Posted by yxibow on July 14, 2009, at 3:33:24
In reply to Re: Intrusive OCD thoughts?, posted by zsmom on July 4, 2009, at 8:46:15
> My 17 yr old son was recently hospitalized for Psychosis NOS. His symptoms did not seem to fit totally with schizophrenia. I asked if it could be obsessive thoughts rather than hallucinations and voices. I have observed him like this for a long time and wondered about OCD thoughts, not really knowing that this diagnosis existed. The doctors did not think much of my position. On the day of discharge, they offered me that very same possible diagnosis. I was floored. They wasted almost 6 weeks without really exploring the possibility. Now he is at home suffering from OCD thoughts with only Clozaril as a medication. They offered a trial of Zofran (brand name) or Ondansetron on the day of discharge. Can anyone tell me what they think about this and the suggested medicine? Thank you.
I'm not sure about the 5HT3 blockers (ondansetron, etc) other than the new ones are ridiculously expensive... I think various things have been tested for anxiety spectrum disorders so I can't say.
I know that almost all of the body's serotonin is in the gut and anxiety can cause all sorts of problems there similar to IBS, which is probably why ginger (a weak 5HT3 blockade) sometimes helps.
SSRIs also brush the 5HT3 transmitter so it takes time to get used to them and that's why the nausea occurs most usually.Discharged with Clozaril ??
I assume he is following the national (international) mandate on blood testing.
Psychosis NOS does not mean Schizophrenia... it means that it is a disorder in the psychosis spectrum which does not fit a set of criteria in the DSM-IV-TR.I have two NOS disorders, one psychosis, but it is a rare situation... it would take pages to explain... but its not something one would think of a "psychotic" disorder.
Psychosis / psychotic... there's a stigma to that word and misunderstanding, but someone can have psychosis and understand perfectly that they have a mental illness and be functioning.
I don't know if your finances or insurance covers it, or whether it is available from a psychologist trained in it or better, a hospital/teaching hospital trained to do it, but getting psychological testing....
...(yes, it includes the common things like the MMPI-II and Rorschach, but there are other subjective and objective tests and they can provide valuable insight into what is actually going on.)
It is possible for someone to have schizophrenia (or schizo-affective disorder) comorbid with OCD.
Was there a specific episode (you don't have to share if you don't wish) that made you feel hospitalization was needed?
I think better testing, such as good psychological testing and further evaluation is really necessary... I understand your frustration about this.
If Clozaril is the only atypical your son has tried, I think that's going to the "big guns" a bit too soon... but I can't practice medicine without a license so to say.A trial of any of the other ones, such as ones with lesser (not weight gain we're talking about) side and long term effects such as Seroquel or Zyprexa, would seem to be more prudent, but maybe he already tried those?
Anyhow just some suggestions
-- tidings
poster:yxibow
thread:903596
URL: http://www.dr-bob.org/babble/20090709/msgs/906679.html