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Hello all,

I was diagnosed with Psychotic Disorder NOS about two months ago, and have been taking 3mg Risperdal twice daily. I have two questions, one, whether I really am psychotic or not, and two, why I am still having paranoia even on the Risperdal.

The "psychotic episodes" that I had did not involve visual, auditory, or tactile hallucinations; they were just, for lack of a better word, "impressions" of a person being next to me, or possibly being next to me. Cognitively I could process that no one was really next to me, and I would check just to be sure, but these thoughts didn't shake the impression. Further, these were related to an OCD obsession I was having at the time, and I'd never had psychotic episodes before.

As for the paranoia, it still creeps out from time to time. Once I was in a train in Canada paying for my meal when the attendant noted that I hadn't signed the back of my debit card. Somehow this gave me the idea that the attendant might look down on me as an American in Canada. Then, for the rest of the train ride, I kept thinking that everyone on the train was staring at me; I could check them to verify that they really weren't, but this reassurance lasted only a few seconds. Then one day I was driving the car and got very anxious, and an image appeared in my mind of a picture of a girl that doesn't like me staring into the camera. I got the uncomfortable feeling that she and the other drivers were staring at me even though, again, I could process that that was not true. Both of these incidents occurred after I took a normal dose of Risperdal,

So what is going on? I know that no one on this site can say for sure, but maybe you have some experience with these symptoms?

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No one here can diagnose you. Your doctors have a much fuller picture of what's going on with you, and vastly more training, than anyone here possibly could. That said, what you're describing doesn't necessarily sound that much like psychosis to me. If you're having significant doubts about your diagnosis, a second opinion might not be the worst idea.

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I can't say what's actually go on but I'll ramble for a little bit. It is possible to be in the middle ground of psychosis where you completely believe and also disbelieve. It's like being of two minds. It's a strange place. It's also possible that Risperdal is not completely controlling your symptoms. Your dose is high enough. It might just not be the antipsychotic for you. All that said, it's possible for extreme OCD to present something like psychosis. So, maybe your diagnosis is not so clear cut. A serious conversation about the two with you pdoc could be beneficial and productive. I'd go there first, but also can't see how a second opinion by someone experienced in both psychosis and OCD would hurt. If not that, then a change in meds. In the end, it could be that your diagnosis is correct and you are questioning like most people do. Anyway, a little investigation couldn't hurt. However, since you are still experiencing symptoms now, call to your pdoc about the ones you are having today.

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I can't say what's actually go on but I'll ramble for a little bit. It is possible to be in the middle ground of psychosis where you completely believe and also disbelieve. It's like being of two minds. It's a strange place. It's also possible that Risperdal is not completely controlling your symptoms. Your dose is high enough. It might just not be the antipsychotic for you. All that said, it's possible for extreme OCD to present something like psychosis. So, maybe your diagnosis is not so clear cut. A serious conversation about the two with you pdoc could be beneficial and productive. I'd go there first, but also can't see how a second opinion by someone experienced in both psychosis and OCD would hurt. If not that, then a change in meds. In the end, it could be that your diagnosis is correct and you are questioning like most people do. Anyway, a little investigation couldn't hurt. However, since you are still experiencing symptoms now, call to your pdoc about the ones you are having today.

Thanks Stacia.

Unfortunately, my next appointment with the pdoc is in two weeks. However, I did talk to her about these things when I visited her yesterday, and she a) kept all my medications the same and b) suggested that it might be OCD, and that we'd finalize things at the next appointment. So I suppose we'll wait until then to see?

Going back to the train episode, I took an extra Risperdal, but that didn't help with the paranoia/feeling of being stared at [not sure if I mentioned that in my original]. So maybe another anti-psychotic would relieve those symptoms, you think? Again, keeping in mind that no one can say for sure except the doctor.

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