Psycho-Babble Medication Thread 885316

Shown: posts 1 to 12 of 12. This is the beginning of the thread.

 

Antipsychotics? All the same?

Posted by Cseagraves on March 14, 2009, at 17:24:09

Hi guys!

Just some opinions needed. Not that I need one now, but thinking about a back up plan if Zoloft doesn't work. Someone gave some advice on a post about adding an antipsychotic to your ssri if needed. When you take both of these together, how does that work? I've taken them seperately, but never together for anxiety. My pdoc at the time kept trying to raise my dosage of the Seroquel. He got it up to 400mgs daily, which did quiet down my brain, but it never got rid of the anxiety.

Have taken Seroquel before, didn't like it. Made me feel awful. Had all of the awful side effects while on it. Not sure of the names of all the rest. (Zyprexa, Ambilify, Geoden)? I'm sure there are others I don't know.

Are they pretty much all the same or are some milder than others?

Another question. Knowing that everyone is different, I just want an opinion. Do you think mixing an ssri with an antipsych med for extreme GAD would be better, or would you think an maoi would work better.

I know nothing will be as easy, but would like to spare myself as much torture as possible. :-)

Just curious,

Thanks,
Courtney

 

Re: Antipsychotics? All the same? » Cseagraves

Posted by Phillipa on March 14, 2009, at 17:57:48

In reply to Antipsychotics? All the same?, posted by Cseagraves on March 14, 2009, at 17:24:09

Personally having gad myself prefer benzos as no diabetes, extreme tiredness, or weight gain associated that's just me. Could you be bipolar and maybe moodstabalizer help? Just suggestion Phillipa

 

Re: Antipsychotics? All the same?

Posted by Zyprexa on March 14, 2009, at 19:38:19

In reply to Antipsychotics? All the same?, posted by Cseagraves on March 14, 2009, at 17:24:09

None of them are the same. They are all very different. Personaly I like zyprexa best for anxiety. I've never tried seroquel. But have tried the rest.

 

Re: Antipsychotics? All the same?

Posted by Relapse on March 14, 2009, at 20:03:34

In reply to Antipsychotics? All the same?, posted by Cseagraves on March 14, 2009, at 17:24:09

Courtney,
After a major crash about 3 months ago, my doc put me on 200mg Seroquel, 600mg lithium and 150mg of Zoloft. My main problem is anxiety. This has helped me to this point (don't want to jinx myself). One caution many here have talked about. Give the meds. a chance to work. I am one who should know better. I have a long history of struggling with anxiety and depression. This last cycle I was on the above listed meds for 3 weeks. I felt the meds were doing absolutely nothing for me. So I started badgering my doc to change the meds. Basically he told me to shut-up, take your meds and a benzo if you need to. About week 4 the meds kicked in. Hope you find the right combo.

 

Re: Antipsychotics? All the same?

Posted by Cseagraves on March 14, 2009, at 20:07:36

In reply to Re: Antipsychotics? All the same?, posted by Relapse on March 14, 2009, at 20:03:34

Thanks relapse. I know I am way to impatient.

Courtney

 

Re: Antipsychotics? All the same? » Cseagraves

Posted by Phillipa on March 14, 2009, at 21:14:23

In reply to Re: Antipsychotics? All the same?, posted by Cseagraves on March 14, 2009, at 20:07:36

I feel a lot of us may be. Know I am. I want it now. Temper tantrum? Love Phillipa

 

Re: Antipsychotics? All the same?

Posted by Meltingpot on March 15, 2009, at 15:11:55

In reply to Antipsychotics? All the same?, posted by Cseagraves on March 14, 2009, at 17:24:09

Hi,

I have to agree with Zyprexa, zyprexa has always given me a lot of relief from suicidal thoughts and anxiety and it tends to work quickly.

I don't think you are being impatient at all, anxiety is hell.

Denise

 

Re: Antipsychotics? All the same? » Cseagraves

Posted by yxibow on March 16, 2009, at 2:07:43

In reply to Antipsychotics? All the same?, posted by Cseagraves on March 14, 2009, at 17:24:09

> Hi guys!
>
> Just some opinions needed. Not that I need one now, but thinking about a back up plan if Zoloft doesn't work. Someone gave some advice on a post about adding an antipsychotic to your ssri if needed. When you take both of these together, how does that work? I've taken them seperately, but never together for anxiety. My pdoc at the time kept trying to raise my dosage of the Seroquel. He got it up to 400mgs daily, which did quiet down my brain, but it never got rid of the anxiety.
>
> Have taken Seroquel before, didn't like it. Made me feel awful. Had all of the awful side effects while on it. Not sure of the names of all the rest. (Zyprexa, Ambilify, Geoden)? I'm sure there are others I don't know.
>
> Are they pretty much all the same or are some milder than others?
>
> Another question. Knowing that everyone is different, I just want an opinion. Do you think mixing an ssri with an antipsych med for extreme GAD would be better, or would you think an maoi would work better.
>
> I know nothing will be as easy, but would like to spare myself as much torture as possible. :-)
>
> Just curious,
>
> Thanks,
> Courtney

No, making an informed choice about using an AP for an augment or other purpose is not an easy thing.

Basically, at least in my opinion the relative strength at maximum dose would be

Risperdal/Invega->Geodon/Abilify->Zyprexa->Seroquel/(Seroquel XR), with *Clozaril in its own category.

But that's just my experience with side effects, in fact Zyprexa did a number on me, but I'm terribly sensitive to APs.

I have and currently take Seroquel.

Generally the best strategy is the MED (minimum effective dose).

I guess my scale is more rated on relative side effects, e.g. mostly EPS symptoms such as akathisia.

It doesn't mean that Zyprexa, for example isn't necessarily not strong for some people as it has a fairly strong effect at D2 but not other transmitters. But it "lets go" faster than Risperdal would.


I guess what I'm saying is that there are liabilities, but there is also a benefit for strong anxiety, especially personally I think with Seroquel.

And yes, Seroquel and Risperdal and Zyprexa at least, do have effects on lipids and weight. Its difficult. Its also probably dose dependent to a degree.

For me, Geodon was I think the strongest at akathisia, and Risperdal was very strong with negative nightmare and other odd effects, as well as causing a slight tic (its still there, but then like I say, I'm probably not a typical example of how people react to APs).

In general though I'd say that regardless of studies pointing to general effectiveness with psychosis, atypicals are much safer (with their own weight issues, yes) than typicals (which aren't perfect either -- Mellaril is still around and it has more heart problem potentials than Geodon).

Hope that helps

-- Jay

 

Re: Antipsychotics? All the same?

Posted by metric on March 16, 2009, at 20:27:10

In reply to Antipsychotics? All the same?, posted by Cseagraves on March 14, 2009, at 17:24:09


Antipsychotics are inherently neurotoxic and useless as anxiolytics. I don't think they should be used chronically even in psychotic patients.

Antipsychotics dose-dependently eliminate the victims (I mean "patients") volition. Dysphoria is an expected consequence.

The only reason they're ever prescribed for anxiety is that they're non-scheduled...

 

Re: Antipsychotics? All the same?

Posted by desolationrower on March 17, 2009, at 0:48:12

In reply to Re: Antipsychotics? All the same?, posted by metric on March 16, 2009, at 20:27:10

>
> Antipsychotics are inherently neurotoxic and useless as anxiolytics. I don't think they should be used chronically even in psychotic patients.
>
> Antipsychotics dose-dependently eliminate the victims (I mean "patients") volition. Dysphoria is an expected consequence.
>
> The only reason they're ever prescribed for anxiety is that they're non-scheduled...
>
>

oh, thats not fair. They're also prescribed because they're very expensive, so drug reps push them hard. And noone is going to further their career with a study showing klonopin reduces anxiety.

-d/r

 

Re: Antipsychotics? All the same? » metric

Posted by yxibow on March 17, 2009, at 6:02:48

In reply to Re: Antipsychotics? All the same?, posted by metric on March 16, 2009, at 20:27:10

>
> Antipsychotics are inherently neurotoxic and useless as anxiolytics. I don't think they should be used chronically even in psychotic patients.
>
> Antipsychotics dose-dependently eliminate the victims (I mean "patients") volition. Dysphoria is an expected consequence.
>
> The only reason they're ever prescribed for anxiety is that they're non-scheduled...


This is such a vast generalization of neuroleptics I'm floored...

They are with out much doubt among the only agents that bring life and peace to people with serious psychotic conditions. They have and still enable people with schizophrenia and other related disorders


People aren't "victims" and that does great disservice to people on this board whose suffering has been helped by APs.


As for off-label use, well that depends on the situation. I'm not going to argue that there are places that agents with less liability in AFFECTIVE disorder patients could be used first line before resorting to APs.


-- Jay

 

Re: Antipsychotics? All the same? » yxibow

Posted by metric on March 17, 2009, at 17:44:46

In reply to Re: Antipsychotics? All the same? » metric, posted by yxibow on March 17, 2009, at 6:02:48

> This is such a vast generalization of neuroleptics I'm floored...
>
> They are with out much doubt among the only agents that bring life and peace to people with serious psychotic conditions. They have and still enable people with schizophrenia and other related disorders

That's often claimed, but rarely by the one's given the drugs. People on neuroleptics don't have the desire to do anything; they're docile vegetables. The drugs are thus beneficial to caregivers and others who might interact with the patient, but not the patient himself. With no other class of drugs is "compliance" such an issue.

> People aren't "victims" and that does great disservice to people on this board whose suffering has been helped by APs.

I think "victim" is an appropriate term to describe those individuals who are given neurolepetics against their will (why do you think long-acting depot injections are available?) as well as healthy people (most mental patients) who are given the drugs without informed consent regarding the well-known toxicity of drugs in this class.

> As for off-label use, well that depends on the situation. I'm not going to argue that there are places that agents with less liability in AFFECTIVE disorder patients could be used first line before resorting to APs.

Prolonged neuroleptic use leads to the loss of dopaminergic neurons (of which tardive dyskinesia is probably a manifestation). Fortunately, they make nearly everbody feel so incredibly awful that they're seldom taken long long enough to do harm.


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