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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 26. This is the beginning of the thread.
Posted by alienatari on June 13, 2006, at 22:20:22
why are you so negative about them med_empowered? Do you have schizophrenia or a bad experience with them?
Anyway, I will not listen to you or anyone else here. YOU ARE NOT A DOCTOR! And most of the people here arnt either.
I thought this place was suppose to be helping and caring not somewhere where people to do stupid things like going against their pdoc(s) opinion(s)
ciao caio
Posted by med_empowered on June 13, 2006, at 22:36:00
In reply to Antipsychotics RULE!, posted by alienatari on June 13, 2006, at 22:20:22
I'm not trying to say stop your meds, or even that antipsychotics are always bad...what I **am** saying is that a lot of times it seems like antipsychotics are used in situations where other drugs could be used. Also, some people who are dx'd with "schizophrenia" can do OK with mood-stabilizers (lots of bipolar people are dx'd schizophrenic initially), so the situation is kind of complicated.
In your case, I say if you like your med combo, go for it--but I do think a lot of times there are drugs besides Haldol that can be used, and that might reduce your side effects.
Posted by blueberry on June 14, 2006, at 5:22:51
In reply to Antipsychotics RULE!, posted by alienatari on June 13, 2006, at 22:20:22
I agree that for the right person in the right circumstance, antipsychotics rule. Based on my own longterm experience with them, I do think they should be saved as a final option after other things such as mood stabilizers and benzos have been tried first.
My only complaint with antipsychotics is what happens after longterm use. For example, 6 years in my case. If you use an antipsychotic for that long for insomnia or as an antidepressant or as an augmentor or anxiety, but not for schizoaffective stuff, well, you will have schizoaffective stuff if you try to stop. Longterm use of antipsychotics can make someone who never had schizophrenia become schizophrenic if they taper off. Those dopamine receptors become super sensitive after being blocked for so long and they do not readily readapt to being unblocked. For me, they did not readapt even after 3 months of being without my 5 year zyprexa following a 4 month taper. It was hell.
Diabetes is another concern. It can happen with any of them. The last thing a mentally ill person needs is to get diabetes. So that should be monitored at home weekly with a glucose meter.
Overall though, the APs can indeed be amazing for the right person in the right circumstance. After longterm use though, it is a one-way street. Benzo withdrawals are bad enough. But I found zyprexa withdrawals to be much more severe than benzo withdrawals.
Just some pros and cons. Every med choice really involves a benefit/risk decision, and those benefits and risks will vary from person to person.
Posted by bassman on June 14, 2006, at 6:26:20
In reply to Antipsychotics RULE!, posted by alienatari on June 13, 2006, at 22:20:22
"Anyway, I will not listen to you or anyone else here. YOU ARE NOT A DOCTOR! And most of the people here arnt either.
I thought this place was suppose to be helping and caring not somewhere where people to do stupid things like going against their pdoc(s) opinion"
If your point is that we should all mindlessly follow our pdoc or internist's opinion without doing our own research to make sure the opinion is well-founded, you are absolutely right, this board is collectively heretical. If the choice of psychotropic meds were deterministic, or even something that could assertained with enough medical knowledge, then it would not make sense to do your own research as to what you are taking, maybe. But the choice of meds is an Easter Egg Hunt at best-try this, then this-no competent doc would tell you anything other than that. I think the average number of AD's people try, for example, is 3-4 or more. As with any other potentially life-altering med scheme, the more you know, the better off you are in terms of not doing anything foolish or finding out later in life that there is damage that is long-term that you were never informed about. And there is much collective knowledge on this board from people who study psychoactive meds and no doubt, know more than 99+% of pdocs. Being a doc doesn't mean you're right, it means you went to school for a long time.
This board is so valuable because it reflects many opinions of people who have actually taken meds (that the pdocs, BTW, have not) and often have passionate opinions from those experiences. It's all about not closing your eyes and letting the doc (or this board) make the decision and rather taking some personal responsibility in the matter-the more you know, the healthier you'll be both now and in the future.
Posted by llrrrpp on June 14, 2006, at 8:49:21
In reply to Re: Antipsychotics RULE!, posted by bassman on June 14, 2006, at 6:26:20
I would add to bassman's post and say that any pdoc worth her salt admits that we currently don't have a great understanding of the mechanisms by which these medicines bring about psychological changes. Furthermore, we don't know very much about why some people can tolerate large doses, and why others are very sensitive to small doses. Furthermore, most pdocs have learned through experience that a certain amount of tinkering is necessary- changing the dose timing, adding augmentors, trying a new type of antipsychotic etc.
What this board does is to give us perspective on the rationale that some pdocs use for choosing certain medications. For instance, when my pdoc prescribed me 25-100 m of seroquel for my insomnia, I was reading the package insert, and it said "antipsychotic" and I was freaking out! Oh my GOD- pdoc thinks I'm psychotic... That I've got the family schizophrenia... Well. Then I read my e-mail with his instructions more closely- "I don't think you're schizophrenic, or bipolar. In my experience, seroquel works very well to augment your AD and it will help sedate you so that you can get a good night's sleep..."
So- I read on the boards that a lot of people have alsobeen prescibed seroquel for insomnia. Some with good outcomes, others with bad outcomes. It helps me think of things I should bring up with my pdoc at the next appt.
Information is power-- even if one doesn't understand all the info on this board, or even if one doesn't understand enough to separate good advice from misinformation. Being able to go see your doctor, and ask about different options gives patients an opportunity to take some control over their treatment, responsibility for what goes in our bodies, and what shouldn't go in our bodies.
Sometimes the most frustrating thing about mental illness is that we have learned not to trust ourselves, and how to be good sufferers. Having information can give us back some of that trust, as well as help us learn that we don't have to suffer through awful side effects and failed trials.
Posted by heaven help me on June 14, 2006, at 10:39:13
In reply to Re: Antipsychotics RULE!, posted by blueberry on June 14, 2006, at 5:22:51
"Longterm use of antipsychotics can make someone who never had schizophrenia become schizophrenic if they taper off. Those dopamine receptors become super sensitive after being blocked for so long and they do not readily readapt to being unblocked. For me, they did not readapt even after 3 months of being without my 5 year zyprexa following a 4 month taper. It was hell."
Blueberry, I am on APs right now and it looks like I will be on them for a long time if not life. If I ever do wean off I am terrified! Do you mind telling me more specifically what you went through? How you felt, what you saw, etc? I know I am asking a lot but I feel better when I have an idea of what may be...probably ought to just trust the Lord in this but I'm in a constant battle to trust Him as well :) (which is NOT a reflection on His trustworthiness). Anyway, blah, blah...If you don't mind answering, I;d appreciate it.
blessigns
mary
Posted by pseudoname on June 14, 2006, at 11:11:30
In reply to Information is Power » bassman, posted by llrrrpp on June 14, 2006, at 8:49:21
What a great post.
> any pdoc worth her salt admits that we currently don't have a great understanding of the mechanisms by which these medicines bring about psychological changes.
Exactly. If I were looking for a pdoc to consult about med issues, that would be one of several test questions. My current pdoc would pass on that point, but mostly what I want from her is a script for the drugs I've already chosen to try.
> Information is power.
So true. But doubts can be scary. If someone really, really wants to believe that his pdoc knows exactly what she's doing and has the answer to his problem, all the skepticism here might be upsetting. I know that when I've got a theory about my problem & meds & therapy that really makes sense to me, contrary data and opinions — especially when they're so passionately presented here — can be very annoying.
But I think honesty about psych treatment uncertainty is a whole lot healthier for everyone and in the end leads to more effective treatment.
> Sometimes the most frustrating thing about mental illness is that we have learned not to trust ourselves, and how to be good sufferers.
Insightful and beautiful. Thanks.
Posted by blueberry on June 14, 2006, at 16:03:58
In reply to Re: Antipsychotics RULE! » blueberry, posted by heaven help me on June 14, 2006, at 10:39:13
Weaning off an antipsychotic can be hard. But like everything else, mileage varies. Maybe someone else wouldn't have as hard a time as I did. Even though I was on zyprexa for 5 years, it was a low dose of 5mg. I can't imagine someone coming down from 10mg or 20mg. Ouch.
Anyway, as those dopamine receptors got opened up to the real world, they were not in shape for the stimuli they would receive. I expected they would adjust, but over 3 months they did not.
These are the things I experienced...
Alternating waves of fierce anxiety or depression, but not at the same time.
Loud ringing in the ears.
Sensitive acoustic startle response...small noises like a phone ringing or a car door closing or footsteps on a hard floor made me jump and made my heart skip.
Lousy sleep, maybe 4 - 6 hours at best.
Free-floating terror and anxiety upon waking.
No appetite. Went from 142lbs to 129lbs, bad.
Leg cramps. Weak legs.
Difficulty concentrating.
Overwhelmed with ordinary simple tasks.
Zero interest in anything.
During the first 3 weeks lots of muscles were twitching and moving around like some kind of worm was under the skin...this did go away.It was rough. I think next time I taper off I need to rely heavily on xanax for many of the symptoms and some kind of antihistimine for appetite.
Posted by linkadge on June 14, 2006, at 16:48:37
In reply to Re: Antipsychotics RULE! » heaven help me, posted by blueberry on June 14, 2006, at 16:03:58
I agree with some of the above posters.
I don't think that blanket statements like "antipsychotics rule" or antipsychotics suck" is entirely accurate.
They are a class of medications that work for some. They do have risks, and taken into perspective they *may* have more long term risks than other psychiatric medications. I too have experienced rebound psychosis, and that is no fun.
Antipssychotics need to be taken seriously. I suppose it might be an intrinsic effect of an antiparanoid drug, than one becomes less paranoid about the hazards of the drug itself.
Linkadge
Posted by bassman on June 14, 2006, at 16:57:45
In reply to Re: Antipsychotics RULE! » heaven help me, posted by blueberry on June 14, 2006, at 16:03:58
I'll never complain about Xanax withdrawal again. That sounds awful-I don't know how you made it through it. Thanks for sharing...that is really, really worth knowing.
Posted by Phillipa on June 14, 2006, at 20:19:05
In reply to Re: Antipsychotics RULE!, posted by bassman on June 14, 2006, at 16:57:45
A person with Schizophrenia needs antipsychotics does anyone disagree? Love Phillipa
Posted by willyee on June 15, 2006, at 19:16:17
In reply to Re: Antipsychotics RULE!, posted by bassman on June 14, 2006, at 6:26:20
> "Anyway, I will not listen to you or anyone else here. YOU ARE NOT A DOCTOR! And most of the people here arnt either.
>
> I thought this place was suppose to be helping and caring not somewhere where people to do stupid things like going against their pdoc(s) opinion"
>
> If your point is that we should all mindlessly follow our pdoc or internist's opinion without doing our own research to make sure the opinion is well-founded, you are absolutely right, this board is collectively heretical. If the choice of psychotropic meds were deterministic, or even something that could assertained with enough medical knowledge, then it would not make sense to do your own research as to what you are taking, maybe. But the choice of meds is an Easter Egg Hunt at best-try this, then this-no competent doc would tell you anything other than that. I think the average number of AD's people try, for example, is 3-4 or more. As with any other potentially life-altering med scheme, the more you know, the better off you are in terms of not doing anything foolish or finding out later in life that there is damage that is long-term that you were never informed about. And there is much collective knowledge on this board from people who study psychoactive meds and no doubt, know more than 99+% of pdocs. Being a doc doesn't mean you're right, it means you went to school for a long time.
>
> This board is so valuable because it reflects many opinions of people who have actually taken meds (that the pdocs, BTW, have not) and often have passionate opinions from those experiences. It's all about not closing your eyes and letting the doc (or this board) make the decision and rather taking some personal responsibility in the matter-the more you know, the healthier you'll be both now and in the future.
>The times when all you could do is rely on the two-three week wait for your 15 med check are over.
Why?Cause then the main material was a PDR and it was written in doc code,the libary only gave u very vague mindless dribble so yess u were smart to consult with ur pdoc.
NOW HOWEVER is quite different,we are exposed to an unending highway of information,the pdr`s are collecting dust as even docters as i saw one are googling stuff.
I value a docs opinion,but im also not gonna leave my health in the hands of someone who can see me once maybe twice a month,not when i have tons and tons of revlavent information in front of me.
Times have simply changed,and the PDR is no longer tha bible,pdr absracts can be found on the net,and when a doc is unsure,that is essentialy there tool.
Posted by Think1234 on June 15, 2006, at 19:27:19
In reply to Re: Antipsychotics RULE!, posted by blueberry on June 14, 2006, at 5:22:51
Antipychotics are dangerous. They are even dangerous with those who are schizophrenic or schizotypal. It can cause pseudoParkinson's,a parkinsons like disorder. Their is also a phenomenom called "dopamine supersensitivity" (google). This can exacerbate a psychotic persons symptoms.
Antipsychotics are a part of a psychiatrists arsenal. But they must be used with extreme caution. Sadly that not the way a lot of Pdocs act.
Posted by Think1234 on June 15, 2006, at 19:35:10
In reply to Re: Antipsychotics RULE!, posted by Phillipa on June 14, 2006, at 20:19:05
No. I don't agree. Antipsychotics often don't work. No one should be forced to take a medication that doesn't work. (Which is often the case)
> A person with Schizophrenia needs antipsychotics does anyone disagree? Love Phillipa
Posted by Phillipa on June 15, 2006, at 20:09:06
In reply to Schizophrenics need Antipyschotics:I disagree » Phillipa, posted by Think1234 on June 15, 2006, at 19:35:10
No one's forcing my friend to take them he likes the calming effect. Love Phillipa
Posted by Jakeman on June 15, 2006, at 23:50:26
In reply to Antipsychotics RULE!, posted by alienatari on June 13, 2006, at 22:20:22
> > Anyway, I will not listen to you or anyone else here. YOU ARE NOT A DOCTOR! And most of the people here arnt either.
>No disrepect intended. Maybe I've had some bad doctors. They knew less than many people who post here. That being said, everything posted here should be taken with a grain of salt. Unfortunately, I've found the same truism appllies to most p-docs. Last week my doctor had to look in a book to see what selegline is.
warm regards, Jake
Posted by linkadge on June 16, 2006, at 15:32:05
In reply to Re: Antipsychotics RULE! » alienatari, posted by Jakeman on June 15, 2006, at 23:50:26
I agree, AP's often don't really do a whole lot for people with schizophrenia.
My mother never had schizophrenia but she was loaded on mellaril for bipolar.
When they took it off the market she had rebound psychosis. Very scary stuff, symptoms she never had before. She suspected everyone in the house of something.
Linakdge
Posted by helpme on July 5, 2006, at 8:34:52
In reply to Antipsychotics do not necessarily RULE!, posted by Think1234 on June 15, 2006, at 19:27:19
Antipsychotics can turn you into a fat diabetic, can make you dumb, can give you permanent tardive diskenesia. They should be a last resort only.
Posted by helpme on July 5, 2006, at 8:37:22
In reply to Re: Antipsychotics RULE!, posted by Phillipa on June 14, 2006, at 20:19:05
Well, how severe is the problem? Is the person disfunctional, unhappy, and causing problems- or merely eccentric? Eccentric isn't worth all the risks- nothing wrong with a harmless eccentric.
Posted by helpme on July 5, 2006, at 8:42:08
In reply to Re: Antipsychotics RULE! » blueberry, posted by heaven help me on June 14, 2006, at 10:39:13
I tried zyprexa for a month and for the first time ever became paranoid, agoraphobic, smelled phantom things, felt the ground wave under me, and felt around, but not in my body. And that's just the start of it. So yes, I think anti-psychotics CAN cause psychotic symptoms. It was prescribed to me for tough depression. What a wreck. I also gained 10 pounds in that single month.
> "Longterm use of antipsychotics can make someone who never had schizophrenia become schizophrenic if they taper off. Those dopamine receptors become super sensitive after being blocked for so long and they do not readily readapt to being unblocked. For me, they did not readapt even after 3 months of being without my 5 year zyprexa following a 4 month taper. It was hell."
>
> Blueberry, I am on APs right now and it looks like I will be on them for a long time if not life. If I ever do wean off I am terrified! Do you mind telling me more specifically what you went through? How you felt, what you saw, etc? I know I am asking a lot but I feel better when I have an idea of what may be...probably ought to just trust the Lord in this but I'm in a constant battle to trust Him as well :) (which is NOT a reflection on His trustworthiness). Anyway, blah, blah...If you don't mind answering, I;d appreciate it.
> blessigns
> mary
>
Posted by Think1234 on July 5, 2006, at 15:24:21
In reply to Re: Antipsychotics RULE!, posted by Phillipa on June 14, 2006, at 20:19:05
My P-Doc tried to give me Geodine (a supposedly "novel" antipyschotic-its action is in fact novel but given that no one knows why APs work in the first place its "novelness" doesn't mean much because we don't know WHAT about its novelness makes it SUPPOSEDLY superior to other APs ) after only two unsuccessful efforts with an anti-depressant. I said no (Thank God). And I think its bizzare and absurd that he would consider giving such a dangerous drug, especially after only a few attempts.
He's also given me klonopin without telling me how addictive it is and how dangerous it is to withdraw. That it can cause hallucinations, etc, if withdrawn from.
He believes that because he's the doctor, and knows more than me-and because his drugs are "infallible", that he has a special privilege to deny me this information. After all, if he told me about the effects of the drugs I might be unwilling to take them. And since i'm a mere ignorant patient, such knowledge would only lead me to make a poor decision. Such as not taking the Klonopin or for that matter the Anti-Psychotic.
These drugs, in particular AP's can do people serious harm.
I think that people are often to insecure or feel guilt to bringsuit when their P-Docs harms them. Of course what double compounds the problem is the P-Docs act in such a similarly incompetent way that in court they can claim that they were just prescribing according to regular protocol.
But if P-Docs were sued more often I think they might think twice about prescribing that AP or withholding information about side effects from their clients.
Posted by bassman on July 5, 2006, at 17:56:57
In reply to Antipsychotics/PDocs need to be sued more often, posted by Think1234 on July 5, 2006, at 15:24:21
I think we are in the age of having to do our own research on drugs and therapies, no matter what they are. I agree with you about AP's-I think the increased use of them is dangerous. I just withdrew from Klonopin and I've withdrawn from Ativan and Xanax. It wasn't a big deal and short of just stopping, I don't think there is as much danger as there is driving on your local interstate. Patients ultimately would pay for the lawsuits to pdocs through higher malpractice insurance. In my area in the US, the pdocs don't take insurance, period-and the visits are very expensive. I guess I never think going to court is a solution to a problem; just causes more problems. My internist always smiles, shakes her head and says, "you are always better informed than the specialists I send you to". And that's because it is my ___!!! The more people "teach" their docs, the more docs may feel the necessity to learn more-but that is really, really hard if you have an arrogant, "I Know Best" doc. Drop them like a bad habit...:>}
Posted by Phillipa on July 5, 2006, at 18:42:50
In reply to Re: Antipsychotics RULE!, posted by helpme on July 5, 2006, at 8:37:22
Helpme no he's not eccentric. He hears voices, sees things that are not there, is afraid everything (paranoid). And he's schizophrenic which I already explained. And antipsychotics treat schizophrenia. Anyone disagree? Love Phillipa
Posted by MoparFan91 on July 8, 2006, at 11:44:07
In reply to Re: Antipsychotics RULE if you have NO other hope, posted by helpme on July 5, 2006, at 8:42:08
> I tried zyprexa for a month and for the first time ever became paranoid, agoraphobic, smelled phantom things,
It sounds like this drug, or at least many of the drugs in that class, were created by Voodoo Priests.
j/kAnyway, the phantom things you describe wouldn't be unlike demons.
>felt the ground wave under me, and felt around, but not in my body. And that's just the start of it. So yes, I think anti-psychotics CAN cause psychotic symptoms. It was prescribed to me for tough depression. What a wreck. I also gained 10 pounds in that single month.
These ARE Devil drugs based on the fact that you and few others are saying about them causing psychosis that has never happened before. I suggest telling everyone to stay away from them.
With Geodon one night, I woke up in paralysis and saw a big fat white demonic creature hovering over my bed, and I had to tell it to go away "In the name of Jesus..." I had been having nightmares with demonic creatures before that. I was having rushes or excitation and electricity through my body in between dreams. On that same drug, I had paranoia as well.
During this trial, Geodon caused me to go to the state psychiatric hospital because I was having paranoia delusions of persecution, hearing voices, and having suicidal ideation. My GP had put me on it for bad depressions as well. Abilify was bad as well but slightly not to this degree. Zyprexa caused a downright super agitated and hostile feeling few hours after each dose. Seroquel made my obsessive thinking Hell.
I cannot take the AP class of drugs at all now. They have never helped me and been nothing but trouble.
Posted by bassman on July 8, 2006, at 11:49:56
In reply to Re: Antipsychotics RULE if you have NO other hope, posted by MoparFan91 on July 8, 2006, at 11:44:07
What an incredible post. Well, now I know what to do if I want my life to become really different, really quickly...:>}
I used to just be very wary of AP's...thanks for the info.
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