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Dr. Bob is Robert Hsiung, MD,
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Posted by Jeroen on September 6, 2008, at 6:50:27
In reply to Re: feeling not well due to Abilify And OR Supliride » Jeroen, posted by SLS on September 6, 2008, at 5:30:19
i have schizoaffective disorder with a bipolar depressive component
schizophrenia and an unknown psychosis caused by lamictal wich i get psychotic on zyprexa and clozapine
strange, and mean things going on in my head
Posted by Jeroen on September 6, 2008, at 6:51:07
In reply to Re: feeling not well due to Abilify And OR Supliride, posted by manic666 on September 6, 2008, at 3:33:58
red alert
Posted by Jeroen on September 6, 2008, at 6:53:00
In reply to Re: feeling not well due to Abilify And OR Supliride » Jeroen, posted by SLS on September 6, 2008, at 5:30:19
if i get psychotic on sulpiride thats it, ill go back to seroquel and face the evil seizures like falling behind and with a taught i never can walk again, because thats what it was
Posted by Phillipa on September 6, 2008, at 19:40:55
In reply to Re: feeling not well due to Abilify And OR Supliride, posted by Jeroen on September 6, 2008, at 6:53:00
Jeroen listen to Scott he is very wise and knowledgeable. Phillipa
Posted by yxibow on September 7, 2008, at 4:04:50
In reply to Re: feeling not well due to Abilify And OR Supliride, posted by Jeroen on September 6, 2008, at 6:50:27
> i have schizoaffective disorder with a bipolar depressive component
>
> schizophrenia and an unknown psychosis caused by lamictal wich i get psychotic on zyprexa and clozapine
>
> strange, and mean things going on in my headI'm still not sure on the whole Lamictal psychosis.
I mean anything can happen with psychotropics -- I have something more or less like generalized Tardive Dystonia
(fairly permanent stiffness from waist down and biceps, aggravated by other medications probably and worse with stress and in the evening)
...from taking Zyprexa at 12.5mg with stiffness occurring covered up by Amantadine, which became futile and potentially not a good idea to continue, for one month. That was 3 years ago.
Seroquel that I take now, which I was taking before, is of course a treatment (ironically Zyprexa too and Clozaril) for TDy and so is Valium (which I still am reeling from reducing)
But my point is that there can be other explanations and without a stable plasma level on any antipsychotic, which seems to be the case, its hard to even evaluate yourself -- I'm not trying to be mean spirited, but there seems to be a laundry list of them going in circles.
Schizoaffective disorder requires more due diligence with medication levels because it is an affective disorder and should not be managed at high doses unless absolutely necessary.
But if there is a bipolar component I am confused as to why the Lamictal "caused a psychosis". Of course Lamictal is not the end all to BP I/II.There are a fairly large list of AEDs including Depakote which could be added on, provided they don't seriously interact with your neuroleptic.
-- best wishes
Jay
Posted by Jeroen on September 7, 2008, at 15:27:37
In reply to Re: feeling not well due to Abilify And OR Supliride » Jeroen, posted by yxibow on September 7, 2008, at 4:04:50
hi, the lamictal gave me an euphoric feeling first day, then it resulted in psychosis
when i quit the anti psychotic i actually feel that euphoric feeling again and propably too much dopamine release,
since i never got psychotic on zyprexa before this lamictal psychosis, I DO NOW so its a psychosis or brain receptor damage
Posted by Zyprexa on September 7, 2008, at 23:10:32
In reply to Re: feeling not well due to Abilify And OR Supliride » Jeroen, posted by SLS on September 6, 2008, at 5:30:19
Jeron,
Its very likely that Abilify would cause those simptoms. I know this from my experiences with it.
Posted by yxibow on September 8, 2008, at 5:54:52
In reply to to yxibow, posted by Jeroen on September 7, 2008, at 15:27:37
> hi, the lamictal gave me an euphoric feeling first day, then it resulted in psychosis
>
> when i quit the anti psychotic i actually feel that euphoric feeling again and propably too much dopamine release,
>
>
> since i never got psychotic on zyprexa before this lamictal psychosis, I DO NOW so its a psychosis or brain receptor damagePsychotropics have a buildup and buildown period in time in the body and varies by person.
Unless one is taking a hard core untested street drug, and even then, I haven't heard of the word "brain receptor damage".
Receptors may be overloaded and used to medication after time and may have to be withdrawn from medication to change.
Neuroplasticity also figures in the equation as to how the brain remaps things as well.
-- Jay
Posted by Jeroen on September 8, 2008, at 6:47:07
In reply to Re: to yxibow » Jeroen, posted by yxibow on September 8, 2008, at 5:54:52
its a nasty psychosis due lamictal, i think i can reverse it with 800 mg of seroquel but thats like a death therapy, the main problem is RAPID HEART RATE AND EXTREME SEDATION. VERY SCARY, also the hardcore EPILEPSY im getting from seroquel
these are the last times of my life sorry ... stupid psychiatry
Posted by Racer on September 8, 2008, at 10:59:10
In reply to to yxibow, posted by Jeroen on September 7, 2008, at 15:27:37
> hi, the lamictal gave me an euphoric feeling first day, then it resulted in psychosis
>
>
> since i never got psychotic on zyprexa before this lamictal psychosis, I DO NOW so its a psychosis or brain receptor damageJeroen, there's something you hear a lot in the sciences: correlation does not equal causation. This may not seem helpful to you, due to the pain you're in right now, but all you can really say so far is that there was a very close correlation in time between your very short trial of Lamictal and the onset of your psychosis. As far as the correlation/causation goes, an argument could be made that the onset of your psychosis is what caused the initial euphoria, which you attribute to the Lamictal.
I know you believe it was the Lamictal, and that could be exactly the case. I just hope you can allow yourself to consider other possible explanations.
Also, what dose of Lamictal were you taking, and how long were you taking it? What dose did you start at, and how long were you on it before increasing it? Lamictal is one of those that requires a very low start and slow titration schedule.
Best luck to you, Jeroen. I hope you find something that helps you very soon.
Posted by Jeroen on September 8, 2008, at 11:25:21
In reply to Re: to yxibow » Jeroen, posted by Racer on September 8, 2008, at 10:59:10
my dose was 25 mg of lamictal
i felt better the first days but then nightmare broke lose
i watched a movie and felt much better, i even smiled, few days later i was rushed to the hospital by police and stayed there for a month
thats how deep my pain is
Posted by Jeroen on September 8, 2008, at 11:38:35
In reply to Re: to yxibow » Jeroen, posted by Racer on September 8, 2008, at 10:59:10
hi, my med to become safe was zyprexa, but now i react badly to it wich is bad i get psychotic on zyprexa
on the other hand abilify not i think ... or less
Posted by Racer on September 8, 2008, at 12:31:18
In reply to To Zyprexa, posted by Jeroen on September 8, 2008, at 11:38:35
> hi, my med to become safe was zyprexa, but now i react badly to it wich is bad i get psychotic on zyprexa
>
Jeroen, can you describe the symptoms you experience when you become psychotic? What symptoms, exactly, are you trying to treat.Psychosis can be a pretty broad term, and maybe it would help to know what it means to you.
Posted by Jeroen on September 8, 2008, at 12:55:15
In reply to Re: About Zyprexa » Jeroen, posted by Racer on September 8, 2008, at 12:31:18
well basically that i'm loosing it, rapid heart beat, paranoia
Posted by Zyprexa on September 8, 2008, at 16:49:36
In reply to Re: About Zyprexa, posted by Jeroen on September 8, 2008, at 12:55:15
What dose were you taking of Zyprexa? Maybe you just were not taking it long enough. It takes a while to start working fully. Especialy when I stoped the abilify, and went back on zyprexa. I had to use higher doses for a while befor it would work like it used to. One year later its starting to work again. Maybe the psychosis you experienced were from too low a dose or that it was old simptoms that just have not gone away yet. If you take a higher dose for a while it might work for your psychosis. I've taken doses of zyprexa as high as 50mg before. I don't sugest that and I only would do it for a day or two.
Personaly I think you should give zyprexa or seroquel a try. And take it for a long time. It may not be effective right away. Make sure you have high enough dose. If a low dose is not working try a higher one.
Posted by Jeroen on September 8, 2008, at 16:54:15
In reply to Re: About Zyprexa » Jeroen, posted by Zyprexa on September 8, 2008, at 16:49:36
seroquel blocks the psychosis fine witouth psychotic episodes
abilify too but its not perfect drugand seroquel is sedating ... but a good night sleep in this miserable world where the healthy rules and poor and sick suffer
Posted by Racer on September 8, 2008, at 17:23:47
In reply to Re: About Zyprexa, posted by Jeroen on September 8, 2008, at 12:55:15
Hi, Jeroen,
Thanks for answering my question. I'm going to ask more, though.
Do you have auditory or visual hallucinations? Pressured speech? Flight of ideas? You've mentioned paranoia, which can be related to psychosis. When you are "losing it," what does that look like for you? Are you angry with people? Frightened? So depressed you want to crawl into bed and never come out again? Do people tell you that you're not making sense or that you are experiencing disordered thinking?
Also, what is the course of your illness? Were you diagnosed before starting the Lamictal? Did your diagnosis change because of your response to Lamictal? Again, the more clear the picture, the better the chance at a helpful answer.
I have no doubt whatsoever that you're suffering, Jeroen, and suffering greatly. I wish I could help you. Maybe having some better idea of what psychosis looks like for you will help with ideas about good medication options for you.
Oh, and if it helps any -- I believe English is not your native language? And you're living in a non-English speaking country? If that is indeed the case, just the fact that you can express yourself in a foreign language makes me think that your thinking probably isn't severely disordered, if at all. ;-)
Posted by Jeroen on September 9, 2008, at 2:19:11
In reply to Re: About psychosis » Jeroen, posted by Racer on September 8, 2008, at 17:23:47
its hard to explain but i have rapid heart beat, 100 times normal anxiety, and 100 times paranoia
Also, what is the course of your illness?
SchizoWere you diagnosed before starting the Lamictal?
YesDid your diagnosis change because of your response to Lamictal?
Schizo + Psychosis
Posted by yxibow on September 9, 2008, at 12:52:39
In reply to Re: to yxibow, posted by Jeroen on September 8, 2008, at 11:25:21
> my dose was 25 mg of lamictal
>
> i felt better the first days but then nightmare broke lose
>
> i watched a movie and felt much better, i even smiled, few days later i was rushed to the hospital by police and stayed there for a month
>
> thats how deep my pain is
I have to concur in this case that correlation is not causation.25mg of Lamictal is a -starting- dose, and is raised very carefully. It is decidedly not psychotropic at that level that I have heard of for anybody, it is merely a dose to test if you have a rash or allergy to it.
3 days of 25mg Lamictal is not even in the psychiatric window of change.
You may have been experiencing endogenous psychosis at the same time which may have in the cosmic spectrum (I'm trying not to attack your feelings) been pinpointed at the micron level by Lamictal but almost quickly gone, if ever at all. And that is not even a evidence based scientific view that most psychiatrists would hold.
-- best wishes
-- Jay
Posted by Jeroen on September 9, 2008, at 13:26:28
In reply to Re: to yxibow » Jeroen, posted by yxibow on September 9, 2008, at 12:52:39
no its caused by lamictal, google and see that anti seizure meds can cause psychosis
Posted by yxibow on September 10, 2008, at 3:09:53
In reply to Re: to yxibow, posted by Jeroen on September 9, 2008, at 13:26:28
> no its caused by lamictal, google and see that anti seizure meds can cause psychosis
Yes, at a plasma level AEDs can do anything -- Keppra is a pretty good example of a potentially psychosis inducing AED.
3 days of 25mg of Lamictal is not a plasma level.
This would have to be a very very very rare case in the annals of psychiatric journals (I'm not trying to be cynical).
I've had unfortunately four rare neurological effects, 11 years later still back, neck and head muscle lockups by dumping Tranxene (partially helped at the moment by Robaxin)......a right index finger micro tic (slightly larger than the pseudoparkinsonism caused by current Seroquel) caused by about 1mg of Risperdal and Prozac -- one to two weeks (and I'm very sensitive to neuroleptics and Risperdal is pretty potent)
....probable Tardive Dystonia caused by Zyprexa 12.5mg, one month
... the most serious, a non-tardive oral-buccal tic with vocalizations [bu-bu-bu, not controllable really] (none much recently) and at least 90% psychologically stimulated (I just had one mentioning it) ...caused probable by Seroquel 400-1200mg over 6 years (which I still have to take to be more functional, at the moment). But 3 days is really rare.
And 3 days is basically a one-off of a drug. It would stop after dropping it.I really have to concur with the previous posts.
I don't know what to say other than there was some psychosis increasing in your system at the time. Maybe it increased it in your viewpoint but its just... hmm... how do I say it from what I've heard from another doctor (and I'm not saying that there is any "right" opinion), a "memory" of an experience.
-- best wishes
Jay
Posted by Jeroen on September 10, 2008, at 3:42:12
In reply to Re: to yxibow » Jeroen, posted by yxibow on September 10, 2008, at 3:09:53
i think it was a week i took it 4-5 days and the side effect manual sais psychosis is a side effect
accept it please
also youve gone trough some nasty dyskinesia yourself
Posted by yxibow on September 10, 2008, at 5:14:54
In reply to Re: to yxibow, posted by Jeroen on September 10, 2008, at 3:42:12
> i think it was a week i took it 4-5 days and the side effect manual sais psychosis is a side effect
>
> accept it please
>
> also youve gone trough some nasty dyskinesia yourself> i think it was a week i took it 4-5 days and the side effect manual sais psychosis is a side effect
>
> accept it please
>
> also youve gone trough some nasty dyskinesia yourselfIf you read PIs, Jeroen, you can find anything. At that level, .1% to 1%, it can cause tinnitus, arthritis, leukopenia, hot flashes, halitosis, alopecia, increased salivation, and yes, psychosis, but we are talking about people with a PLASMA level.
4-5 days at 25mg would not build up any significant psychotropic plasma levels.
But if you insist that you have a secondary psychosis, I can't say further -- I'm not trying to be mean, but it doesn't follow. Please don't compare myself to you -- I have the "breakfast of champions" if you want to be perverse, of medications, at 8 of them currently. Concurrent use (polypharmacy) is more likely to produce unknown results. Simpler is always best but sometimes a number of medications have to be added.
Do I have heavy dysthymia or cyclothymia, probably the first. Do I have thoughts of suicide, yes. I'm afraid of death though (really that is a fear of life -- living, with whatever I have or don't have -- my hairdresser of 20 years has MS. Has she stopped?). And what would suicide do to my parents and my caregivers (my doctors) as well?
Yes, the tic and the fear of future success at the moment when medications are not quite titrated right and I need to work through psychological therapy more than medication therapy at the moment -- justly because I do have sensitivity to medication.
It is conceivable now that I have reached 20mgs of memantine, that at this plasma level caused some really wierd stuff to happen the other day. Or maybe it was the Amantadine (they're both noncompetitive NMDA antagonists) that I tried for my Tardive Dystonia [thats not dyskinesa] that boosted the NMDA system. Or maybe it was the conversation with my psychologist. Or maybe it was a blip in my disorder.
I have a streak running in my mother's side -- she has phobias and some depression, her sister has some slight depression and anxiety occasionally but the depression is due to circumstance, not the streak, and the third (aunt) that I did not know, committed suicide from what was probably BP-II (99% sure, never much further police investigation).
So I have the brunt of all of this. I was hospitalized at 17 for SEVERE OCD. And now I am fighting a disorder I never thought I would ever get.And yes, I am sensitive to neuroleptics because I have an affective (mood) disorder.
But you have to see at various points I was on more than one medication -- clashes can happen.
The tics and the dystonia were RARE and unpredictable and I do feel very sorry for myself at times and wish I could go into oblivion, but what would that accomplish either? I have memory loss now from taking Valium, but that was after 4 years. Its being adjusted down and is a double edged sword.
In fact half my medications are double edged swords -- to realize the world as my unknown "orphan disorder" of visual somatiform and psychosis NOS (which does not mean psychotic in any way or I wouldn't be writing in this manner or style probably, no offense to anyone who is severly psychotic) ..... I would have to go down on medication which would mean I would have, yes, more symptoms, or maybe realizing the world would make me feel more "REAL", hammered with medications. Its all a very complicated dance.
You can't compare people -- I've noticed that on here and I'm not trying to create a vast generalization, but everyone is genetically different.
Sometimes doctors disagree with the patient.Tardive dystonia, generalized as I probably have, is almost impossible to be diagnosed by a neurologist -- its worse with cold on my legs, yet I generally overheat and my body temperature is 97.5 -- maybe thats genetic, or maybe thats because I'm overweight.
Severe tardive dystonia causes torticollis and twisted necks and all sorts of other things which for that, neurologists CAN tell and may possibly be able to use things like bromocriptine and tetrabenazine (very cautiously).
Tardive dystonia, which in some cases will remit only for 10% of patients, is NOT tardive dyskinesia and while it is not a pleasant thing, it has more palleatives, including the very Seroquel I'm taking, and probably the Valium, and maybe I'm experiencing it more now with less Valium. Heaven knows.
The tic is not Tardive. That was confirmed. The only treatment mentioned was Clozaril because Seroquel may aggravate it. We never got there because the Valium level is at a crossing point (you can't take much of any benzodiazepines with Clozaril). It may be intertwined also with the psychological things that accompany my disorder.
No, I don't like having a "red light" on me that turns on when I am angry at someone or anxious -- that is, the tic happens. Its probably not good for my teeth -- I have a night guard but I'm afraid of loosing it with my short term possession displacement, etc, memory now.
But thank goodness, no, there is no dyskinesia. Yes, I worry about that with Seroquel (about 0.1% chance, who knows with me) -- yet I need it now or I couldn't put on a belt or drive my car because of the underlying anxiety and perhaps how many years I took the Seroquel and the phase of the moon (sorry for the crassness).
So its hard to figure how to reduce that and not cause havoc of my personal daily life that while I don't feel connected to other people, I am capable of a lot of things and there is a intelligent mind waiting to be free again and much happier.
In conclusion -- yes, you can insist, as the patient (or as NAMI prefers, consumer) that you have some semi-permanent condition caused by Lamictal.I do insist I have some form of dystonia, be it tardive or not. In fact I have a double dystonia because I still have some neurological "memory" of dropping a benzo a decade ago when I didn't know the consequences and the people who treated me did not give me back what I needed immediately.
I know when I wasn't on Seroquel recently that 100mg of Seroquel melted away it on my legs -- so is that a litmus test for TDy -- it could be. Tics do not go away as much at my age (30ish) as they do at around 18.
I can't say any more about the Lamictal but if you read the PI you will just obsess about it more, if I can comment about it, just as I obsess about my tic. Its there. So are people with MS or missing a leg have REAL things happening, just as the somatoform things I feel are real, though not organic. But somehow people go on. I hope I go on too and I sincerely hope you do also.This isn't a lecture, I understand -- well nobody can say "I understand your pain" -- that's a cliche and unfair, but I understand your distress and how you want to get back to where you were. But sometimes we look back with rosy lenses (that's an Americanism) at the past. We live in the Here and Now.
-- much wishesJay
Posted by Jeroen on September 10, 2008, at 5:21:58
In reply to Re: to yxibow » Jeroen, posted by yxibow on September 10, 2008, at 5:14:54
thanks, i hope you get some answers real soon too
Posted by Jeroen on September 10, 2008, at 5:25:31
In reply to Re: to yxibow, posted by Jeroen on September 10, 2008, at 5:21:58
i have severe schizophrenia, and now psychosis
but the only med i responded to was seroquel and it totally made me feel normal again, but it doesnt work anymore and so far nothing else works
i dont know why, but i loved seroquel
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