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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 28. This is the beginning of the thread.
Posted by parasolips on February 28, 2005, at 1:23:12
hi folks,
so my problem is this: i feel like there are bugs crawling all over my skin. this has been going on for the past several days. i suppose it's possible that there actually ARE bugs crawling on my skin, but the thing is, i live in very close quarters with a bunch of other people and none of them feel itchy or anything.a few details, to supplement:
-i have recently weaned myself off of Effexor XR. i still get the "brain shocks" sometimes but i think i'm pretty much past the bulk of the withdrawal.
-i smoke quite a bit of marijuana, and have since around september of last year. i pretty much function as usual after smoking though.
-i have been dxed at different times with bipolar, schizoaffective, borderline, social anxiety, and psychotic disorder nosi've been having a lot of confusion and feelings that i'm "going crazy" lately too. i used to have visual illusions (peoples faces would look weird, etc) but i don't think this bug thing has come up quite like this before.
any ideas about what i should attribute this feeling to, and what i should do about it?
should i see a general doctor or a psych doc?
thanks for the help...
Posted by med_empowered on February 28, 2005, at 2:35:19
In reply to bugs crawling on skin, posted by parasolips on February 28, 2005, at 1:23:12
hey! Sorry about the whole bugs on your skin thing...that sucks. Its a good sign that you realize bugs aren't crawling on your skin (or probably aren't, anyway). This is actually a pretty common hallucination; it is seen in psychotic states caused by mental illness (schizophrenia/schizoaffective, occasionally found in people with bipolar with psychotic features, sometimes a feature of psychotic depression) AND in psychotic states that are chemically indued (the feeling of bugs on the skin is a CLASSIC hallucination found in amphetamine/methamphetamine induced-psychosis; its also pretty common in psychosis induced by other stimulants, as well). As for causes in your case...you can't really eliminate the possibility that withdrawing Effexor (especially if done abruptly) could be causing problems. ALthough rare, antidepressants have been known to induce psychotic reactions since the days of the Tricylics (this is why they are RX'd with caution to those with a history of psychosis and rarely to those who are actively psychotic). If you've had hallucinations in the past, you may just be more vulnerable to hallucinations than other people; a mixture of drugs/medications and stress could be the "cause" of this. If you're smoking marijuana heavily, please lay off for a while, to see if things get better. Have you been using other drugs/medications as well? As I said earlier, the "bugs on the skin" sensation is extremely common in amphetamine psychosis....it is found in schizophrenia and other psychotic disorders, but is pretty uncommon (most common: auditory hallucinations). As for seeing a doctor...good idea, very good idea. I'd personally opt to first go to a general-practice doctor (GP), because she or he should run blood-tests that can help identify or rule out potential problems with your overall health that could cause/contribute to this. Be sure also to tell the doctor about any medications you are now taking or have been taking and be very detailed about any drugs you have been using. Although not common, heavy pot use among those vulnerable to psychosis can cause a psychotic reaction. Anyway, the most likely result would be that the doctor will RX an anti-psychotic, maybe with other meds (sleeping pills, anti-anxiety meds if you seem very anxious) to try to stop the hallucinations. They may also refer you to a psychiatrist. Anti-psychotics usually take a few weeks to stop an ongoing psychosis that is part of a mental illness; if you're dealing with amphetamine or other stimulant induced psychosis, they can work A LOT faster; a single effective dose of Haldol, for instance, will block the effects of stimulants and cause an almost immediate reduction in psychotic symptoms. I mention this b/c usually, when prescribed for psychotic disorders, anti-psychotics are prescribed over the long-term; if you're dealing with a problem that is drug-induced or a sudden "psychotic break," it may only be necessary to take the anti-psychotic short-term and then re-evaluate. Good luck!
Posted by jay on February 28, 2005, at 7:23:01
In reply to bugs crawling on skin, posted by parasolips on February 28, 2005, at 1:23:12
Just get to a doctor asap! With possible psychosis, you may want to stay away from the mary-jane, until you are more stable. If psychosis is involved, you should be on an antipsychotic, not just Effexor. Please get medical healp asap.
Best,
Jay
Posted by fires on February 28, 2005, at 9:00:26
In reply to bugs crawling on skin, posted by parasolips on February 28, 2005, at 1:23:12
A true story to consider: An ER doc was on a radio program many years ago on which he descibed a patient in the ER who complained about bugs crawling under his skin. No bugs were found. As the young man was being taken to the p ward, he asked the ER doc: "How do you think the bugs got into the cocaine in the first place?"
Be careful.
Posted by parasolips on February 28, 2005, at 14:53:07
In reply to Re: bugs crawling on skin » parasolips, posted by fires on February 28, 2005, at 9:00:26
thank you so much for the responses! i'm probably going to go to the dr as soon as i can.
just to fill in some into:
-i don't do methamphetamines <sp?>. i've tried both meth and coke, but only as "one-time-things"
-i used to be on antipsychotics, but i really really don't want to go on them again. i mean...i will if necessary, but i'm really into living my life med free at this juncture.thanks again!
Posted by lunesta on February 28, 2005, at 16:23:46
In reply to bugs crawling on skin, posted by parasolips on February 28, 2005, at 1:23:12
this is not an uncommon feeling actually. I get this sensation, a tingling type feeling, and I use Neurontin, and now Lyrica to inhibit it. Its related to nerve pain/damage.
I would suggest a trial of Neurontin or Lyrica.
Posted by med_empowered on February 28, 2005, at 16:40:20
In reply to Re: bugs crawling on skin, posted by lunesta on February 28, 2005, at 16:23:46
hey! anti-psychotic treatment is usually the treatment of choice for "acute psychosis" (and the management of chronic psychotic problems, like schizophrenia). If you are having these sensations but they're not too distressing to you and they don't interfere with your ability to interact with others, then it may not be the way to go. Personally, though, I'd still see a doc about some sort of anti-anxiety med. And...sorry about emphasizing the whole amphetamine psychosis thing.
Posted by Phillipa on February 28, 2005, at 17:18:24
In reply to Re: bugs crawling on skin » parasolips, posted by fires on February 28, 2005, at 9:00:26
See your doc. Fondly, Phillipa
Posted by Minnie-Haha on February 28, 2005, at 17:33:01
In reply to bugs crawling on skin, posted by parasolips on February 28, 2005, at 1:23:12
> so my problem is this: i feel like there are bugs crawling all over my skin...
>
> any ideas about what i should attribute this feeling to, and what i should do about it?The name for this sensation is formication (with an "m"). Are you a woman? Are you by any chance having changes in your menstrual cycle? About 10 percent of menopausal women experience this crawly skin feeling, but usually in just one or two areas, and not everywhere. FYI.
Posted by Minnie-Haha on February 28, 2005, at 17:38:36
In reply to Re: bugs crawling on skin = formication » parasolips, posted by Minnie-Haha on February 28, 2005, at 17:33:01
> > so my problem is this: i feel like there are bugs crawling all over my skin...
> >
> > any ideas about what i should attribute this feeling to, and what i should do about it?
>
> The name for this sensation is formication (with an "m"). Are you a woman? Are you by any chance having changes in your menstrual cycle? About 10 percent of menopausal women experience this crawly skin feeling, but usually in just one or two areas, and not everywhere. FYI.IF your itching is related to menopause, you might find relief from
Medical: anti-itch gels or creams, or cold compresses
Herbal: dandelion, or raw beets
Homeopathic: Caladium, or Rhus tox
Posted by parasolips on February 28, 2005, at 17:40:49
In reply to Re: bugs crawling on skin = formication » parasolips, posted by Minnie-Haha on February 28, 2005, at 17:33:01
> > so my problem is this: i feel like there are bugs crawling all over my skin...
> >
> > any ideas about what i should attribute this feeling to, and what i should do about it?
>
> The name for this sensation is formication (with an "m"). Are you a woman? Are you by any chance having changes in your menstrual cycle? About 10 percent of menopausal women experience this crawly skin feeling, but usually in just one or two areas, and not everywhere. FYI.
>
i am a woman, and i AM having some weirdness in my menstrul cycle, but i'm pretty sure i'm not menopausal because i'm 23. :)
i went to the gyno like, last week though and she said i have amenorrhea...i haven't had my period in 3 months and there's no apparent reason for it.woo i love being screwed up in so many areas of my life. at least im consistent.
Posted by Minnie-Haha on February 28, 2005, at 17:48:47
In reply to Re: bugs crawling on skin = formication, posted by parasolips on February 28, 2005, at 17:40:49
> i am a woman, and i AM having some weirdness in my menstrul cycle, but i'm pretty sure i'm not menopausal because i'm 23. :)
> i went to the gyno like, last week though and she said i have amenorrhea...i haven't had my period in 3 months and there's no apparent reason for it.Interesting... Here's a link to an article about amenorrhea
http://www.nlm.nih.gov/medlineplus/ency/article/001218.htm
Did you OBGYN do any tests? At your age, I'd want to find out why you're not menstruating. It could be nothing to worry about, and it could be serious. Maybe see another OBGYN or an endocriologist!
Posted by Minnie-Haha on February 28, 2005, at 17:51:41
In reply to Re: bugs crawling on skin = formication, posted by Minnie-Haha on February 28, 2005, at 17:48:47
Actually, this is a more appropriate link...
Posted by parasolips on February 28, 2005, at 18:01:43
In reply to Re: bugs crawling on skin = formication, posted by Minnie-Haha on February 28, 2005, at 17:48:47
> > i am a woman, and i AM having some weirdness in my menstrul cycle, but i'm pretty sure i'm not menopausal because i'm 23. :)
> > i went to the gyno like, last week though and she said i have amenorrhea...i haven't had my period in 3 months and there's no apparent reason for it.
>
> Interesting... Here's a link to an article about amenorrhea
>
> http://www.nlm.nih.gov/medlineplus/ency/article/001218.htm
>
> Did you OBGYN do any tests? At your age, I'd want to find out why you're not menstruating. It could be nothing to worry about, and it could be serious. Maybe see another OBGYN or an endocriologist!
>i thought it was pretty strange that they didn't do too many tests...just a urinalysis to make sure i wasn't pregnant.
i've had a cyst on an ovary before too so there you go. better just find a second opinion.don't suppose you can think of a link between that and the bug-thing though, eh?
there's a lot of crazy things going on with my life and health right now so i'm pretty overwhelmed with figuring out what on earth is going on.
Posted by Minnie-Haha on February 28, 2005, at 18:06:14
In reply to Re: bugs crawling on skin = formication, posted by parasolips on February 28, 2005, at 18:01:43
> i thought it was pretty strange that they didn't do too many tests...just a urinalysis to make sure i wasn't pregnant.
> i've had a cyst on an ovary before too so there you go. better just find a second opinion.
>
> don't suppose you can think of a link between that and the bug-thing though, eh?
>
> there's a lot of crazy things going on with my life and health right now so i'm pretty overwhelmed with figuring out what on earth is going on.The bug thing I'd link to your female hormones being out of whack, and that might be as easy to fix as getting on birth control pills, but I'd get some tests done first. Are you excessively thin or fat? Either of those will mess with your period, though for different reasons. Could you have PCOS? A thyroid disorder? Diabetes or some other blood-sugar sorta thing? Good luck sorting it out!
Posted by parasolips on February 28, 2005, at 19:01:46
In reply to Re: bugs crawling on skin = formication, posted by Minnie-Haha on February 28, 2005, at 18:06:14
i made an appt for a regular doctor tomorrow.
do you think it would help at all if i took an abilify from my old prescription?
i feel like my brain is not working right now. gah.
Posted by med_empowered on February 28, 2005, at 19:54:46
In reply to Re: bugs crawling on skin = formication, posted by parasolips on February 28, 2005, at 19:01:46
hey! sorry you're stressed. Taking some Abilify might help you out; then again, antipsychotics seem to take about 6 weeks to really "kick in," which is why they're mostly used for things like schizophrenia or psychotic depression, issues that have been going on for a while. It's completely your call. If your doc can't find a reason for your current issue through bloodwork, etc., you may want to ask about some kind of medication...from the sounds of things, you're seriously stressed, so some kind of anti-anxiety med might help you out. Then
Posted by Minnie-Haha on February 28, 2005, at 22:34:26
In reply to Re: bugs crawling on skin = formication, posted by parasolips on February 28, 2005, at 19:01:46
That's tough to say. I'm not familiar with psychoses or very familiar with anti-psychotics. Maybe it'd help, esp. if you're problem is psychosis related and not "female" or hormone related. I'm glad you're going to the doctor. Keep us posted...
Posted by AMD on March 1, 2005, at 16:44:55
In reply to Re: bugs crawling on skin = formication, posted by parasolips on February 28, 2005, at 17:40:49
"They need a dating service for folks like us," I think, as I sit here in a Starbucks, manic as hell (well, mixed, with emphasis on depression), looking at all these other "normal" folks enjoy their conversations and coffee while I, on the other hand, perform searches for "cocaine and cognition" (I did some cocaine Saturday night for the first time in years, and it apparently fired of a deadly chain reaction that in addition to making me depressed is making it hard to concentrate and thus killing any faith I have in my own typically above average intelligence) and try to keep myself from crying or otherwise having a nervous breakdown, while also attempting to complete a technical project consisting of some 7,500-plus lines of Java code and a high-end security design -- with a dozen people waiting for this deliverable -- and, too, occasionally glancing at the door in anticipation of the arrival of an ex-girlfriend (who was sane enough to split with me before things got really bad) to take me for a quick slice of pizza, today being my birthday.
amd
Posted by parasolips on March 1, 2005, at 19:31:36
In reply to Re: bugs crawling on skin = formication » parasolips, posted by AMD on March 1, 2005, at 16:44:55
> "They need a dating service for folks like us," I think, as I sit here in a Starbucks, manic as hell (well, mixed, with emphasis on depression), looking at all these other "normal" folks enjoy their conversations and coffee while I, on the other hand, perform searches for "cocaine and cognition" (I did some cocaine Saturday night for the first time in years, and it apparently fired of a deadly chain reaction that in addition to making me depressed is making it hard to concentrate and thus killing any faith I have in my own typically above average intelligence) and try to keep myself from crying or otherwise having a nervous breakdown, while also attempting to complete a technical project consisting of some 7,500-plus lines of Java code and a high-end security design -- with a dozen people waiting for this deliverable -- and, too, occasionally glancing at the door in anticipation of the arrival of an ex-girlfriend (who was sane enough to split with me before things got really bad) to take me for a quick slice of pizza, today being my birthday.
>
> amd
oh man can i relate to that.
maybe i shouldn't get into my experiences here but let me just tell you that i've been in some REALLY prototypically "crazy" situations (ie 2 nights ago when i locked myself in the bathroom and completely freaked out because some old nirvana song triggered something...) and also dated some people that have been "certifiable" as well (i.e. i'm dx borderline, right? but i do NOT have time or tolerance to deal with the manipulations of dating a borderline....which i started doing recently but couldn't handle it).
anyway.today i went to the doctor. not a good experience. i hate western medicine and in a place like berkeley (where i am) it seems really outdated. she basically told me to stop smoking weed and THEN we could talk. gah.
when i told her i had a history of psych problems and i was worried this could be resultant from that, she asked me if i was suffering from "anxiety or depression."
"not currently..." i told her...and held my tongue from adding, "but how about mania and psychosis?"
she was VERY adament that all of my problems were not valid and that they were caused by my use of marijuana.i'm going to go to my dbt therapist on friday and see what she thinks.
sorry to ramble. slightly manic. still itchy. still smoking.
Posted by parasolips on March 1, 2005, at 19:36:45
In reply to Re: bugs crawling on skin = formication » parasolips, posted by AMD on March 1, 2005, at 16:44:55
> "They need a dating service for folks like us," I think, as I sit here in a Starbucks, manic as hell (well, mixed, with emphasis on depression), looking at all these other "normal" folks enjoy their conversations and coffee while I, on the other hand, perform searches for "cocaine and cognition" (I did some cocaine Saturday night for the first time in years, and it apparently fired of a deadly chain reaction that in addition to making me depressed is making it hard to concentrate and thus killing any faith I have in my own typically above average intelligence) and try to keep myself from crying or otherwise having a nervous breakdown, while also attempting to complete a technical project consisting of some 7,500-plus lines of Java code and a high-end security design -- with a dozen people waiting for this deliverable -- and, too, occasionally glancing at the door in anticipation of the arrival of an ex-girlfriend (who was sane enough to split with me before things got really bad) to take me for a quick slice of pizza, today being my birthday.
>
> amdoh wait...
and HAPPY BIRTHDAY?!?hope that wasn't too ironic.
my birthdays never go too well for some reason.
i hope you get at least one thing you wanted (good pizza, perhaps?)
Posted by AMD on March 1, 2005, at 21:54:28
In reply to Re: bugs crawling on skin = formication, posted by parasolips on March 1, 2005, at 19:31:36
I know you don't want to hear this ... but seriously, you might try giving the marijuana a rest. I have a friend (in Berkeley also!) who suffers from extreme depression ... who isn't getting any better despite taking Celexa, which worked for her for awhile, and now something else ... and happens to smoke pot two or three times a day. I was living near Berkeley for almost two years before two weeks ago when I moved back to New York, so I know the culture there. I've smoked a bit of weed myself -- but all it does for me is zap my memory and cognitive skills for about a week.
Remember, too, that anything is worth trying (well, almost anything) for a little while. You might be surprised.
amd
Posted by AMD on March 1, 2005, at 21:57:26
In reply to Re: bugs crawling on skin = formication, posted by parasolips on March 1, 2005, at 19:31:36
I just realized that perhaps you were being sarcastic "western medicine outdated" -- I'm feeling slow today, forgive me.
Posted by parasolips on March 2, 2005, at 3:38:10
In reply to Re: bugs crawling on skin = formication, posted by AMD on March 1, 2005, at 21:54:28
i actually moved to berkeley from new york myself. very different life, i'm finding.
i guess the marijuana is something like self-medication to replace the effexor, lamictal, abilify, and othro-tricyclen that i've stopped taking all within the last 6 months.it's hard to be sane in an insane world
[or something equally cliched]
> I know you don't want to hear this ... but seriously, you might try giving the marijuana a rest. I have a friend (in Berkeley also!) who suffers from extreme depression ... who isn't getting any better despite taking Celexa, which worked for her for awhile, and now something else ... and happens to smoke pot two or three times a day. I was living near Berkeley for almost two years before two weeks ago when I moved back to New York, so I know the culture there. I've smoked a bit of weed myself -- but all it does for me is zap my memory and cognitive skills for about a week.
>
> Remember, too, that anything is worth trying (well, almost anything) for a little while. You might be surprised.
>
> amd
Posted by Minnie-Haha on March 2, 2005, at 11:32:03
In reply to Re: bugs crawling on skin = formication, posted by parasolips on March 1, 2005, at 19:31:36
> today i went to the doctor. not a good experience. i hate western medicine and in a place like berkeley (where i am) it seems really outdated. she basically told me to stop smoking weed and THEN we could talk. gah.
Did you talk about your amenorrhea? Can you get a referral to an endocrinologist?
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