Psycho-Babble Medication Thread 1109162

Shown: posts 1 to 25 of 46. This is the beginning of the thread.

 

AP's and relief

Posted by rjlockhart37 on March 22, 2020, at 16:31:30

i've been reading all these stories or thing about people getting hooked on addicting drugs, but acutally i've found that anti-psychotics have a major relief, in mental tension and anxiety, they lift anxiety and then they put out the fire thats going on and your back down to earth. People taking xanax all the time, rather take like haloperidol or perphenazine, i have to say they give relief, sometimes even better than benzos, only thing they don't work on GABA. But they suppress stress, and over dopamine levels that cause a crazed feeling. All these celebrities with addiction to common benzos and opioids, anti-psychosis meds are definitely a preference, not in getting you high, no no....but the relief they have. You feel so much better down to earth, rather than taking benzos.

Anyone else feel the same?

 

Re: AP's and relief

Posted by Lamdage22 on March 23, 2020, at 0:21:14

In reply to AP's and relief, posted by rjlockhart37 on March 22, 2020, at 16:31:30

For the most part, yes. I think it helps me think more clearly. I'm not as prone to believing fake news and conspiracy theories. But it is kind of last resort. The side effects are not mild.

 

Re: AP's and relief

Posted by undopaminergic on March 23, 2020, at 5:31:40

In reply to Re: AP's and relief, posted by Lamdage22 on March 23, 2020, at 0:21:14

> For the most part, yes. I think it helps me think more clearly. I'm not as prone to believing fake news and conspiracy theories. But it is kind of last resort. The side effects are not mild.
>

In general, the most notable effect I get is the sedation from histamine antagonism.

Clozapine is regarded as the best anti-psychotic (AP) but it does very little for me, other than make me drool on the pillow at night, because it disrupts the swallowing reflex, and makes me choke on some kinds of food unless I wash it down with milk or other liquid.

Trimipramine (Surmontil) which I started taking for depression, is the most potent AP for me so far. After I started it, I've come to the insight that it is very important to avoid manic episodes. I have also gained some insight into why I've ended up in hospital repeatedly -- I'm not just a victim of circumstance or other people. Trimipramine has a receptor binding profile that resembles clozapine, so its more potent AP-like effects are a curious thing.

What are your notable side-effects?

-undopaminergic

 

Re: AP's and relief

Posted by Lamdage22 on March 23, 2020, at 7:16:03

In reply to Re: AP's and relief, posted by undopaminergic on March 23, 2020, at 5:31:40

Sedation and Weight Gain (Although i can now fight it). And weird dreams. Some people go from skinny to XXL in a matter of weeks. Not healthy. I do take Metformin for this, but it doesn't work for everyone.

 

Re: AP's and relief

Posted by undopaminergic on March 23, 2020, at 12:18:45

In reply to Re: AP's and relief, posted by Lamdage22 on March 23, 2020, at 7:16:03

> Sedation and Weight Gain (Although i can now fight it). And weird dreams. Some people go from skinny to XXL in a matter of weeks. Not healthy. I do take Metformin for this, but it doesn't work for everyone.
>

Very common with most atypicals. But not all of them are as strong antihistamines as Seroquel and Zyprexa. Indeed some of them have negligible affinity for the histamine H1-receptor.

Have you considered amisulpride (or sulpiride; maybe tiapride), lurasidone, blonanserin, sertindole, or cariprazine?

The "old-style" APs also cause less weight gain, although they are more likely to provoke the antipyramidal side effects. Some examples of typicals with low histamine H1-affinity are haloperidol, thiothixene, perphenazine, trifluoperazine, and fluphenazine. At least some of these, such as haloperidol, are very effective APs.

My psychiatrist thinks Seroquel is a poor antipsychotic. A nurse I've spoken with is of a similar opinion. It is also *very* antihistaminic -- only clozapine has a higher histamine H1 affinity relative to dopamine D2.

What all APs have in common is the D2-antagonism. Clozapine is the mildest at the D2, yet it is regarded as the most effective. It is the preferred AP for psychosis in Parkinson's disease.

-undopaminergic

 

Re: AP's and relief

Posted by Lamdage22 on March 23, 2020, at 13:45:50

In reply to Re: AP's and relief, posted by undopaminergic on March 23, 2020, at 12:18:45

I have not tried any of these with the exeption of lurasidon. Tiapride sounds really cool. I will look into it. Thanks!

> Have you considered amisulpride (or sulpiride; maybe tiapride), lurasidone, blonanserin, sertindole, or cariprazine?
>
> The "old-style" APs also cause less weight gain, although they are more likely to provoke the antipyramidal side effects. Some examples of typicals with low histamine H1-affinity are haloperidol, thiothixene, perphenazine, trifluoperazine, and fluphenazine. At least some of these, such as haloperidol, are very effective APs.
>
> My psychiatrist thinks Seroquel is a poor antipsychotic. A nurse I've spoken with is of a similar opinion. It is also *very* antihistaminic -- only clozapine has a higher histamine H1 affinity relative to dopamine D2.
>
> What all APs have in common is the D2-antagonism. Clozapine is the mildest at the D2, yet it is regarded as the most effective. It is the preferred AP for psychosis in Parkinson's disease.
>
> -undopaminergic
>

 

Re: AP's and relief

Posted by undopaminergic on March 24, 2020, at 8:01:46

In reply to Re: AP's and relief, posted by Lamdage22 on March 23, 2020, at 13:45:50

> I have not tried any of these with the exeption of lurasidon.
>

How did that work out?

> Tiapride sounds really cool. I will look into it. Thanks!
>

My pleasure. Why do you think tiapride in particular is really cool? It is structurally and pharmacologically related to sulpiride and amisulpride; I've tried both of these, the former several times including now; I'd say they are/were free from adverse effects for me, but I have very limited experience with doses above 600 mg.

It is interesting to note that the first time I tried sulpiride, it had a stimulant effect more powerful than methylphenidate (Ritalin, Concerta), but I developed complete tolerance.

-undopaminergic

 

Re: AP's and relief

Posted by Lamdage22 on March 24, 2020, at 11:00:30

In reply to Re: AP's and relief, posted by undopaminergic on March 24, 2020, at 8:01:46

I don't know, I just felt really weird and had akathisia.

 

Re: AP's and relief

Posted by Lamdage22 on March 24, 2020, at 11:01:41

In reply to Re: AP's and relief, posted by Lamdage22 on March 24, 2020, at 11:00:30

I am not "healed", but doing much better, so i am not to keen on trying stuff that might make me worse.

 

Re: AP's and relief

Posted by undopaminergic on March 24, 2020, at 11:47:32

In reply to Re: AP's and relief, posted by Lamdage22 on March 24, 2020, at 11:01:41

> I am not "healed", but doing much better, so i am not to keen on trying stuff that might make me worse.
>

What about trying things that might make you better? Is the glass half-empty or half-full?

Given your complaints about adverse effects, I think you should definitely try APs that are less likely to cause these exact symptoms. Now, Zyprexa is a very effective AP, but Seroquel is not, and is one of the absolute most potent anti-histamines (indeed, my psychiatrist has prescribed me generic Seroquel as needed for sleep).

So, given your current regimen, and your preferences, I would start with a cross-titration of Seroquel and tiapride. If you wish to err on the side of caution, you can even leave the Seroquel as it is, for a start.

In the longer term, I think you should try to determine the minimum adequate dose of APs. I am of the opinion that if you over-treat psychosis you may inhibit psychological self-healing, because you are in effect tricking your brain and psyche that there is no need for healing.

In case you're wondering, I am practising what I preach. The only obstacle is my psychiatrist, who seems to believe, with no experimentation, that I need more APs than I do. I have no symptoms of psychosis at all, which means I am probably being over-treated.

-undopaminergic

 

Re: AP's and relief

Posted by Lamdage22 on March 25, 2020, at 3:06:53

In reply to Re: AP's and relief, posted by undopaminergic on March 24, 2020, at 11:47:32

Hi undopaminergic,

i am trying to avoid tardive dyskinesia and Sulprid or Amisulpride is notorious for that. And the reviews of Tiapride are not the best.

I can live with the side effects. I can't live with tardive dyskinesia and disfigurement because of tics.

Long term I am planning to come off of Seroquel. I just reduced it from 800 to 700.

Sometimes doing nothing with meds is better. Or do you find that the "trymania" here leads to success very often?

 

Re: AP's and relief

Posted by Lamdage22 on March 25, 2020, at 3:20:51

In reply to Re: AP's and relief, posted by Lamdage22 on March 25, 2020, at 3:06:53

I might not need any Antipsychotic if I hadn't tried Psychmeds! Phenelzine Induced Psychosis!

 

Re: AP's and relief

Posted by undopaminergic on March 25, 2020, at 4:10:46

In reply to Re: AP's and relief, posted by Lamdage22 on March 25, 2020, at 3:20:51

> I might not need any Antipsychotic if I hadn't tried Psychmeds! Phenelzine Induced Psychosis!
>

Phenelzine-induced tardive psychosis?

-undopaminergic

 

Re: AP's and relief

Posted by Lamdage22 on March 25, 2020, at 4:47:05

In reply to Re: AP's and relief, posted by undopaminergic on March 25, 2020, at 4:10:46

If you want to say it like this, maybe. I got addicted to not being depressed and the euphoria and I had no idea what psychosis even is, so I didn't recognize. It was very destructive. I don't have Psychosis now but I do take tons of Neuroleptics. I was on MAOI not just once. I wasn't always psychotic on it but it always ended that way. The first diagnosis after Phenelzine was Phenelzine induced Psychosis.

I have lost friends due to this. Manic/psychotic and greatly reduced social anxiety but this combination wasn't helpful for my relationships!

There is no way to prove that i wouldn't have been psychotic if i hadn't tried Nardil, but it seems likely. You can't prove the opposite either!

 

Re: AP's and relief

Posted by undopaminergic on March 25, 2020, at 4:47:32

In reply to Re: AP's and relief, posted by Lamdage22 on March 25, 2020, at 3:06:53

> Hi undopaminergic,

Hi!

> i am trying to avoid tardive dyskinesia and Sulprid or Amisulpride is notorious for that. And the reviews of Tiapride are not the best.
>

I don't agree tardive dyskinesia (TD) is at all common with sulpiride or amisulpride. In fact it is rare even with the old typicals.

This is an interesting report on TD with quetiapine (Seroquel):
https://www.ncbi.nlm.nih.gov/pubmed/19673087
It is particularly interesting because there was no TD with amisulpride but after switching to quetiapine it manifested, and the TD worsened after switching to ziprasidone. All of these drugs are atypical APs.

There are obviously individual vulnerabilities at play here. TD cannot be predicted, and it seems that it can happen with any AP, including clozapine:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5560019/
In this study, the patient developed TD after more than 6 years of clozapine. It does not make intuitive sense.

> I can live with the side effects. I can't live with tardive dyskinesia and disfigurement because of tics.
>

I agree it would be most unfortunate. That is another reason to minimise exposure to APs.

> Long term I am planning to come off of Seroquel. I just reduced it from 800 to 700.
>

Oh, I'm glad to hear that. Your signature still says 900 mg.

> Sometimes doing nothing with meds is better. Or do you find that the "trymania" here leads to success very often?
>

Most suggestions made here are not implemented, and in most cases, the individual is lost to follow-up. I don't think the success rate of suggestions here are worse than the trials done by psychiatrists, but quite possibly better.

-undopaminergic

 

Re: AP's and relief

Posted by Lamdage22 on March 25, 2020, at 4:54:54

In reply to Re: AP's and relief, posted by undopaminergic on March 25, 2020, at 4:47:32

I don't think that either. Yeah, i didn't have any problems going from 800 to 700 but I was on 800 for months. I started out at 900. Amisulpride can have a mood brightening effect which would be an advantage. Also less weight gain. But the weight gain is under good control! So the only arguments left would be less sedation and more mood brightening.

Hmm. I don't know. I did get symptoms from Haldol. I had Face spasm. Also I am very prone to Akathisia. Thats why I remain sceptical.

> I don't think the success rate of suggestions here are worse than the trials done by psychiatrists, but quite possibly better.

 

Re: AP's and relief

Posted by undopaminergic on March 25, 2020, at 4:57:24

In reply to Re: AP's and relief, posted by Lamdage22 on March 25, 2020, at 4:47:05

> If you want to say it like this, maybe. I got addicted to not being depressed and the euphoria and I had no idea what psychosis even is, so I didn't recognize. It was very destructive. I don't have Psychosis now but I do take tons of Neuroleptics. I was on MAOI not just once. I wasn't always psychotic on it but it always ended that way. The first diagnosis after Phenelzine was Phenelzine induced Psychosis.
>
> I have lost friends due to this. Manic/psychotic and greatly reduced social anxiety but this combination wasn't helpful for my relationships!
>
> There is no way to prove that i wouldn't have been psychotic if i hadn't tried Nardil, but it seems likely. You can't prove the opposite either!
>

Sorry you had to quit the MAOI, especially as it sounds like it was very effective for your depression.

Did stopping the phenelzine make the psychosis either better or worse?

-undopaminergic

 

Re: AP's and relief

Posted by Lamdage22 on March 25, 2020, at 4:58:47

In reply to Re: AP's and relief, posted by undopaminergic on March 25, 2020, at 4:57:24

Better! At least in the long run. Yeah it was tough to give up but necessary. I should have quit the first time I had Psychosis on it.

 

Re: AP's and relief

Posted by Lamdage22 on March 25, 2020, at 5:04:34

In reply to Re: AP's and relief, posted by Lamdage22 on March 25, 2020, at 4:58:47

Im a big friend of getting blood work and optimizing nutrients. I had several deficiencies. I should have done that in the first place. And if I had been given my current Antidepresant regimen right away, things would be MUCH better. The combination of these two things would have been the sweet spot. But you can't know in advance! That is the problem.

 

Re: AP's and relief

Posted by undopaminergic on March 25, 2020, at 5:12:31

In reply to Re: AP's and relief, posted by Lamdage22 on March 25, 2020, at 4:54:54

> I don't think that either. Yeah, i didn't have any problems going from 800 to 700 but I was on 800 for months. I started out at 900. Amisulpride can have a mood brightening effect which would be an advantage. Also less weight gain. But the weight gain is under good control! So the only arguments left would be less sedation and more mood brightening.
>
> Hmm. I don't know. I did get symptoms from Haldol. I had Face spasm. Also I am very prone to Akathisia. Thats why I remain sceptical.
>

I had a kind of neck-spasm on mirtazapine. These things happen, I don't mean to claim otherwise, but I'm trying to put it into perspective.

In my experience, you can get the antidepressive effect from sulpiride too. Amisulpride is not available where I live, which is why I tried sulpiride first, and got tolerance to the stimulating/antidepressant effect. I bought amisulpride (Solian) on the Internet in the hope that it might work better, but it didn't.

Flupenthixol has antidepressant effects (typically 0.5 to 1 mg for this purpose), but I did not have success with it.

And a bunch of atypicals have been approved for adjunctive uses in depression. This means they are better than placebo.

-undopaminergic

 

Re: AP's and relief

Posted by undopaminergic on March 25, 2020, at 5:17:40

In reply to Re: AP's and relief, posted by Lamdage22 on March 25, 2020, at 4:58:47

> Better! At least in the long run. Yeah it was tough to give up but necessary. I should have quit the first time I had Psychosis on it.
>

How long did it take to get the psychosis under control? Did you have to try many APs?

-undopaminergic

 

Re: AP's and relief

Posted by Lamdage22 on March 25, 2020, at 5:22:23

In reply to Re: AP's and relief, posted by undopaminergic on March 25, 2020, at 5:17:40

4 months for overly psychotic symptoms, one year for more subtle symptoms. Then it took several years to really beat the post psychotic depression. The shame and guilt for how I behaved still remains.

 

Re: AP's and relief

Posted by undopaminergic on March 25, 2020, at 5:25:28

In reply to Re: AP's and relief, posted by Lamdage22 on March 25, 2020, at 5:04:34

> Im a big friend of getting blood work and optimizing nutrients. I had several deficiencies. I should have done that in the first place. And if I had been given my current Antidepresant regimen right away, things would be MUCH better. The combination of these two things would have been the sweet spot. But you can't know in advance! That is the problem.
>

Right. There are doctors who specialise in this kind of thing. It would be interesting to work with one.

If anything, I regret that I have been unable to try MAOIs, and that I have taken so long before I tried my first TCA. I have mixed feelings about reboxetine (Edronax). It was helpful at the time, but I now have "tardive" depersonalisation due to it.

-undopaminergic

 

Re: AP's and relief

Posted by Lamdage22 on March 25, 2020, at 5:25:33

In reply to Re: AP's and relief, posted by Lamdage22 on March 25, 2020, at 5:22:23

I was much less belligerent right away after stopping though. Like I said: It didn't help.

 

Re: AP's and relief

Posted by Lamdage22 on March 25, 2020, at 5:31:58

In reply to Re: AP's and relief, posted by undopaminergic on March 25, 2020, at 5:25:28

You mean nutrients? Yeah I work with one

> Right. There are doctors who specialise in this kind of thing. It would be interesting to work with one.

But you could have reacted the way I did. You never know. I think it is good that other meds are tried first. I think the first thing if somebody is initially depressed should be testing for nutrient deficiencies. Then therapy to see if history and surroundings contribute to the problem. If both can be anwered with "no", you can then try meds. And not right away MAOI. Just my two cents!

> If anything, I regret that I have been unable to try MAOIs, and that I have taken so long before I tried my first TCA. I have mixed feelings about reboxetine (Edronax). It was helpful at the time, but I now have "tardive" depersonalisation due to it.


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