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Schizotypal Personality -- medication

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Hi everyone!

My name is João, I'm 30, and I live in Lisbon, Portugal.

I was diagnosed with schizotypal personality disorder traits when I was 23.

My first visit to a psychiatrist occured in 2001 when I was 19 because I had severe social anxiety.

I feel like I have some latent psychosis, i.e., I've never experienced full blown paranoia or hallucinations (I mean, the more "visible" part of a psychosis), but I do suffer from emotional detachment, obsessive ruminations, magical thinking, a tendency to social withdrawal. [i've also mostly been medicated with a low dose antipsychotic since 2005 as an adjunct to antidepressants.]

I've tried 7 different college courses with no success during these 12 years. I always ended up quitting. Now I'm confined to my house. I still live with my parents and I don't work. I want to start a life project but I now feel extremely lethargic, apathetic, depressed.

I'd like to try new medication to help me get started. My pdoc precribed me Zeldox / Geodon 40mg (one at lunch) but I felt so drowsy that I stopped taking it (he said it would be activating). He thinks other options would be Abilify or Invega. I've tried Abilify some years ago (but I don't remember why my older pdoc decided to switch).

I understand medication is not really the solution but I feel it could help me on the short term.

Thank you for reading.

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Hello, welcome!

Most or all of the symptoms you list are not psychosis. Which is good news.

How long did you take the Geodon? Most meds take quite some time to get used to (like several weeks to months).

If it was sedating, did you try taking it after supper or at bed time?

*These medications your doctor is recommending CAN be part of the solution, although nothing is a cure. They can help bring the anxiety under control which will allow you to be more active.

Other things you can do to improve:

-Regular sleep hours with good sleep

-Regular meals

-Get some exercise every day

-Get outside get some sun every day

-Be with people who make you happy

-Take your medications every day

-Consider seeing a talk therapist

-Make a plan of achievable goals each week

Do the things you can, and don't get upset about what you cannot do.

Regards, a.m.

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Thanks for your reply, AirMarshall! ;)

I took Geodon for 2 days only and explained my doctor I had stopped due to extreme drowsiness.

My reaction to this medication was not normal (I know it's common to cause drowsiness, but I've taken several different antipsychotics in the past and I don't remember anything close to this). I've tried Seroquel 50 (a relatively small dose) one month before Geodon and I also had a strange reaction to it, feeling suicidal (it seemed to have aggravated my depression so I had to discontinue Seroquel). And I remember taking Seroquel before.

I've tried Abilify and Socian (Amisulpride) in the past. I don't know why my doctor changed that medication though. I also used Serdolect (Sertindole) 4 mg: this one was also not sedating to me but caused me sexual dysfunction: otherwise it worked well.

It's important to me that I take something activating rather than sedating now because I already have low levels of energy at the moment. Anxiety is not a concern at the moment.

Thank you for taking the time to read.

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OK, I understand that you have tried several medications.

-Insisting on an activating medication, is not reasonable. You may find one that is somewhat activating, but that is not how they are designed to work.

-Barring any truly bad side effects like mania, psychosis, etc. it takes time for the body to adjust to new medications often weeks. It is important to make an honest effort to accommodate the side effects, and not just drop medications after just a few days.

Medication changes are seldom pleasant, but don't give up hope. There are so many good medicines.

a.m. :)

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Thanks for your advice, AirMarshall,

I'll give Zeldox / Geodon a new try but at 20 instead of 40 mg (to start).

Maybe 20 is enough for me. I'll talk to my doctor about that.

(However, 20 mg is not commercialized at the moment in Portugal: it is approved but not on sale... and it's a capsule which makes it difficult to divide)

I'll keep you posted. Bye!

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Guest Vapourware

I found ziprasidone [Zeldox] pretty sedating as well, so I used to take it at night. Maybe switching it to night will help?

Amisulpride has good anti-depressant qualities, so if ziprasidone doesn't work out, you could look at Amisulpride again.

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To keep you updated: I've taken ziprasidone (Geodon / Zeldox) 20 mg at night and it didn't make me as extremely drowsy as the other time I tried it (it's half the previous dose). It gave me mild akathisia 2 hours after I took the capsule. Then I had to go to bed because I felt very, very tired. I slept for 14 hours (had some unusual vivid dreams... probably because of the medication: the other time I had nightmares).

I still feel very groggy. I'm going to take a cup of coffee now. I wonder how people who take 80 mg or more do it!

[update] I'm feeling very, very depressed and I can only attribute it to Geodon. Should I stop taking it again and talk to my doctor? I don't want him to think I'm not collaborating. Maybe this feeling goes away? First a deterioration of symptoms and then it gets better? I guess I should keep taking it as prescribed to see how things go.

Thanks for reading!

Edited by joao_carrilho
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I took Geodon for 2 months before giving up on it. I went up slowly to 80mg and omg... the drowsiness and sedation was more than I could handle. I was 'hungover' from it the better part of a whole day, even though I took them at night. I couldn't drive safely while taking it, and it made my performance at my job suffer greatly due to its cognitive effects. I gave up and was switched to Abilify at the time, which didn't make me drowsy, but also did not activate me.

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