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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by herpills on March 29, 2011, at 15:59:48
Well, I'm ready to give up on Abilify because I can't stand the akathesia and increased anxiety, and I refuse to take more Klonopin just to ease those side effects. The thing is, my pdoc thinks that since I have been in the hospital before for my bipolar that I have to be on an antipsychotic. I just don't feel like just because I have been in the hopital means I need to be on certain classes of meds. I'm stable right now on lamictal and lexapro. Has anyone else had this experience from their pdoc? herpills
Posted by Phillipa on March 29, 2011, at 19:40:32
In reply to Previous hospatilizations = more meds?, posted by herpills on March 29, 2011, at 15:59:48
What happens if not on an atypical do you remain stable or relapse? Phillipa
Posted by mtdewcmu on March 29, 2011, at 23:35:42
In reply to Previous hospatilizations = more meds?, posted by herpills on March 29, 2011, at 15:59:48
That doesn't make much sense to me. Antipsychotics are not traditionally part of the standard of care for bipolar. It's only recently that they have been used in bipolar, afaik. So I can't see how it can be absolutely necessary to take one for bipolar.
> Well, I'm ready to give up on Abilify because I can't stand the akathesia and increased anxiety, and I refuse to take more Klonopin just to ease those side effects. The thing is, my pdoc thinks that since I have been in the hospital before for my bipolar that I have to be on an antipsychotic. I just don't feel like just because I have been in the hopital means I need to be on certain classes of meds. I'm stable right now on lamictal and lexapro. Has anyone else had this experience from their pdoc? herpills
Posted by mtdewcmu on March 29, 2011, at 23:54:58
In reply to Re: Previous hospatilizations = more meds?, posted by mtdewcmu on March 29, 2011, at 23:35:42
> That doesn't make much sense to me. Antipsychotics are not traditionally part of the standard of care for bipolar. It's only recently that they have been used in bipolar, afaik. So I can't see how it can be absolutely necessary to take one for bipolar.
>I'm not talking about acute mania with psychotic features, of course. In that case, APs are the standard.
Posted by Phillipa on March 30, 2011, at 19:51:33
In reply to Re: Previous hospatilizations = more meds?, posted by mtdewcmu on March 29, 2011, at 23:54:58
Mood stabalizers. Phillipa
Posted by mtdewcmu on March 31, 2011, at 0:20:47
In reply to Re: Previous hospatilizations = more meds?, posted by Phillipa on March 30, 2011, at 19:51:33
> Mood stabalizers. Phillipa
They call any drug that works for bipolar a mood stabilizer. The only drug that is just a mood stabilizer is lithium. Some anticonvulsants and also some antipsychotics are used as mood stabilizers. But I don't see why someone would be obligated to use an AP if they are not experiencing psychosis.
Posted by bleauberry on March 31, 2011, at 17:12:07
In reply to Previous hospatilizations = more meds?, posted by herpills on March 29, 2011, at 15:59:48
> Well, I'm ready to give up on Abilify because I can't stand the akathesia and increased anxiety, and I refuse to take more Klonopin just to ease those side effects. The thing is, my pdoc thinks that since I have been in the hospital before for my bipolar that I have to be on an antipsychotic. I just don't feel like just because I have been in the hopital means I need to be on certain classes of meds. I'm stable right now on lamictal and lexapro. Has anyone else had this experience from their pdoc? herpills
The hospital's job is merely to stabilize the crisis. You are beyond that. Now the job is to get back to better functioning. Being stable on current meds is a good start. Not it just has to be improved upon. In that department, Abilify is obviously yelling out to anyone who will listen that it is not the drug to do that job.
I would replace it with Nortriptyline, starting very low. The hard part, no matter what you do, will be getting off Abilify. If you do that, plan on a slow weaning in tiny steps. Its long halflife makes that a little easier....every other day, every third day, etc...and if needed use a razor blade to make custom sized pill chunks. They don't have to be accurate for this. No matter, you can expect some dysphoric yuckiness and a false alarm return of depression and false alarm anxiety after you are done with. Adjustment period. So if you start another med within that window, you won't know what is doing what.
If it were me, I would begin lowering the abilify dose and cross tapering in a replacement med like nortriptyline at very low doses. I would extend the cross taper as long as possible to avoiid any big unstaiblization, which would be a sign of moving too fast in the process.
It isn't the amount of meds we take that assures a better outcome...often just the opposite actually....it's the choice of meds and doses customized for the particular person.
I mentioned Nortriptyline for particular reasons specific to your situation.
I've been hospitalized and also failed all the meds and ECT. So how many psych meds does it take to keep me stable? Zero. The meds were actually part of the problem. What keeps me feeling my best are substances that aren't even psychoactive. But that's another story. Well actually, I guess ultra low dose naltrexone could be considered psychoactive. But everything else is purely non-psychoactive and not intended for depression, but just happen to work better on my depression than anything else. I guess I'm probably hitting the depression causing disease itself head on rather than just trying to manipulate the symptoms.
Posted by Christ_empowered on March 31, 2011, at 18:50:46
In reply to Re: Previous hospatilizations = more meds?, posted by bleauberry on March 31, 2011, at 17:12:07
Before I was hospitalized, my shrink just kind of threw pills at me and didn't really take me seriously. 2.5 years later, I was put into a mental hospital--not entirely willingly, mind you--and diagnosed with Bipolar type I w/ Psychotic Features.
For some reason, the hospital arranged for me to see the same shrink I'd seen years ago. This time around, I not only got more meds, I got put on one of the most sedating combos imaginable.
Since I'd been in the hospital and I have the psychotic features, I was put on a full dose of Depakote and a full dose of Abilify, plus Klonopin plus Ambien.
I found that not only did my doctor put me on more meds and more sedating meds, I was treated differently. On the one hand, my problems were taken seriously--awesome. On the other hand, b/c I'd had a "severe manic episode w/ psychotic features," I was treated as if I was ready to go manic at any moment. My doctor kept trying to increase the Abilify, even though I'm prone to akathisia, EPS, and neuroleptic-induced dysphoria.
So yeah, long story short: it definitely happens. Hospitalization=increased severity of illness, at least in the eyes of the people who prescribe the drugs. Other factors that may make a patient seem more deviant and/or "threatening" (history of substance abuse, history of violence, even race--African-American patients are often put on higher doses of antipsychotics than white patients) seem to make neuroleptic use (and high-dose neuroleptic use) more likely.
Posted by mtdewcmu on March 31, 2011, at 18:56:33
In reply to yeah, happened to me, posted by Christ_empowered on March 31, 2011, at 18:50:46
The pharmaceutical industry isn't helping. They are pushing their expensive antipsychotics for anything and everything to make up revenue lost as other of their drugs are going generic.
Posted by Christ_empowered on March 31, 2011, at 19:11:38
In reply to yeah, happened to me, posted by Christ_empowered on March 31, 2011, at 18:50:46
yeah, you're right--they're pushing those antipsychotics for everything. Depression, sleep problems, anxiety, bipolar disorder...its crazy.
I benefit from my 30mgs/day of Abilify (probably b/c, technically, my problems run more to the schizoaffective end of things...at the very least, I have a lot of psychosis for a Bipolar I patient), so I'm not anti-neuroleptics. I am, however, a little concerned by how they're prescribed so frequently for conditions that could be treated with other medication(s).
Posted by mtdewcmu on March 31, 2011, at 19:21:56
In reply to bi pharma, posted by Christ_empowered on March 31, 2011, at 19:11:38
> yeah, you're right--they're pushing those antipsychotics for everything. Depression, sleep problems, anxiety, bipolar disorder...its crazy.
>
> I benefit from my 30mgs/day of Abilify (probably b/c, technically, my problems run more to the schizoaffective end of things...at the very least, I have a lot of psychosis for a Bipolar I patient), so I'm not anti-neuroleptics. I am, however, a little concerned by how they're prescribed so frequently for conditions that could be treated with other medication(s).
>
>Right. They are created by well-intentioned scientists, based on the latest theories, so there is nothing inherently wrong with them. But then the corporate types try to wring as much money from them as possible by whatever means. And a lot of pdocs seem to have broken BS detectors and eat up all the nonsense.
Posted by Lou Pilder on March 31, 2011, at 20:39:20
In reply to Re: bi pharma, posted by mtdewcmu on March 31, 2011, at 19:21:56
> > yeah, you're right--they're pushing those antipsychotics for everything. Depression, sleep problems, anxiety, bipolar disorder...its crazy.
> >
> > I benefit from my 30mgs/day of Abilify (probably b/c, technically, my problems run more to the schizoaffective end of things...at the very least, I have a lot of psychosis for a Bipolar I patient), so I'm not anti-neuroleptics. I am, however, a little concerned by how they're prescribed so frequently for conditions that could be treated with other medication(s).
> >
> >
>
> Right. They are created by well-intentioned scientists, based on the latest theories, so there is nothing inherently wrong with them. But then the corporate types try to wring as much money from them as possible by whatever means. And a lot of pdocs seem to have broken BS detectors and eat up all the nonsense.
>mtdewcmu,
You wrote,[...the corporate types try to xxx by whatever means...(psychiatrists) have broken xxx... eat up all the yyy...].
I am unsure as to what you are wanting to mean here. If yoou could post answers to the following, then I could have the opportunity to respond accordingly.
A. What are the criteria that you used, if any, to lable a person as a {corporate type}?
B. What are the criteria that you used to conclude, if that is what you are wanting to convey, that these corporate types try to xxx?
C. What is the yyy that the (psychiatrists)that have broken zzz eat up?
D. How could one fix the broken zzz, if you know?
E. If a psychiatrist could have a broken zzz, could a person that goes to a psychiatrist to get mind-altering drugs also have a broken zzz?
F. other aspects
Lou
Posted by Lou Pilder on April 1, 2011, at 17:54:01
In reply to Previous hospatilizations = more meds?, posted by herpills on March 29, 2011, at 15:59:48
> Well, I'm ready to give up on Abilify because I can't stand the akathesia and increased anxiety, and I refuse to take more Klonopin just to ease those side effects. The thing is, my pdoc thinks that since I have been in the hospital before for my bipolar that I have to be on an antipsychotic. I just don't feel like just because I have been in the hopital means I need to be on certain classes of meds. I'm stable right now on lamictal and lexapro. Has anyone else had this experience from their pdoc? herpills
h_p,
You wrote,[...to give up on Abilify...refuse..Klonopin...my (psychiatrist) thinks..I {have to} be on an antipsychotic...].
One school of thought in psychiatry is that there is not a cure and that a person must take mind-altering drugs to deal with symptoms perhaps for the rest of that person's life.
Now does that way of thinking have to be accepted or could there be another way of thinking?
You see, if one takes that road in their thinking, that road could lead to the drug given not helping and then the person is given another drug which could cause brain damage and then given another drug that could cause a movment disorder sometines not reversible, and then given another drug and they get diabetes, and then given another drug and they die suddenly and the cause of death is listed as [cardiac arrest], or they get an incurable blood disease and die from that or commit suicide and/or kill others, or some other life-ruining condition.
If anyone is considering being a discusant in this thread, I am requesting that they view the foollowing video.
Lou
To see this video,
A. Pull up Google
B. Type in:
[youtube,Drug compamy salesman tells how psychiatric drugs can cause brain]
You will see a lady with a red dress on. The time is 4 min posted oon aud 14, 2009
Posted by Lou Pilder on April 1, 2011, at 18:30:12
In reply to Lou's response-tehchdrgzanddy » herpills, posted by Lou Pilder on April 1, 2011, at 17:54:01
> > Well, I'm ready to give up on Abilify because I can't stand the akathesia and increased anxiety, and I refuse to take more Klonopin just to ease those side effects. The thing is, my pdoc thinks that since I have been in the hospital before for my bipolar that I have to be on an antipsychotic. I just don't feel like just because I have been in the hopital means I need to be on certain classes of meds. I'm stable right now on lamictal and lexapro. Has anyone else had this experience from their pdoc? herpills
>
> h_p,
> You wrote,[...to give up on Abilify...refuse..Klonopin...my (psychiatrist) thinks..I {have to} be on an antipsychotic...].
> One school of thought in psychiatry is that there is not a cure and that a person must take mind-altering drugs to deal with symptoms perhaps for the rest of that person's life.
> Now does that way of thinking have to be accepted or could there be another way of thinking?
> You see, if one takes that road in their thinking, that road could lead to the drug given not helping and then the person is given another drug which could cause brain damage and then given another drug that could cause a movment disorder sometines not reversible, and then given another drug and they get diabetes, and then given another drug and they die suddenly and the cause of death is listed as [cardiac arrest], or they get an incurable blood disease and die from that or commit suicide and/or kill others, or some other life-ruining condition.
> If anyone is considering being a discusant in this thread, I am requesting that they view the foollowing video.
> Lou
> To see this video,
> A. Pull up Google
> B. Type in:
> [youtube,Drug compamy salesman tells how psychiatric drugs can cause brain]
> You will see a lady with a red dress on. The time is 4 min posted oon aud 14, 2009
>
Friends,
When someone takes psychotropic drugs, the chemical does what it does. Some people have happen to them what the drug does in a short time, while other people have what the drug does show up in a longer time from when they start the drug. Some people do not get what other people get from the drugs. Not all people, let's say, will die suddenly from heart failure from taking the drug, while others may. But there are medical facts associated with taking, let's say, Tylonal. And there are medical facts associated with taking psychotropic drugs. The facts are published and known after years of studies of people taking psychotropic drugs. If you are taking these type of drugs, do you know what he chances are of you , let's say, gettin tardive dyskinesia or Parkinson's like disease or akethesia or sudden death or suicide thinking? I do know the chances and would like for interested people to view the following video.
Lou
To view this video,
A. Pull up Google
B. Type in:
[youtube, psychiatric drugs, Dr Gary Kohls, Antipsychotics and neuroleptics]
You will see his picture and the heading{Antipsychotics or Neuroleptics}
The time is 10 min posted on April 10, 2009
This is the end of the thread.
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