Cheerleading for Haldol!

[blackbird]

Hi

I take 30mgs abilify for psychosis, it helps somewhat but I asked my pdoc yesterday if he would add a teeny dose of haldol into the cocktail as I found it was really helpful the first time I took it and I had zilch side effects. I still want to take my abilify but he seems to think that you can only take one or the other (hes big into monotherapy) when all I wanted was a 0.5mg dose as an adjunct med. The old P doc seems to think they wouldnt play well together in the brain. Is dual therapy not a reasonable idea, I could sign a waiver....

[Fiona]

Well, there might be a good reason for it, anytime you combine two somewhat similar meds you can magnify the side effects -- even if you had no or minimal side effects on them separately. And you might not like the results of that.

Is there something the Abilify isn't doing for you? Maybe you need something other than another anti-psychotic? There's something to be said for sticking to one med, but multiple meds are sometimes needed to address different parts of the illness.

I've never heard of a patient being able to go beyond a doctor's wishes by signing any kind of a wiver. Doesn't mean it can't be done though, you might want to ask this question down in the forum about health care/health systems as someone there might have an answer.

Fiona

[Guest Guestxyz]

Hi

I take 30mgs abilify for psychosis, it helps somewhat but I asked my pdoc yesterday if he would add a teeny dose of haldol into the cocktail as I found it was really helpful the first time I took it and I had zilch side effects. I still want to take my abilify but he seems to think that you can only take one or the other (hes big into monotherapy) when all I wanted was a 0.5mg dose as an adjunct med. The old P doc seems to think they wouldnt play well together in the brain. Is dual therapy not a reasonable idea, I could sign a waiver....

<{POST_SNAPBACK}>

Hi.

You say that you've been on a high dose of Abilify. Assuming that you have been on it for quite some time (at least a couple of weeks) you should really consider taking another antipsychotic.

It's probably best to stick to taking only one antipsychotic. Especially with abilify, because of the way it works. I don't know your history, but you should be aware that psychotic experiences are toxic to the brain. That means that your brain functions are being damaged, and your prospects for recovery get a lot worse and the chance that you'll have future psychoses is much greater.

Well, the abilify doesn't seem to do it's job (well enough). There are other atypical antipsychotics that generally tend to work well. But if you've had some good experience with haldol, why not choose that one ? As your main antipsychotic.

Try to talk about this with your doc, I think it's that it's important enough to do what it takes to end your psychosis. There are so many options. If your doc is not very knowledgeable, you can do some research on your own. crazymeds.us has some useful information. Even combinations of certain antipsychotics (but probably not with abilify) can work. There are also therapies that can be used if a more regular approach does not work, such as ECT (electro convulsive therapy) and others.

I hope you get out of your psychosis because you deserve it. If the doc is not helpful you can always approach another.

Good luck.

[blackbird]

I take it abilify and haldol dont work well together in the brain? 

[Fiona]

I take it abilify and haldol dont work well together in the brain? 

<{POST_SNAPBACK}>

It's very likely they don't, but it looks like it would vary from one person to the next. Unfortunately, the only way to be absolutely sure would be to try it out. And if the answer is "they don't" you could have some pretty nasty side effects as part of it.

On the other hand, you do need (and deserve) to have all your symptoms resolved.

Fiona

[blackbird]

Are there any old school APs that would work well beside abilify?

[Fiona]

Are there any old school APs that would work well beside abilify?

<{POST_SNAPBACK}>

There may be, but it's beyond what I can research right now.

Why are you so interested in taking a typical antipsychotic in addition to Abilify?

Fiona

[blackbird]

Well I like abilify, It has no side effects but its not really working 100% for me, its working maybe 50%, I thought maybe something else might augment its effects.

[Guest Guestxyz]

Well I like abilify, It has no side effects but its not really working 100% for me, its working maybe 50%, I thought maybe something else might augment its effects.

<{POST_SNAPBACK}>

Augmenting Abilify with something else to combat psychosis is possible, I know of a couple of things, but on the medium term and long term I can't think of any sensible combination, except:

Maybe a medium to high dose of Seroquel, it works more on serotonin than on dopamine, would make sense, but really, I don't think that's the best solution.

If you want more information about the tradtional, typical antipsychotics, you could look at http://www.schizophrenia.com/meds.html#traditional.

I'm not a doctor, but if you have a positive experience with haldol, why not use that as monotherapy ?

Clozapine and ECT (electro convulsive therapy) are sometimes used in cases of treatment resistant psychosis.

Just out of curiosity, have you been using hash/marijuana/weed or whatever you want to call it on a regular basis for some time ? It has been known to cause psychosis/schizophrenia, although there is disputed between psychiatrists.

If so, that stuff can leave traces in the brain for years. I'm not sure if the problem is that certain chemicals (THC?) remain in the brain for years, or that the problem is that the cannaninoid receptors in the brain have been altered.

I'm not sure how to combat that in the best way, but I once read a succes story about a guy who had been using marihuana for years. He took medium to high dosages of Seroquel for several years, and with few or no side-effects on the long run. Then he stopped taking it, and he did not relapse.

[Guest guestxyz]

In the previous post I said cannaninoid, but I meant cannabinoid.

[blackbird]

I was a heavy cannabis smoker for years but havent ued it now in over 2 years and yes it was the initial trigger for my psychosis.

[herpie]

I think that, yes, if haldol worked it could be helpful as add-on. I mean, yes they theoretically act on the same receptors in the brain, but in not exactly same way (Abilify blocks dopamine receptors for shorter period than Haldol does, and it has probably different affinities for particular receptor subtypes), and the combined effect may be beneficial. It's not like all antipsychotics are exactly the same wrt dopamine receptor blockade. Hell, we know one person (Bohemian) who said he once needed 3 different APs at the same time to control all of his symptoms!

But because pharmacokinetic interactions are possible, use tiny doses and do it always with your doctor's supervision (he may be able to tell what does should be used so that Haldol doesn't make Abilify build up in your system too much - or vice versa). And watch out for signs of parkinsonism/dyskinesias, as their emergence is a good reason to give up Haldol (you don't want a permanent irreversible movement disorder, do you?).

Clozapine - well, it may work, but it has some risks too (agranulocytosis), and Abilify/Haldol combination might be safer if used properly.

[Dweii]

I was prescribed Haldol yesterday and it really knocks out my manias/mixed states. I might ask about replacing Fluanxol with Haldol, since Fluanxol doesn't stop manias, even at the high dose I'm on. But it might be too sedating for everyday use, I don't know. What I like about Fluanxol is that it's not sedating at all, rather a bit stimulating, and it has no side effects and even works a bit like an antidepressant. I've read somewhere it's actually used as an antidepressant in Britain.

Now, I assume Haldol and Fluanxol is ok to take at the same time, since I'm on Fluanxol and was prescribed Haldol for PRN use. So maybe combination of the two would be helpful? But then again, I'm trying to be on as little meds as possible. Goddamn pills!

I just might wait for my Lithium levels to go up and see if that does the trick.

[Ocracoker16]

I have not had great responses to taking 2 antipsychotics at the same time.  I am currently on Seroquel 800 mgs.  Risperdal/Seroquel and Abilify/Seroquel were very unsuccessful.  I have combined 5 mgs Haldol with Seroquel which was effective for psychosis short term though the akathesia was pretty bad.  I use Haldol on a PRN basis now.

Katie