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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 22 of 22. This is the beginning of the thread.
Posted by vbs on September 11, 2012, at 22:03:41
It's been years since I've posted. I've posted under the names vbAgent and JohnnyBLinux. I doubt anyone remembers me. The problem I'm having is that I hear voices alot. I currently take Saphris 10 mg, Zyprexa 10 mg, Cymbalta 60 mg, propranolol 10 mg bid, and lisinopril 20 mg each day. I started the Zyprexa about a month ago. I don't understand why I keep hearing voices. I'm pretty sure I'm going to be titrated up on the Zyprexa at my appt next week. Am I treatment resistent? Will a higher dose really help? Or shoul I try a different anti-psychotic? Any suggestions will be helpful.
Posted by jono_in_adelaide on September 11, 2012, at 22:30:29
In reply to schizoaffective - meds not working well, posted by vbs on September 11, 2012, at 22:03:41
Have the Sapharis and Zyprexia been of any help so far?
Posted by vbs on September 11, 2012, at 22:39:54
In reply to Re: schizoaffective - meds not working well, posted by jono_in_adelaide on September 11, 2012, at 22:30:29
> Have the Sapharis and Zyprexia been of any help so far?
They help somewhat. I still hear voices for 2-3 days every week. It's frustrating.
Posted by jono_in_adelaide on September 11, 2012, at 22:49:05
In reply to Re: schizoaffective - meds not working well, posted by vbs on September 11, 2012, at 22:39:54
Given thatt hey have helped, I would try a dose increase (provided the side effects arnt too bad) and if a dose increase doesnt help, then try a different drug or combination of drugs, of course all this depends on what your doctor suggests
Posted by jono_in_adelaide on September 11, 2012, at 22:52:22
In reply to Re: schizoaffective - meds not working well, posted by vbs on September 11, 2012, at 22:39:54
I remember reading that some people do well on a combo of one of the new atypical antipsychotics and one of the older typical drugs, Stelazine, Haldol, Thorazine etc - I guess thats somthing to hold in reserve
Posted by Phillipa on September 11, 2012, at 22:55:06
In reply to schizoaffective - meds not working well, posted by vbs on September 11, 2012, at 22:03:41
I know you under both names. I remember conversations we had. I don't recall you hearing voices last time you posted. Is this a new diagnosis? Phillipa
Posted by Christ_empowered on September 12, 2012, at 0:20:06
In reply to schizoaffective - meds not working well, posted by vbs on September 11, 2012, at 22:03:41
Is the cymbalta helping? My shrink won't use antidepressants in me...she says they can worsen psychosis.
Posted by jono_in_adelaide on September 12, 2012, at 0:54:54
In reply to Re: schizoaffective - meds not working well, posted by Christ_empowered on September 12, 2012, at 0:20:06
She's right of course christ, they CAN worsen psychosis, but to me, thats like saying that Advic can cause ulcers, and therefor noone should ever take Advil for a headache.
if you are bothered by depressive symptoms, you should be given the benifit of a trial of antidepressants, to see whethere they improve your depression, and also wether they worsen psychosis.
If they do worsen it, then stop them, but if they dont and you derive benifit, then you keep taking them.
Posted by vbs on September 12, 2012, at 17:42:46
In reply to Re: schizoaffective - meds not working well » vbs, posted by Phillipa on September 11, 2012, at 22:55:06
> I know you under both names. I remember conversations we had. I don't recall you hearing voices last time you posted. Is this a new diagnosis? Phillipa
Yes, it's a new diagnosis. I used to have just ADD & depression. I took stimulants for a very long time w/o problems. But starting a few years ago stims caused two severe psychotic episodes, and I was hospitalized. I now don't work and live on SSDI.
Posted by phidippus on September 12, 2012, at 18:19:29
In reply to schizoaffective - meds not working well, posted by vbs on September 11, 2012, at 22:03:41
I don't think its time to say your treatment resistant. A higher dose of the Zyprexa might help, but my intuition is telling me you need to try a different antipsychotic. Have you tried Haldol?
Eric
Posted by vbs on September 12, 2012, at 18:57:17
In reply to Re: schizoaffective - meds not working well » vbs, posted by phidippus on September 12, 2012, at 18:19:29
> I don't think its time to say your treatment resistant. A higher dose of the Zyprexa might help, but my intuition is telling me you need to try a different antipsychotic. Have you tried Haldol?
>
> EricI hope the doc goes up on Zyprexa. I was on Haldol for a few weeks about 4 years ago when I was in the psych hospital. I wasn't hearing voices at that time. Haldol made me feel weird so I stopped taking it.
Posted by Zyprexa on September 16, 2012, at 20:51:59
In reply to schizoaffective - meds not working well, posted by vbs on September 11, 2012, at 22:03:41
I think you should take a different AP. I had instant results when I atarted zyprexa. Also I find that if I try a longer trial or higher dose of a AP that is not working, it just makes me worse. I went on a very high dose of geodon in an atempt to get off the zyrexa, and it just got worse. I also tried abilify that was even worse. Yes at that very high dose of geodon for 2 years on it I was paranoid and hearing voices when no one was in the room. Then when I tried the abilify doc just wanted to go up on dose and I felt like I was getting worse as the dose went up. He wanted to bring it up to 30mg. It cost me my job and took many years to get back to sort of normal. yes I'm back on the zyprexa now. I can usualy tell if a med will work fairly quickly, like within a week tops.
Posted by phidippus on September 16, 2012, at 21:50:22
In reply to Re: schizoaffective - meds not working well » vbs, posted by Zyprexa on September 16, 2012, at 20:51:59
Have you ever tried Clozaril?
ES
Posted by Zyprexa on September 19, 2012, at 17:03:28
In reply to Re: schizoaffective - meds not working well » Zyprexa, posted by phidippus on September 16, 2012, at 21:50:22
I've never tried clozaril, to my knowledge. I don't know what they were giving me in the hospital. I have tried risperdal and perphenazine.
Posted by Christ_empowered on September 19, 2012, at 18:03:12
In reply to Re: schizoaffective - meds not working well » phidippus, posted by Zyprexa on September 19, 2012, at 17:03:28
are you still taking the perphenzine with the zyprexa, or is it just zyprexa now?
My shrink was talking about low-dose Haldol with my Abilify. I was like...Hell no. I'm on 900 neurontin in addition to 30 Abilify now.
Have you tried any anticonvulsants, maybe a benzo?
Posted by Zyprexa on September 19, 2012, at 20:39:06
In reply to for zyprexa..., posted by Christ_empowered on September 19, 2012, at 18:03:12
Yes still taking perphenazine. Its on the way out though. Was taking 12mg 3 times a day. Now only 8mg twice a day. Its probably being discontinued in 2 months.
No benzos ever. Took lamictal and depakote before, but not for that long a time and they didn't help.
Posted by phidippus on September 19, 2012, at 22:06:19
In reply to Re: schizoaffective - meds not working well » phidippus, posted by Zyprexa on September 19, 2012, at 17:03:28
Clozaril or Clozapine is considered to be the most effective antipsychotic. Unfortunately, its side effect profile is scary. The FDA requires clozapine to carry five black box warnings for agranulocytosis, seizures, myocarditis, for "other adverse cardiovascular and respiratory effects", and for "increased mortality in elderly patients with dementia-related psychosis."
I've known some hopeless cases get a new grant on life because of this drug. I cannot overemphasize its efficacy in treatment resistant cases.
Eric
Posted by Zyprexa on September 20, 2012, at 8:14:44
In reply to Re: schizoaffective - meds not working well » Zyprexa, posted by phidippus on September 19, 2012, at 22:06:19
I'm not sure if I ever took clozaril. Maybe when in mental hospital. I know they put me on some drug which gave me involuntary swalowing. Maybe that was it or maybe it was haldol.
Posted by phidippus on September 20, 2012, at 8:42:30
In reply to Re: schizoaffective - meds not working well » phidippus, posted by Zyprexa on September 20, 2012, at 8:14:44
It was more likely the Haldol.
Eric
Posted by phillipa on September 20, 2012, at 20:48:51
In reply to Re: schizoaffective - meds not working well » Zyprexa, posted by phidippus on September 20, 2012, at 8:42:30
Yes agree most likely Haldo. I saw miracles with Clozaril when working in psych. Those that nothing worked for this med worked for. I didn't see any agranulatosis either. Phillipa
Posted by phidippus on September 20, 2012, at 21:27:17
In reply to Re: schizoaffective - meds not working well » phidippus, posted by phillipa on September 20, 2012, at 20:48:51
I knew a guy who was bipolar and had temporal lobe epilepsy. He waas on Haldol AND Clozapine AND a ton of mood stabilizers. Whoo.
Eric
Posted by Zyprexa on September 21, 2012, at 0:52:03
In reply to Re: schizoaffective - meds not working well » Zyprexa, posted by phidippus on September 20, 2012, at 8:42:30
Thats what I thought too.
This is the end of the thread.
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