Posted by ed_uk2010 on January 28, 2015, at 6:01:07
In reply to Re: Multiple mechanism with Zyprexa and some atyp, posted by Lamdage22 on January 28, 2015, at 5:39:13
Morning.
>The delusions were that everything is about me in a way if that makes sense. That everything is connected.
Yes, it does. Sometimes called 'delusions of reference' ie. involving beliefs that things which are not really specific or even related to yourself are personal to you. People often believe that someone on television is talking to them personally, for example.
>Is that about right?"
>
> YES.Good to know I've got approx. the right idea.
>Psychosis, well i never recovered from drug induced psychosis.
It's difficult to know what your diagnosis should be, or if it indeed matters. Prominent delusions of reference are more typical of schizoaffective disorder or drug-induced psychosis than psychotic depression. To me, it sounds rather like you had a drug-induced psychotic episode superimposed on a chronic depressive illness.
>I dont think i can reduce Zyprexa.
OK, in that case, you just need to look at managing the side effects. You've already had success with metformin. If you are still overweight there are further options to consider.
>I would say im somewhere in between psychotic depression and schizo-affective, type depressive.
It does make sense yes, but I think the diagnosis has been blurred by the additional of drug-induced symptoms eg. while on MAOIs. Amongst other things, MAOIs inhibit the breakdown of dopamine in the brain - they're not a good choice for those prone to psychosis.
>Tendency is definitely depression.
I see that. That's your state much of the time. The psychotic episodes and grandiose thoughts have existed more briefly in the overall course of your illness.
So, I suppose you need:
1. Avoid all drugs likely to worsen your illness eg. stimulants, MAOIs, dopaminergics etc.
2. Keeping taking Seroquel. It should stabilise your mood and prevent psychotic relapse. It has some antidepressant effect.
3. Adjust your Zyprexa dose gradually if necessary, to find a dose which works well without causing too many side effects.
4. Continue metformin, and consider other options for weight loss if needed. Both medication and non-medication options.
5. Decide whether you'd like to continue pipamperone or try a different med to aid sleep.
6. Consider what might be a useful way of improving your depression without risking mood destabilisation or psychosis. What symptoms of depression do you have right now, apart from low mood? If you look at a list of depression symptoms online it might help to clarify what sort of mood state you're in right now, which could potentially help in treatment selection.
Do you have any other psych problems right now apart from depression and insomnia, which are in need of treatment? eg. nightmares, anxiety etc.
poster:ed_uk2010
thread:1074889
URL: http://www.dr-bob.org/babble/20150102/msgs/1075663.html