What are the overall best (atypical) antipsychotics for Depression, Anxiety, Agitation, OCD, Bipolar...?By Adolf
"Best" as in being effective with fewer side effects. Which ones were the best for you? Which ones did you take? What condition(s) did you treat? What side effects did you get? How did the antipsychotics compare to "conventional" antidepressants?
Can antipsychotics be an alternative to "conventional" antidepressants? What are the risks? What are the benefits? Do they make you a tomato with time? Psychiatrists prescribe them more often in recent times, it seems.
I apparently have very treatment-resistant OCD. My pdoc hasn't said it, but I have gathered this from my profound lack of insight into my obsessions, psychotic preoccupations, and the fact that OCD is not only interfering with life, but treatment as well.
I have tried novel strategies like memantine (30 mg), lamotrigine (400 mg), zonisamide (400 mg), topiramate (400 mg), etc. I've tried somewhat high doses of SSRIs (my pdoc hates prescribing anything at max dose) (fluoxetine 80 mg, fluvoxamine 100 mg (nightmare), escitalopram 10 mg (nightmare), sertraline 200 mg), SNRIs (venlafaxine XR 825 mg!!, duloxetine 120 mg, desvenlafaxine 150 mg, Fetzima (joke...)), Viibryd 40 mg, Trintellix 20 mg, etc., clomipramine 225 mg. I've tried various antipsychotics (typical and atypical) alongside SSRIs: fluphenazine 1 mg tid, perphenazine 4 mg tid, trifluoperazine 5 mg bid, haloperidol 1 mg tid to 5 mg x1, pimozide 2 mg bid, etc. Nothing seems to really help. Basically, if there's a way to treat it, I've probably tried and failed it or tried it partially due to conservative prescribing habits of my pdoc.
I have not tried low-dose clomipramine + SSRI, supratherapeutic doses of SSRIs (pdoc won't hear of it...), higher doses of typical antipsychotics (for acute psychotic preoccupations), certain antipsychotics (thioridazine, clozapine, etc.). I'm thinking about seeking a second opinion from another pdoc soon because my current pdoc is no longer helping me. She just keeps me on the same useless regimen and never wants to change anything, pats me on the back saying "you're better than you think you are," and sends me on my way. The office staff are severely understaffed, and one of them in particular always bitches me out after my sessions because it's so late, but it doesn't matter if I take 5 minutes or 55 minutes... she's going to bitch me out no matter what about it. She never says anything to the people who go back there and take two hours though. Just me, because I'm at the end of the day. It royally pisses me off and I'm about to snap at her, and I really don't want to (the office staff person). I'm also about to snap at my pdoc and ask if she'd rather the meds kill me or me kill me due to inadequate medication. I know meds aren't all there is in treatment, but she seriously has to budge for something to change.
I am seeing a therapist, but he's new and still getting to know me, so nothing has been done yet. He's taking notes and asking thorough questions though. I like him so far. He actually has a white dry-erase board in his office that he uses to illustrate things he's trying to convey to patients, and he's the only therapist with one in that whole office. I wish I could see my original therapist though. She's known me since I was 9 years old... She knows me like no other mental health practitioner knows me, and has the most extensive history on me. Last I saw her, she was in "partial retirement," which meant she blocked off half her office to this new guy (ex-pastor gone family counselor), disposed of all her notes on all her patients, sent half of her patients to this new guy, and kept the other half of her patients (mostly younger patients she said). I saw her twice or 3 times during that time, and she dismissed me after that. I wasn't really seeing her for my own purpose, but because of a problem I had I didn't know how to deal with. I tried calling her semi-recently when I was looking for a counselor several times, texting her, everything, and never got an answer, so I assumed she fully retired.
Anyway, I didn't mean to digress so much in this post.
I've been off my meds for about a month now as I never can remember to take them. Last night my fiance and I got into an argument while I was making dinner and it got really bad. He's Bipolar and not on meds right now, but he usually manages it pretty well (he has BP2). He's been super maniac the last few days (full moon, anyone?) and with our current situation at home which includes a lot of variables that have contributed, he's also been extremely cranky. I hate when he yells at me, I want to mention he has NEVER, EVER threatened to put a hand on me, but growing up my parents did a little uh, mental abuse here and there about me being "Crazy". And it usually ended in me in my room, bawling. I began crying because he had been yelling, and wouldn't back off and give me space. Me, being my overdramatic self TW: pulled a knife on him.
I'd never hurt him. Ever. I want to put that out there. Unless he hurt me. Like actually, physically put his hands on me.
I have a friend who lives a couple blocks away, and I called him to come over and diffuse the situation. He gave me the good ol cop talk of "I can arrest you for that, don't do it again", sitch. And he mediated between us both. I also know that if he felt like my fiance was in danger, he'd have me arrested or do it himself. My fiance even said he doesn't feel unsafe and part of me doesn't get why.....
I put the knife down in the kitchen and was crying so hard because that is not like me at all. (This was before he came over. I had literally no intentions of using it, but I am so fucking overdramatic it's unreal.) I'm now in a constant state of worry that my fiance's mental health is worse because of me. He's had abusive exes in his past and I vowed to never be one. He has PTSD from being abused as a kid, too. So he's really screwed
A lot of this post is me "venting" or getting things off my chest. I'm going to try to do better with my meds. To add insult to injury, my therapist moved away a few months ago and never told me. Not a word, so I have a new appt with a new one in my psych office this week...and I'm worried about unloading this onto her. I'm worried about a new therapist in general. I don't like new things.
The entire situation, thinking about it, makes me sick to my stomach.....I...don't know how else to feel.....
Sometimes out of the blue I get this feeling that I did something wrong and people will come to get me, because of this. Then I keep on reviewing what I did throughout the day and see that I did not do anything wrong. What causes this? Is this ocd or paranoia? How to prevent/deal/improve with this?
Sometimes out of the blue I get this feeling that I did something wrong and people will come to get me, because of this. Then I keep on reviewing what I did throughout the day and see that I did not do anything wrong. What causes this? How to prevent/deal/improve with this?