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recovering my ability to feel?


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Since I've started Haldol my flat affect, paranoia among other things has improved, however I've lost the ability to experience life vividly. My surroundings seem lifeless, and it's a really unbearable state after a while. At first i was grateful that i had recovered from a horrendous psychotic episode because of the haldol, but now i want my life back. The last time i tried decreasing the haldol my anxiety was unbearable, so is there any way to recover the ability to experience things vividly without changing the haldol? Or should I expect to live my life this way if i want to remain stable? I dont' think changing antipsychotics is an option since I'm more stable now than Iv ever been in no small part due to the haldol

Edited by Nullo
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The haldol really has not given me any bad side effects except for what I'm bringing up here. I've tried almost every AAP except Geodon and Clozapine, my response was always "incomplete", with the AAPs - i could never get the right effectiveness. I felt like a freak walking around with flat affect all the time, i really DONT want to go back to that. Now, after taking haldol and receiving 27 or so bifrontal ECTs i feel capable of holding down a job and going out in social situations without too much self-consciousness. I didn't know it was possible to feel the way i do now and that there was nothing strictly "wrong" with me (so to speak) until i received those treatments. I've heard good things about Clozapine, but given how anxiety prone i am i'd probably be incessantly worried about lower WBC count. I'm guessing the responses i'll get will sayy that there's no other way around this and that i may have to learn to live with this inability to feel. I know it's not anhedonia because i'm not depressed, it's definitely medication-related.

Edited by Nullo
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 I'm  not strictly at the point where nothing else is working and I don't wish to use up all my options just yet.  The Haldol is working, just not the way I'd like it to... and there's still many first generation APs left to try. Only when i've actually run out of options would i rely on clozapine, and i have in mind complete worse case scenario, cause the possibility of low WBC count is not something to be taken lightly.

Edited by Nullo
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14 minutes ago, Nullo said:

 I'm  not strictly at the point where nothing else is working and I don't wish to use up all my options just yet.  The Haldol is working, just not the way I'd like it to... and there's still many first generation APs left to try. Only when i've actually run out of options would i rely on clozapine, and i have in mind complete worse case scenario, cause the possibility of low WBC count is not something to be taken lightly.

Yeah but it's also really rare and the blood tests would pick it up. 

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@Nullo, the first-gen antipsychotics are known to cause blunted affect due to their high affinity dopamine antagonism. If you have too much dopamine antagonism in all dopaminergic pathways, particularly in the mesocortical pathway, you will experience flattened/blunted affect, or a decrease in the emotional response to daily life events (can't think of the word to describe this... Thanks Topamax!) This is why the AAPs are supposed to be so much better, because they have all the 5-HT1A partial agonism, 5-HT2A/2C antagonism, etc., that causes dopamine release that targets this negative symptom.

I wonder what it would be like if you were to add a medication into your regimen that has potent 5-HT1A partial agonism, or potent 5-HT2A or 5-HT2C antagonism?

Maybe you could bring this up with your pdoc?

Some possibilities to add to your regimen:

  • 5-HT1A partial agonists (promote downstream dopamine release, decrease anxiety)
    • low dose buspirone (BuSpar) (this would preferentially antagonize the presynaptic D2 autoreceptors also, which would also cause dopamine release)
    • a tiny dose of aripiprazole (Abilify) as an adjunct (like 2-5 mg) to your Haldol (a commonly done practice with first-gen antipsychotics, use a first-gen high potency AP like Haldol + a dopamine partial agonist like Abilify)
  • 5-HT2A/2C antagonists
    • trazodone (Desyrel) (low dose, i.e., 50 mg, taken at bedtime only antagonizes 5-HT2A receptors among a few others... would help with sleep and anxiety... also a 5-HT1A partial agonist, weight neutral)
    • nefazodone (Serzone) (a good med, related to trazodone, but has a black-box warning for liver toxicity, might not be a good candidate what with your high anxiety about potential health problems from meds... also a 5-HT1A partial agonist, weight-neutral)
    • mirtazapine (Remeron) (acts as both a 5-HT2A/2C antagonist as well as being a potent antihistamine, so would be sedating and cause weight gain for most... if it works, it helps people with anxiety and the deepest of deepest depressions; for some though, it won't work. Also antagonizes presynaptic α2A/2C adrenergic autoreceptors for increased release of norepinephrine and serotonin)
    • nortriptyline (Pamelor) (a tricyclic, possibly the safest one, with potent 5-HT2A/2C antagonism and just enough antihistaminergic properties to help you sleep at night in low doses; at higher doses, it may become stimulatory due to its potent and selective norepinephrine reuptake inhibition, which can help with atypical depressive symptoms. Could cause little to no weight gain.)
    • amoxapine (Asendin) (a tetracyclic with potent 5-HT2A/2C antagonism as well as D2 antagonism [a sort of "built-in" antipsychotic mechanism of action] whose metabolites also have antipsychotic properties. It's actually the active metabolite of loxapine, a first gen antipsychotic, which is sometimes described as an AAP due to its potent 5-HT2A antagonism in relation to its D2 antagonism affinity. Could cause minimal weight gain.)

Best of luck to you!

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Thank you mikl for listing those possible options. I intend on showing your list to my PA and hopefully he will correspond with other doctors in the practice about this as well                                                                                                                                                 

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The only other first gen i've tried is Navane. It worked out really well but i was paranoid about TD. Aside from concerns about TD (i still have those concerns with Haldol, and i am considering asking to stop the haldol at my next appntment) i've had very good results from first gens.. maybe its because my conditions requires something potent...Why do you ask?

Edited by Nullo
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43 minutes ago, Nullo said:

The only other first gen i've tried is Navane. It worked out really well but i was paranoid about TD. Aside from concerns about TD (i still have those concerns with Haldol, and i am considering asking to stop the haldol at my next appntment) i've had very good results from first gens.. maybe its because my conditions requires something potent...Why do you ask?

Cuz u mentioned "many left to try' earlier so I was wondering which kinds were helping 

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