and were talking to me before they made an analysis, drew a conclusion, and prescribed any medications. My diagnosis had been previously Schizoaffective and Bipolar 1 With Psychotic Features preceding that. I realize that this doesn't apply to your most recent response, but are you essentially stating that because you deemed my issue as plain Schizoaffective Disorder that I should only listen to the psychiatrists claiming that it's likely plain Schizoaffective Disorder first, you second, and the psychiatrists claiming it was Bipolar 1 With Psychotic Features last based on your own analysis? Are the professionals claiming it was Severe Mania stupid to believe that it could be Bipolar 1 by this point in time? If my current psychiatrist were emphasizing BP1 only would that make him idiotic?

I think I'm doing a lot of my own legwork in discovering what is actually wrong with me where my doctors have failed or simply aren't interested in immersing themselves any further into my own mind. There simply hasn't been enough psychoanalysis to warrant what any of them are saying about me really. The longest I've ever spent with a psychiatrist in a single appointment is 35 minutes (5 minutes over the maximum time allowed by the agency). I'm currently trying to find a private psychiatrist who will take my insurances.

With that said, while I'm no longer condemning antipsychotics in any way, I believe that the diagnosis's of schizophrenia and schizoaffective should be extremely reserved for only utterly extreme and highly repeated cases (3 or more). Not just 2 incidents where someone still retained lucidity during the immediate evaluations without sufficient psychoanalysis done at any point. Psychiatrists should simply be required to do more work when labeling someone as schizophrenic or schizoaffective rather than just an average 15 to 25 minute interview and slap someone with the label because they have so many patients. Imagine someone who is being wrongly labeled as schizoaffective and being required to take antipsychotics which they're intolerant to because the psychiatrists spent so little time analyzing that specific patient and just tossed them into a wide-bracket cesspool without thorough justification? Imagine how much that patient has to potentially suffer (if they have an intolerance) when they were really just BP1, BP2, or something else overlooked? Psychiatrists should be forced to research to the situation until they can do no more.There should be a criteria that's 5 miles long just to reach the conclusion of schizophrenia. Just my 3 cents on that. 

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9 hours ago, Blahblah said:

I wanted to add though... Mania can really flip out your brain. Especially if the psychosis always occurs AFTER peak of intense Mania (and insomnia which can cause hallucinations). I had a somewhat similar experience to the OP. I will describe a personal experience regarding this. The first time I was hospitalized as a teen was after I had started my first psych medication (Zoloft). I had a bad reaction - became anxious, distressed, restless and couldn't sleep. (didn't tell the doc because I was told that it takes 2 weeks for you to "get used" to the medication and that it could cause side effects, sleep disturbance.)

Anyhow, after 5 nights of no sleep, I became manic/mixed and started having symptoms of psychosis/paranoia. After I was hospitalized, the doctors threw like 4 different diagnosis (from schizophrenic to schizoaffective, Bipolar etc...(I only had a history of anxiety & depression, never any mania before). They threw antipsychotics at it (and made me stay on them way long after the episode has subsided) but I reacted like the OP, sedated, depressed, flat. Over time, my diagnosis was changed. Other doctors confirmed that this episode was in fact, Med-induced.

My doctors in the hospital (including my initial psychiatrist) all told me that Zoloft NEVER causes psychosis. When if you read the side effects - it says that this is possible, especially in teens! So sometimes doctors can give you the incorrect diagnosis - they make mistakes and they've never probably tried any of these meds, they can't memorize every possible side effect. Especially if you've only seen 1 doctor, its always good to get several opinions! And let someone get to know you over time before slapping a lifelong diagnosis on you.

I think OP would be worth trying Lithium to prevent mania - I hear that Depakote can cause more weight gain. Lamictal is more helpful for depression (less for stopping mania)..

I don't know if you read everything I had said, but I was also on Zoloft at the time of my 2nd psychotic episode and that was literally all I was taking. My experience differs later on when I revealed this to a psychiatrist at one of the county jails during my little journey. He acknowledged that anyone with Bipolar 1 or Schizoaffective Disorder should avoid Zoloft like the plague when taken by itself while those illnesses are present. He simply said it raises someone's mood gradually too much and can eventually generate psychosis, even if they're just BP1. I listened to him carefully after that and will never take any SSRI, including Zoloft ever again. It's not worth it for myself.

Thank you for the additional information on mood-stabilizers. I'm going to relay all I've learned to my psychiatrist at my following appointment next week in order to make the best decision possible.

Edited by SheltieUnderdog

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