Just an update based on my posts earlier during this year. I ultimately wound up remaining on the oral antipsychotic (Latuda 20mg) which I started taking after completing my 2nd probation term in this decade in January 2018 stemming from a January 2015 motor vehicle offense which ultimately slammed me with a 3rd degree felony (after already acquiring a misdemeanor for resisting arrest on foot in June 2012) related to having schizoaffective disorder and experiencing manic episodes and hallucinations. I was previously diagnosed with Bipolar 1 With Psychotic Features after the 1st incident I was involved in back in June 2012.
My main issue the entire time I was serving both probation terms was that I was always court ordered by a judge to continue taking the antipsychotics by injection and to continue my psychological treatment. My primary concerns with the antipsychotic medication was always having intolerable akathisia (inability to sit still), tremendous amounts of weight gain (My height is 5'8 with a small to medium frame and my weight maxed out in January 2018 at almost 310lb after being around 155lb until after June 2012, severe gynecomastia (recently won Risperdal / Invega class-action lawsuit), anxiety, depression, and disorganized speech (currently seeing a speech pathologist to suppress language disorder).
Following the completion of my 2nd probation term, I was initially placed on Latuda 40mg taken with food at night and then tested out Fanapt 6mg. I was still experiencing most of the side-effects and was still outright desperate to eliminate all of the symptoms I just mentioned. By the beginning of March 2018, I did ultimately try consulting with my psychiatrist about switching to a mood-stabilizer as monotherapy acting in place of an antipsychotic and accepted the risk that if I actually suffer from schizoaffective disorder and it wasn't Bipolar 1 With Psychotic Features that I would probably relapse and hallucinate again and I was even in agreement to keep a bottle of antipsychotics as a PRN and to just eat them like crazy if anything happened.
I discussed everything with him (I never considered him to be a control freak) and he said that he would eventually be willing to try my suggestion but asked me if I had any other idea in mind that involved remaining on an antipsychotic for slightly longer. I suggested to him that I'd be willing to try taking the Latuda at 20mg instead of 40mg before switching to a completely different class of drugs.
In retrospect, I'm not even completely certain if any of the oral antipsychotics including the higher dosage of Latuda or Fanapt were even that badly tolerated.. Now, I'm not condemning an entire class of drugs because I now support some of the low-dose oral antipsychotics for myself but I ultimately think that my former overall disgust and intolerance for the antipsychotics was because I was only ever taking them when I was either locked up in county jail and the overall quality of the drugs was really bad and primarily because the only time I was ever actually taking them was when I was taking court-ordered injections. That basically explains why my experience with the mental health system always sucked up to that point.
I'm not trying to speak to highly of myself here but my psychiatrist has always said that he considers me to be one of his higher functioning patients, therefore the reason why he thinks I was always so vocal about all the underlying side effects from the injections and was more sensitive to them than the majority of his patients, even at 260, 280 or 310 pounds, my weight was never really a factor for me in terms of reacting to the meds with less sensitivity.
It simply didn't matter what injection he would put me on. I was on so many of them including Invega, Aristada, and Invega and they always caused more damage than they did anything positive for me. I always felt like the compromises I had to make to not hallucinate and remain out of legal trouble were simply too much to take. The slow-release form of the injections was always too intense for me but I was honestly being completely forthright when I admitted that I didn't want another episode involving the boys in blue to occur ever again.
At the time of my last post, my dosage was already reduced to 20mg and I was still complaining on a regular basis about everything I was still feeling but it wasn't until the end of March when the restless / walking on hot sand feeling finally began to subside. My overall appetite decreased enough to where I lost over 50 pounds by the beginning of the summer (since then the weight loss has stopped at around 260lb unfortunately but I have remained generally stable in terms of my weight). I won a class-action lawsuit against Risperdal / Invega in February and my weight became low enough where my plastic surgeon agreed to perform male-breast reduction surgery on me after denying me previously because I became so overweight / obese after I was released from county jail and the results were very successful without needing revision surgery thus far.
My speech disorder did improve a little but unfortunately wasn't completely going away by the end of the summer. I still felt like I had something like aphasia where I couldn't think of common words or name common objects and the words wouldn't return to my mind until 10 or 20 minutes after the conversation took place. The speech pathologist I eventually saw for this referred me to the audiology department at my local hospital for Central Auditory Processing Testing and it was revealed that I do in fact have a language decoding disorder (my intuition was right all along) which is certainly aggravated by having schizoaffective disorder and maybe even still by the medication.
I only become somewhat anxiety-ridden and become depressed right after I take the medication with some food, therefore I normally take it right before I go to sleep. By the time I wake up, I am no longer experiencing the anxiety and paranoia but I never become psychotic.
Still, the most important thing is that I'm no longer experiencing any of that indescribable akathisia and thank god the weight gain reversed before I hit 350 and I no longer have to walk around with female-like breasts anymore.
This is easily the most balanced I've felt since I developed the mental illness in the beginning of this decade. I'm not a morbidly obese zombie with female-like breasts pacing all day and night with akathisia but I'm also not hallucinating and running away from the local police department during a welfare check or speeding from the state troopers on major highways either. The delusions are still there at certain times except mild enough where I just laugh them off most of the time and don't believe the majority my own deception.
Utterly intolerant to Antipsychotics, Strongly considering Lithium or Lamictal as Monotherapy for Schizoaffective Disorder.By SheltieUnderdog
I've been on and off antipsychotics sporadically for the last 7 years since age 22 (since 2011). I'm extremely sensitive to them and have a very high response to every one I've been on. I've gained 145lbs from an increase in appetite and metabolic changes, have severe akathisia that is utterly insane and makes me want to cut my own legs off, I developed severe gynecomastia from Risperdal and Invega respectively (Won the Risperdal lawsuit, but no surgeon will touch me because of my weight), experience anxiety (The most on Abilify), fatigue, drowsiness, impotence (On Fanapt), anhedonia (From aggravated depression on Haldol), blurred vision (On Fanapt), lack of concentration, mild tardive dyskenesia (In combination with TMJ syndrome, I think it's permanent), dry eyes (Can't secrete my own tears), nasal congestion (aggravated, because I have it anyway without taking APs) , disorganized speech (Literally developed a speech impediment from a combination of Fanapt and Topamax), GI issues, etc
I've experienced almost every common recorded side effect from this category / class of drugs. The lack of control over my weight and appearance and the akathisia are the worst (that's why they're listed first and reiterated). These drugs have destroyed the relatively abysmal life I had before I developed this illness and presently cut it down to absolutely nothing. I have no life. I spend the majority of my life either going to multiple doctor's appointments for my medical issues or otherwise eating uncontrollably, and pacing back and forth and smoking cigarettes occasionally. I browse the internet with my thoughts racing. I might try to watch a TV show or play video games or play bass guitar like I used to but I can barely hold concentration or focus long enough. I want this to end, I really want out. I want to experience a fraction of life again.
I was previously diagnosed Bipolar 1 With Psychotic Features before my 2nd and most recent episode. As I said, I haven't taken APs consistently for 7 years. I've gone off of them twice for pretty significant periods of time before I relapsed. I usually last about 10 or 11 months (almost a year) without symptoms and perform consistently better in life in general with everything gradually going back in my life to when before I was 22. The side effects and depression usually disappear within a week. At 5 to 8 months I'm very stable, but in just under 11 months I start feeling like I'm on top of the world, become severely manic and delusional, hallucinate, experience an episode, and get into legal trouble. The 1st time around, I resisted arrest during a welfare check called in by my parents and went to the hospital and the 2nd time I successfully eluded the cops by motor vehicle on the highway and got caught hours later and went to county jail.
I understand I could be facing harsh consequences but I've never been on a heavy mood-stabilizer before. All they do is overload me with APs. After the 1st episode I stopped taking psych meds completely because of how much I despised how I felt except for Zoloft and resisted almost all treatment. I avoid SSRIs now and will this time because I think it may have been responsible for raising my mood too much before the 2nd incident took place.
The key to preventing future incidents for me, I believe, is to make the hallucinations and mania more tolerable to where I won't feel the need to act on them. The delusions are a joke, I can easily handle them. I'm currently taking Latuda 20mg and I'm requesting that my psychiatrist allow me to keep 2 or 3 bottles stored in my cabinet or 1 on me at all times in case any symptoms were to occur while taking Lithium. During the last episode, I was frantically searching for antipsychotics or any appropriate psych medication but didn't have them because I threw all of my former meds away after the first episode had taken place. This time I will have them to back me up and if it turns out that I need to suffer immeasurably on Latuda 20mg or another AP for the remainder of my life then so be it but I deserve a chance on a mood stabilizer simply because of what I've gone through and what I'm experiencing on APs.
Has anyone ever tried Lithium as monotherapy for schizoaffective disorder or bipolar 1 with psychotic features? I hear it still has some side effects (would like to know what all of those are) but that it's immeasurably more tolerable than antipsychotics. I realize many people use it in combination with an antipsychotic but this is not in reference to that. Is there anything better than those two that's not an AP? This post is simply to inquire about anyone's thoughts or experiences about using Lithium or Lamictal as monotherapy for schizoaffective mania. A dosage and frequency recommendation would also be appreciated from those that have taken it, although I realize that I will ultimately need my psychiatrist to determine that.
I found 1 study on this subject from the early to mid 1980's here: https://watermark.silverchair.com/10-1-30.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAAcYwggHCBgkqhkiG9w0BBwagggGzMIIBrwIBADCCAagGCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQMAypxqSBIPHx7kbXfAgEQgIIBeTskilYIIUxtfy4i-FH7a6BQ4SrsYxqZG44q7kWx1rVJdLbZ4PMxE33_FUje8rDj4FoUYJI27hYGzv-06pCL6xPDrbVg7n-g9QzqTwoPiRxgDv2VnqzwifudoudTuskAGEKItv5TfD1_V9opXCFF7vJXJln8ij8NeNkMLUpe_n-Xbp6TtkU7rXYdPCZ9dObhTfmQ4PEHkwKfcJcOVAjXzelMWD1EPzWPxCK5zu1l1d2w8ojnqH68mbvgaDuvBxyPTY-EEdADh9N0NIUPQCWHXZKWE2gEBsG_AbWS-bkPdgjxtXcn8Y_5KljQbU2Geb_ERYYWuWFMEk6CRs7FYte_16TOiCQVlahMabKxw0BdjlqvdGaPYZTKBoBWb9Poswigg8jbF1whmlo7WWRyCLCLdbKt4xkmZCU0qmv_j5FTFzeXsq05ptOFY10M3jpUft1xV75pMsPtVJ8U7d42OYqMksXhZyrA8B5k9XNhfJGS0XgmTTSLHNOdcTY2
Speech in general has always been a little bit of an issue for me. I did see a speech pathologist in the past but I was about 12 and didn't care much to benefit from it then. Just for the record, I have always noticed that my speech is much sharper when I'm not taking antipsychotic medications. Strangely enough, I seem to speak the most clearly right before I have a relapse and I am becoming manic. Almost every antipsychotic I have taken has had a negative reaction on my speech but never as much as the most recent, Fanapt. I was recently switched from Latuda 20mg to Fanapt 6mg (once daily) to suppress akathisia. At first everything seemed fine and the akathisia which was a longtime battle of mine was tapering down just slightly on the Fanapt. Then a few weeks settle in and I start feeling like I've been hit by an 18-wheeler upon waking up and just overall sedated and "spaced out". I am forgetting things, mostly short-term memory loss. A few days ago I went into a retail pharmacy to buy a few specific things, walked inside the sliding doors and completely forgot what I walked inside for a few second, although I did ultimately remember a few minutes later. Not just this but I also seem to have developed blurred vision and can absolutely not drive or operate a vehicle on this medication.
Additionally my speech is completely shot and disorganized almost half the time. My speech patterns at times are almost like someone who is borderline cognitively impaired yet my IQ is in the 101-109 range (I am average). I'm forgetting words that once came easily to me and have to scan my brain hard for them, sometimes for over 10 minutes. Usually I know what I want to say but it either doesn't come out right or I just can't get it out in words. It's extremely frustrating and it's causing depression and I've threatened suicide to family and friends yet backed off that is how bad its become. I just want my ability to speak normally to be returned to me. I am coming off the Fanapt but would like to be given some suggestions as to what steps I should take to rehabilitate my speech and what medications are not disabling for someone's speech or what medications could counteract disorganized speech. My current psychiatrist is unsympathetic and doesn't care. And my initial question is can Fanapt cause a speech impediment?
I have bad akathisia right now, driving me to suicide thoughts.
If you don't know akathisia it is an intense restlessness both physical and mental. Every cell is screaming do something! DO SOMETHING! You twitch, pace, smoke cigarette after cigarette. You do not sleep. Your thoughts run wild. You see the only solution as ending your life. I'm typing this as an alternative to pacing, crying, banging head against wall.
It is a fairly common side effect to neuroleptics and a less common side effect to other psychiatric drugs. I got it from 9 days of 20mg fluoxetine, then they switched to 5mg Citalopram (a crazy low dose) and I still have it. I have cut this today to 2.5mg after advice from the Surviving Antidepressants board. Also on 2mg diazepam (a tiny dose) and 60mg propanalol.
Today is the worst it has been.
It's one saving grace is it tends to ease now and again.
There is no real treatment, in fact doctors tend to assume it is a worsening of your condition and up the dose of your meds, so you can't really get help from the medical community.
I went on the anti depressants for a mild case of anxiety. I am now extremely ill
Anyone else suffer this hell?
Because of my extremely negative reactions to almost all the AP injections down the list, my probation officer and my psych are allowing me to switch to an oral medication for my last month on probation before I graduate. They know it's not even a risk if I didn't take it (which I'm going to) because it usually takes me many months to a year for me to become symptomatic and have a relapse. I'm not one of those type of people who relapse in less than a week or even a month. So this Tuesday, I have an appointment with my psych to discuss my options with the oral medications.
According to my psych and what I know, I'm very responsive to low doses of anti-psychotics, almost becoming completely rational in a few hours of taking Zyprexa 2.5mg or Abilify 2mg. However, I'm also very sensitive at the same time and experience severe amounts of Akathisia that last all day from the moment I wake up to when I go to sleep. I could pace back and forth all day if there were no interruptions. I feel like I want to jump through a ceiling or run through a glass door to alleviate the constant need to be moving. We have tried everything from Cogentin, Artane, Propanolol, Clonazepam, Benadryl, and now Gabapentin 600mg 3x per day and all it's doing is helping with my anxiety and stabilizing my mood but not relieving the Akathisia. The counteractive drugs simply don't work for me. Never did. They're to weak compared to the agent that's causing the Akathisia.
I saw a commercial over the summer that claims that Fanapt has a lower Akathisia risk than other atypical anti-psychotics but I'm not entirely sure. It seems that Fanapt has to be taken twice a day and is recommended at at least 6mg after the 1mg starting dose. I want something that can remain low. I've also read that Seroquel, at the higher doses, like 400mg to 800mg can treat schizophrenia with less of the Parkinson like side effects. I've discussed this with my psych and he says he wants to keep Seroquel as a last resort because of its low efficacy. He may not be realizing that I don't have the average type of schizoaffective disorder (if that exists). He's fearing that my claims of the extremely low-dose oral meds while I was in jail is not a true account.
So. conclusively, what is the best option for a schizoaffective patient who's highest priority is ridding the Akathisia while still taking the medication consistently? I don't care about the 100% efficacy or having some symptoms. I just want the ******** akathisia gone. I also have other side effects from this crap they've been sticking in my arm for the last 15 months such as Weight Gain, Gynecomastia (just won a huge lawsuit against Janssen Pharmaceuticals for Invega), Sedation, Fatigue, Depression, Anxiety, Panic Attacks, Anhedonia, Throat Swelling, Involuntary Eye Movements, and Suicidal Ideation. Just to name a good amount of them. Please help me as my appointment takes place later this week and I want more knowledge going into it. Thanks