Posted by ed_uk2010 on January 21, 2015, at 14:33:23
In reply to Re: olfactory hallucinations?, posted by b2chica on January 21, 2015, at 12:39:10
Hi B2,
>diagnosis has varied.. the last two were bouncing between psychotic depression and (more likely) bipolar Mixed.
Can I ask.... what were you prescribed amphetamine (Adderall) for? Amphetamines often produce a pronounced short-term mood elevation but can aggravate mood disorders in the long run, lead to issues with dependence and misuse, induce psychotic symptoms (especially voices) and cause considerable insomnia. In the long-term, amphetamines rarely improve depression and can make it worse. Reducing the dose too fast or stopping abruptly can certainly exacerbate depressive symptoms though - very much so.... it is temporary, but a gradual reduction over a few weeks is safer for your mental health, provided that you can avoid the temptation to take extra doses. Amphetamine withdrawal symptoms tend to be especially bad for about ten days after stopping. Severe fatigue, depression and feeling completely unable to cope are common. On the bright side, symptoms often start to improve quite a lot about 2 weeks after stopping. In some cases; mood, anxiety and sleep may be much improved a few weeks after discontinuation. I do feel that amphetamine is likely to be harmful in psychotic depression, even if it appears to give you temporary boosts. I don't know whether you're still taking it though..... Amphetamine treatment is generally a bad idea for anyone with a tendency to misuse medication, anyone with insomnia or psychosis, anyone with a history of eating disorders etc. Short-terms gains are often followed by longer term problems and more distress. If you have already stopped amphetamine, I wouldn't personally recommend that you restart.
Have you tried lithium? Or Seroquel?
Seroquel is used a lot in psychotic depression, bipolar depression and mixed states. It could be an alternative if Zyprexa isn't working too well for you at the moment. Seroquel is not (usually) a more effective antipsychotic than Zyprexa, but may have more antidepressant effect for some people.
Lithium is useful in many types of bipolar/mood disorder. It may improve stability in the long-term and reduce suicidal thoughts and behavior, making you safer. It can readily be combined with the likes of Seroquel or Zyprexa if needed. Many people need this type of combination.
Antidepressants are often necessary in psychotic depression, but can be a problem in bipolar disorder. If you have manic/mixed symptoms alongside your depression (rapid thoughts and speech, excess energy - not caused by Adderall, flight of ideas from one topic to another etc), antidepressants may be a problem. If you have depression and anxiety without manic symptoms, antidepressants are much more likely to help. You need the input of a good doctor here. Have you ever had an episode of mania in the past?
>right now i am in the -meta- phase of suicidal ideation.. however i am starting with more agitation and despair.
I'm wondering whether a bit of lithium could help, unless your symptoms are more to do with medication withdrawal. Lithium often reduces suicidal thoughts and agitation associated with mood disorders. You wouldn't necessarily need a high dose or have many side effects.
>yes meds have changed in that she wanted to strip me of all meds except the pristiq. well guess what that has done.
So you stopped the benzo and Adderall? Wasn't it Xanax you were on? How long had you been on these other meds and what doses were you on?
Illusions and other perceptual disturbances are very common after stopping high-potency benzos which have been used for a few months or more. After stopping a benzo, illusions are MUCH more common than true hallucinations (which are rare). The illusions are often accompanied by tremor, panic, severe anxiety, feelings of unreality, fear without a clear cause, muscle tension, blurred vision, increased sense of smell, sensitivity to being touched, sensitivity to loud noises, sweating (especially heavy night sweats), rapid heart rate, dilated pupils, restlessness and temporarily aggravated depression. Illusions in the absence of any of the above symptoms are unlikely to be related to withdrawal. Bear in mind, benzodiazepine withdrawal symptoms are not relieved by Zyprexa or other antipsychotics. The mental symptoms of depression, anxiety and bipolar disorder can resemble withdrawal symptoms.... but some symptoms are much more typical of withdrawal. As examples: dilated pupils, constantly rapid heart rate, severe sweating, tremor and hypersensitivity of the senses are more representative of withdrawal states.
>interesting about the benzo's. i stopped after my hospital visit on jan 5th. yesterday i was smelling things that were just very unpleasant, some i didnt know just adverse response to it.
It's not clear to me whether these were hallucinations or extreme over-sensitivity to actual smells. Rapid benzo withdrawal produces sensitivity to all smells, not just bad smells. Perfume and food smells may be overpowering or nauseating. You may notice the smell of other people, smells in the environments smells on your clothes, towels and bedding (especially if you sweat at night). Olfactory hallucinations associated with depression are normally bad smells which someone believes is coming for their own body - but in this case there is no oversensitivity to other smells in the environment. Olfactory hallucinations in depression normally occur when the depression is very severe. Perceptual disturbances after stopping a benzo generally occur at the same time as panic states, tremor and sweating.
You could test yourself by spraying perfume... does it smell normal and pleasant or unusually overpowering? Has this symptom appeared since stopping benzos or did you have it before? That's a major clue as well. In general, withdrawal symptoms from Xanax are particularly severe in the week following discontinuation. The symptoms would have peaked around 7th-14th January and then probably improved slightly. If you do have withdrawal symptoms, you are likely to notice an improvement spontaneously over the next couple of weeks. On the other hand, if your symptoms are more related to severe depression, a spontaneous improvement is less likely and medication such as an antipsychotic or lithium could help you a lot. Anti-epileptics such as Depakote and Tegretol can be of some benefit both during benzo withdrawal and as an add-on to antidepressants in bipolar folk.
>so i am sure this is all related somehow to sleep deprivation.
The relationship between sleep and mood disoders is complex. Mood disorders can cause poor sleep - this occurs in depression and mixed states. Mania tends to cause over excitement with a reduced need for sleep. Depression normally leads to fatigue and the desire to sleep, but it's very difficult to actually get the sleep. Severe anxiety and benzo withdrawal almost always causes problems with sleep. Severe sweating during sleep is typical of benzo (or alcohol) withdrawal - it is not typical of anxiety or depression. This may give you a clue. Unusually vivid dreams occur for several weeks after stopping benzos and Adderall. This is called an REM rebound. It improves spontaneously. Nightmares can also occur in depression.
Several weeks ago, you were taking Adderall and benzos - and were unwell. But... were you unwell in a different way to how you are at the moment? If so, how did your symptoms differ?
>that i will die from not enough sleep.
Many people feel that. It's horrible. But... people don't die for this reason. The body forces itself to have tiny micro sleeps even if your sleep quality is extremely bad. This means that you will never die purely from insomnia. Alcohol use is a major cause of sleep disruption, even in people who find it beneficial for falling asleep.... do you drink? Vitamin deficiencies caused by alcohol can cause further mental health problems. A good B-complex is appropriate.
> the reason i am starting to loose faith is that i've been Actively asking for help for MONTHS.. and i am no better off.Have you heard from your pdoc? I hope my reply gives you a few ideas RE what the cause of your current problems may be. Of course, your problems may well have several causes, not just one. This is the norm, not the exception.
Take care B2.
poster:ed_uk2010
thread:1075317
URL: http://www.dr-bob.org/babble/20150102/msgs/1075347.html