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pDoc recommends that I stay on the meds...


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New to the forum!

Basically I have begun the process of weaning off 10mg Abilify (currently been taking 5mg for the past 4 days... so far all good) so now the question is how long to stay on the 5mg for? pDoc would prefer me to stay on the medication longer but i'm just getting sick of it all... Ill give you some more background information!!!

I had my first psychotic episode while on holiday in Vietnam (16th of March) ... a combination of weed (I only had one puff though), very high temperature, lack of sleep (that got worse as the psychosis developed) and not eating. Basically I got to the point where I believed that I was in the devil's part of the world and that all people food and water were contaminated... so no eating, drinking or sleeping! so I booked a flight back to Australia and somehow made it back!

Once I made it back to Australia it was clear that things weren't right so I was initially medicated on 15mg of olanzapine... after 3 months I tapered down to 10mg and then a month later I switched to 10mg of abilify!

Initially the abilify was HELL!! restless, agitated, hard to sleep but all the symptoms have gone away (thankgod!) and now I sleep like a baby (too much actually).

I am stable and have been for a long while (the almost 6 months i've been medicated)...well the whole time actually... and I have been diagnosed with first episode psychosis (and has been regarded by the pDoc as a rather short episode also)


My current situation is that the pDoc wants me to stay on the medication a little bit longer to prevent a 2nd episode from occuring... my thinking is that I want to get off abilify to stop any long term effects from the medication and generally just get back to "normal" or lets just say whatever the "new normal" may be. I've never liked the idea of being on medication and would rather risk the chance of a 2nd psychosis episode than being uncomfortable (with brain shrinkage and all the negative cognitive effect of APs) taking abilify for a longer amount of time.... I just don't want permanent side effects (or anymore at this stage)

Would love your opinion on my situation!!!!!

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Hi, welcome to crazyboards.

 

I'm sorry you had a psychotic break.  That must have been terrifying, in a foreign country.

 

In terms of your meds... I would say stay on them a while.  But you could consider talking to your pdoc about switching to a different aap because there are some that are not as sedating.  I just started Latuda and am loving it.  No restlessness, weight neutral, makes me sleepy at night but I wake up early in the morning.  

 

I'm not sure how bad long term AAP use is on your brain, but remember that having a psychotic break is also bad for your brain.  It literally eats away at your grey matter.  

 

It is definitely possible that you will just have one psychotic break in your lifetime.  That happens sometimes.  I was pretty sure that would be the case with me... I went off meds, and about a year and a half later had a second psychotic break... went off meds again and had a third about a year and a half after that... so now I take my meds.  

 

From what I gather, having a breakthrough psychosis seems to make it easier for it to happen again, so it might be important to stay on meds a while so that you don't start creating a new pathway in your brain for psychosis.  

 

In general I would tell your pdoc that you want to eventually go off of meds, but I would also listen to him if he said to stay on them a while longer.

Edited by koakua
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The risks of brain rot from meds are seriously oversold to fearful  consumers !  As koakua says, severe episodes of MI

are just as if not more risk to the grey matter (and all the rest of the brain).    Erring on the side of caution coming off the

drugs will minimise the chances recurring psychotic episodes ... so will staying well away from weed, alcohol and any

other mind messing nasties. 

 

If you are reasonably bright you will be able to research this stuff to exhaustion if you want or need to.    You will no

dought discover that no one would consider that a second psychotic episode is prefferable to continuing preventative

meds... especially if they have controlled or eliminated symptoms.    

 

Go slow and safe, every psychotic episode inceases the risk of another ... and the destructive potential for your brain

and your life is considerable.

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Please post some credible research showing atypical antipsychotics like Abilify cause brain shrinkage. PubMed is the US National Library of Medicine. It provides free access to the abstracts of most medical and mental health research. The link is http://www.ncbi.nlm.nih.gov/pubmed That would be a good place to research your atypical antipsychotic brain shrinkage theory.

 

The research that I am aware of shows that atypical antipsychotics (and antidepressants) promote neurogenesis (birth of new brain cells). For example, this research http://www.ncbi.nlm.nih.gov/pubmed/17696572 On the other hand, psychosis causes brain damage. I think you have your facts mixed up.

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Hi, welcome to crazyboards.

 

I'm sorry you had a psychotic break.  That must have been terrifying, in a foreign country.

 

In terms of your meds... I would say stay on them a while.  But you could consider talking to your pdoc about switching to a different aap because there are some that are not as sedating.  I just started Latuda and am loving it.  No restlessness, weight neutral, makes me sleepy at night but I wake up early in the morning.  

 

I'm not sure how bad long term AAP use is on your brain, but remember that having a psychotic break is also bad for your brain.  It literally eats away at your grey matter.  

 

It is definitely possible that you will just have one psychotic break in your lifetime.  That happens sometimes.  I was pretty sure that would be the case with me... I went off meds, and about a year and a half later had a second psychotic break... went off meds again and had a third about a year and a half after that... so now I take my meds.  

 

From what I gather, having a breakthrough psychosis seems to make it easier for it to happen again, so it might be important to stay on meds a while so that you don't start creating a new pathway in your brain for psychosis.  

 

In general I would tell your pdoc that you want to eventually go off of meds, but I would also listen to him if he said to stay on them a while longer.

 

Thanks for your reply? If you dont mind I'd like to know more about your psychosis to help with my situation if possible :)

How long was your psychosis and do you know what triggered it?

How long after the psychosis did you take anti-psychotics before your stopped?

Was it at the 2nd episode of psychosis that they gave you a diagnogsis?

 

Thanks for your help!!

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Please post some credible research showing atypical antipsychotics like Abilify cause brain shrinkage. PubMed is the US National Library of Medicine. It provides free access to the abstracts of most medical and mental health research. The link is http://www.ncbi.nlm.nih.gov/pubmed That would be a good place to research your atypical antipsychotic brain shrinkage theory.

 

The research that I am aware of shows that atypical antipsychotics (and antidepressants) promote neurogenesis (birth of new brain cells). For example, this research http://www.ncbi.nlm.nih.gov/pubmed/17696572 On the other hand, psychosis causes brain damage. I think you have your facts mixed up.

 

I dont have any credible research and its probably just mis-information all over the internet... who knows!

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Well, the risk you balance against is that a second psychosis increases the risk for third and subsequent psychoses.

 

About a third of people with first psychotic episodes have purely drug-induced psychosis. About a third have a single episode of psychosis with no clear underlying cause. And about a third have an emerging thought disorder (schizophrenia or the like).

 

You know yourself best.

 

And your pdoc knows meds best.

 

The desire to get off meds is helpful, but only if you won't have to go back on them due to a second episode.

 

ETA: Here's a current thread that might be of interest to you: http://www.crazyboards.org/forums/index.php/topic/66193-chances-of-coming-completely-off-meds-from-psychosis/#entry684647

 

I'm going to merge these two threads, as I didn't realize you had posted the same thing in two places.

We ask members to only post once instead of multiple times on the same issue to help keep answers consolidated in one place.

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  • 2 weeks later...

Im pretty sure atypicals cause brain damage. For one either zyprexa shouldnt be an atypical (but it is) or the atypicality categorization might not be fully or simply relevant towards brain mass volume reduction. Olanzapine causes almost as much as haloperidol according to one study and since it is a strong medication I believe its true. Risperidone is an equally strong medication, but according to my pdoc it causes much less, like 1/5 of what haloperidol causes. Abilify would probably be around there, but honestly I think it causes a little more than 1/5 of haloperidol.

Edited by konings
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How do you get to the full articles on PubMed?  I keep clicking links and they just give a short summary about what the paper is about.  I can't seem to figure out how to get the whole article. 

 

Please post some credible research showing atypical antipsychotics like Abilify cause brain shrinkage. PubMed is the US National Library of Medicine. It provides free access to the abstracts of most medical and mental health research. The link is http://www.ncbi.nlm.nih.gov/pubmed That would be a good place to research your atypical antipsychotic brain shrinkage theory.

 

The research that I am aware of shows that atypical antipsychotics (and antidepressants) promote neurogenesis (birth of new brain cells). For example, this research http://www.ncbi.nlm.nih.gov/pubmed/17696572 On the other hand, psychosis causes brain damage. I think you have your facts mixed up.

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Please post some credible research showing atypical antipsychotics like Abilify cause brain shrinkage. PubMed is the US National Library of Medicine. It provides free access to the abstracts of most medical and mental health research. The link is http://www.ncbi.nlm.nih.gov/pubmed That would be a good place to research your atypical antipsychotic brain shrinkage theory.

 

The research that I am aware of shows that atypical antipsychotics (and antidepressants) promote neurogenesis (birth of new brain cells). For example, this research http://www.ncbi.nlm.nih.gov/pubmed/17696572 On the other hand, psychosis causes brain damage. I think you have your facts mixed up.

 

Here's one, from the Archives of General Psychiatry, which is not a minor publication:     

Long-term antipsychotic treatment and brain volumes: a longitudinal study of first-episode schizophrenia.

It's a disconcerting read for me, considering I am on antipsychotics.

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I've also read that article some time ago and it really put me on the verge of a crisis. I have been under an AAP for some time now and it is no fun at all to read that it can actually affect the brain volume. Not sure how to interpret that but it does not sound reassuring. Is there any other article that elaborates in this subject, positively or negatively?

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  • 3 weeks later...

The key issues in longitudinal studies are that they have no controls and no double blind structure.   The reason that there are no truly objective studies is that the positive effects of the neuroactive drugs so far out weigh the supposed negative effects that it is ethically indefensible to with hold them from any group of patients.               And note that the claimed negative brain studies claimed only 'subtle' losses of volume in varying numbers of patients for varying periods of time.

 

We do however have substantial data on the structural changes to brain tissue and volume in historical records.   Before the development of psychoactive drugs people with lifelong Schizophrenia or Epilepsy quite often had their brains autopsied in an effort to locate the source of their terrible illnesses.                      These pickled brains are still common objects on disply in Anatomy museums all around the world   ...   most of these pretreatment brains have eye-visible structural and volumetric anomalies.                                         

 

As MI folk we are often 'between a rock and a hard place' when choosing our drugs to maximise benefits and minimise harms.           But this not an equation that is applicable to drugs or no-drugs  ...   we are safer in immeasurable ways if we work at finding a cocktail of meds. that best control our symptoms.

Edited by glasssss999
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