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Old 05-03-2018, 09:28 AM #21
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Default Re: Zyprexa: Weight, Appetite among others

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Originally Posted by Findingreason View Post
No, you don't sound like you are preaching. Thank you for your information.

I agree with you to a certain extent on the medication. I'm on a total of 7 meds. And one PRN. It is a lot, yes. But its 2 meds for my hormone replacement therapy, 1 for essential tremor (which I had before APs), 2 antipsychotics, 1 mood stabilizer, and 1 antidepressant. Then the PRN is diazepam.

Are you able to cite sources for the symptoms imposed by benzos? I did a little research and found it to be a rare occurrence. None of my pdocs have ever shown concern towards that med either. If it was lets say, a stimulant medication like Adderall or Ritalin, I know those can definitely cause psychosis in patients. But I'm on neither. If SP sees this, I'd be curious of your input on this too.

I know a few others on the boards here have also been/are on two APs as well. I do not want to stay on two APs, but I know right now it helps me stay stable. The ward pdoc adding Abilify did bring me out of psychosis. I still have some symptoms semi-regularly (voices, paranoia, etc), but its not like when I was in the ward. After getting specialized therapy for this at the psychosis polyclinic for a while, I want to request to go off at least the Zyprexa, as it is has the most unpleasant side effects of any of my meds. Otherwise, all that aside, I am actually feeling quite good overall. My mood for the most part is very good, my depression is under control, no erratic mood swings. Subtract Zyprexa I do not see any reason to switch or discontinue other meds as my mental health is quite good outside the stuff I mentioned above.

I honestly don’t know much about benzos other than they are addictive so they are on my avoid list but Like any med ymmv right?
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Old 05-03-2018, 10:01 AM #22
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Default Re: Zyprexa: Weight, Appetite among others

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Originally Posted by Findingreason View Post
No, you don't sound like you are preaching. Thank you for your information.

I agree with you to a certain extent on the medication. I'm on a total of 7 meds. And one PRN. It is a lot, yes. But its 2 meds for my hormone replacement therapy, 1 for essential tremor (which I had before APs), 2 antipsychotics, 1 mood stabilizer, and 1 antidepressant. Then the PRN is diazepam.

Are you able to cite sources for the symptoms imposed by benzos? I did a little research and found it to be a rare occurrence. None of my pdocs have ever shown concern towards that med either. If it was lets say, a stimulant medication like Adderall or Ritalin, I know those can definitely cause psychosis in patients. But I'm on neither. If SP sees this, I'd be curious of your input on this too.

I know a few others on the boards here have also been/are on two APs as well. I do not want to stay on two APs, but I know right now it helps me stay stable. The ward pdoc adding Abilify did bring me out of psychosis. I still have some symptoms semi-regularly (voices, paranoia, etc), but its not like when I was in the ward. After getting specialized therapy for this at the psychosis polyclinic for a while, I want to request to go off at least the Zyprexa, as it is has the most unpleasant side effects of any of my meds. Otherwise, all that aside, I am actually feeling quite good overall. My mood for the most part is very good, my depression is under control, no erratic mood swings. Subtract Zyprexa I do not see any reason to switch or discontinue other meds as my mental health is quite good outside the stuff I mentioned above.
I'll have to find the article. I believe it was from Medscape. I'm not sure though, because I read it about 4 years ago. Give me a few days to find it.

My psychiatrist once told me that benzodiazepines make psychotic symptoms worse. I believe that because whenever I took .5 mg of Ativan, I heard voices. Sometimes I would have blackouts, which was very scary. Side effects like that can be mistaken for psychiatric disorders, which could mean a medication increase, the addition of another one and/or a misdiagnosis.

Long term use of benzodiazepines isn't good. The risk of iatrogenic harm is really high.

Therapy and medication tend to work better than medication alone.

I read in the roll-call that were doing some traveling. Have fun.
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Old 05-06-2018, 04:40 PM #23
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Default Re: Zyprexa: Weight, Appetite among others

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I appreciate you being willing to help despite my symptoms. I'm not totally sure where things went in the wrong direction. I've always seen you as insightful and intellectual in how you post on here, and at some point I may have misinterpreted that you were using it against me in perhaps some ulterior motive as you mentioned? What you said about my thoughts of not belonging or being allowed to post here make more sense the more I think about it. Like you and others were trying to get me to leave and vanish. For some reason I have thought people do have some vendetta against me. It has taken a lot of courage and strength on my part to be open here about what's going on in my head. Even then as I type this, I feel like you and others will use it against me. I still struggle to accept there *is* a problem like now that more than one pdoc at the ward and polyclinic have said I have. I feel like I should just leave these forums cause it cannot even be possible. That's the push/pull I have in my head regularly regarding trying to come to terms with this.

I'm curious what you meant by splitting? I know it's a symptom related to borderline personality disorder, and such. I get that black and white thinking a lot in the past; and maybe thinking you were on a course plotting against me was a form of all or nothing thinking? I wonder if it's that plus paranoia. The reason I ask is I am generally good at recognizing splitting behaviours in myself, and I recognise them for what they are. That ability to differentiate splitting has saved me from many potentially heartbreaking arguments with people close to me where I chose logic and analysis over blind emotional all or nothing thinking. What caught me off guard this time is I didn't even realise what was going on with you until yesterday's encounter on here. Then it cascaded into me realising my thoughts about others here was also likely the same situation. The whole thing sent me into a nervous breakdown yesterday, trying to comprehend what happened, in addition to feeling sick already.

Thank you again. For pointing out what was happening to me after I was open about stuff yesterday. Telling me it had no basis of truth in your reality made me realise it was not truth for me either because you weren't trying to get me to leave or anything. I still struggle with the thoughts but I am trying to work through it. Like, I feel like others are watching me close here and waiting to attack. Its distressing.
Sorry, it's taken a while to reply; combination of being physically unwell and busy.

I'm glad to see elsewhere that travelling to see your friends is helping you feel better. Honestly, I think that your BPD has been triggered big time recently: you've posted a lot about not feeling safe/belonging here, and about frequently asking your wife and partner if they are mad at you etc. I'm wondering if it might have something to do with your difficulty studying/sitting your exams triggering this feeling that you're not good enough; for your wife & partner, for us, you're not 'sick enough' to post here etc etc. But idk, that's just a guess.

Is there anything that you, or people IRL, can think of that has happened recently to trigger all of this?

Re: splitting - it seems to me from my interpretation of your posts that your feelings about me have gone from effusive appreciation of my posts just a couple of months ago, to feeling that I'm out to get you. That's a big dichotomy, which is why I mentioned splitting. In actuality, I am neither that amazing, nor that bad: I'm just a regular person with good and bad points, like everyone else.

Re: benzos increasing psychosis - Benzos, as a class, can both cause psychosis, and cause a dissociative state that people mistake as psychosis. Benzos can also improve the symptoms of psychosis. Them causing psychosis isn't that common, and it's called a paradoxical reaction because it's opposite to the intention - all sorts of drugs can cause paradoxical reactions: antipsychotics can CAUSE psychosis, and not just on withdrawal, for example, but they're usually rare effects.

It can also depend on the individual drug. For example, I can take diazepam and it it is helpful to me (but tolerance is a massive problem, and addiction is a big fear, so I avoid it like the plague), but the first time that I took lorazepam in hospital, it caused visual hallucinations and kept me awake. Normally, they give you lorazepam to make you calm down and fall asleep! The nurses didn't believe that lorazepam could cause either of those effects, and they kept telling me that it was just me being 'mental', but luckily the pdoc believed me (and told the nurses that these effects are possible!) and she changed it to diazepam, which doesn't have that effect on me.

Also, benzos are very similar to Z-drugs (zopiclone and zolpidem), and zolpidem in particular is often abused by people wanting to hallucinate. They call it 'chasing the walrus', apparently. The first, and only, time that I took it, it made me have scary visual hallucinations, and didn't even make me sleep. It happens more commonly with them than with benzos, but it shows that the potential for psychosis is there with benzos as they're structurally very similar and act in similar ways.

Then there's the problem of them causing dissociative experiences that people mistake for psychosis, which can happen with anything that sedates. As Didgee said, it puts you in a near-sleep/dreaming state, where it is common to have hypnopompic/hypnagogic hallucinations, and feeling unreal/'out of touch with reality'. We get lots of people post here with dissociative experiences (usually because of anxiety, rather than benzo use though) that they are terrified are signs of psychosis/sz, because they can feel kind of similar.

The other issue with benzos is that they lower inhibitions so there is an increased risk of impulsivity, SH and suicidality. They can also cause blackouts during these times too, so people come too and find that they have done some really dangerous things to themselves without conscious intent. It also can affect memories being stored: I was prescribed benzos one time, years ago, around exam revision and was warned that I might find it harder to revise and remember the info with benzos in my system.

Anyway, all that to say that these are recognised possibilities with these types of drugs, as Didgee said, but, as ever, individual milage varies.

Re: 2 APs - I know that it's a lot more common in the US, and other places, than it is in the UK to prescribe 2 APs. Polypharmacy is kind of frowned upon here, even though there is sometimes a need for it (though I am still horrified by some of the polypharmacy that I see across PC that really feels way OTT to me). It causes a lot of issues with side effects and not knowing which drug is helping/causing a side effect. If it's done, you should only increase one at a time to try to figure out if it's helping/worsening side effects, but I frequently see people who've gone into hospital on, say, 5 drugs, which all get stopped cold turkey, and then they're released on 4 different drugs a few days later! Their neutrons must not know which way is up!!! How is the patient or outpatient pdoc supposed to know what is withdrawal effects from what drug, starting side effects from which new drug, and which ones might be helping, and what's the underlying illness situation!?? It's baffling!

Anyway, the current recommendations (in the UK, at any rate) is that two APs just increase side effects that aren't worth the minimal/no additional benefits of the additional AP. The ONLY exception is that the addition of aripiprazole MAY improve negative symptoms that might be worth the additional side effects, but it's still kind of iffy because negative (& cognitive) symptoms are the hardest to treat and don't really respond much, if at all. And that high doses may be needed at first, but should then be reduced to lower maintenance doses when stable.

I do want to add though that I don't personally think that you are currently in a place to drastically mess with your APs. I'd recommend taking whatever therapy you can get to work on your emotional regulation and distress tolerance skills, and then, when stable, start lowering/coming off meds until you're at the right pros:cons level. That would give you the best chance of being able to successfully able to lower the dose/number of meds, and stay on that lower amount. But, obviously, that's a discussion you need to have with your pdoc.

All the best

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Old 05-07-2018, 04:34 AM #24
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Default Re: Zyprexa: Weight, Appetite among others

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Sorry, it's taken a while to reply; combination of being physically unwell and busy.

I'm glad to see elsewhere that travelling to see your friends is helping you feel better. Honestly, I think that your BPD has been triggered big time recently: you've posted a lot about not feeling safe/belonging here, and about frequently asking your wife and partner if they are mad at you etc. I'm wondering if it might have something to do with your difficulty studying/sitting your exams triggering this feeling that you're not good enough; for your wife & partner, for us, you're not 'sick enough' to post here etc etc. But idk, that's just a guess.

Is there anything that you, or people IRL, can think of that has happened recently to trigger all of this?
No need to apologise! I figured something was going on. I hope you feel better soon.

Hmm, I could look into this a bit more. I know that worrying my wife and partner are mad at me and continually asking that could be related to OCD. I was diagnosed with it many years ago and did a lot of treatment for it. I feel the thoughts are rather quite intrusive, and ones that I must act on by asking, else they won't go away. It happened with my partner and I in 2012, around the time I received treatment for said condition. I need to get ahold of the book Brain Lock again and re-read the skills it taught and practice them.

That being said, I agree the other symptoms are very much BPD ending up back in. I guess this is something in upcoming therapy I can identify what is what and progress in trying to get back on track.


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Originally Posted by WeepingWillow23 View Post
Re: splitting - it seems to me from my interpretation of your posts that your feelings about me have gone from effusive appreciation of my posts just a couple of months ago, to feeling that I'm out to get you. That's a big dichotomy, which is why I mentioned splitting. In actuality, I am neither that amazing, nor that bad: I'm just a regular person with good and bad points, like everyone else.
Hmm, that is a good point. I looked at you from two extremes...Though even whilst I was on the extreme that you were after me, I still saw you as very intellectual and insightful. I just thought it was being used against me.

Quote:
Originally Posted by WeepingWillow23 View Post
Re: benzos increasing psychosis - Benzos, as a class, can both cause psychosis, and cause a dissociative state that people mistake as psychosis. Benzos can also improve the symptoms of psychosis. Them causing psychosis isn't that common, and it's called a paradoxical reaction because it's opposite to the intention - all sorts of drugs can cause paradoxical reactions: antipsychotics can CAUSE psychosis, and not just on withdrawal, for example, but they're usually rare effects.

It can also depend on the individual drug. For example, I can take diazepam and it it is helpful to me (but tolerance is a massive problem, and addiction is a big fear, so I avoid it like the plague), but the first time that I took lorazepam in hospital, it caused visual hallucinations and kept me awake. Normally, they give you lorazepam to make you calm down and fall asleep! The nurses didn't believe that lorazepam could cause either of those effects, and they kept telling me that it was just me being 'mental', but luckily the pdoc believed me (and told the nurses that these effects are possible!) and she changed it to diazepam, which doesn't have that effect on me.

Also, benzos are very similar to Z-drugs (zopiclone and zolpidem), and zolpidem in particular is often abused by people wanting to hallucinate. They call it 'chasing the walrus', apparently. The first, and only, time that I took it, it made me have scary visual hallucinations, and didn't even make me sleep. It happens more commonly with them than with benzos, but it shows that the potential for psychosis is there with benzos as they're structurally very similar and act in similar ways.

Then there's the problem of them causing dissociative experiences that people mistake for psychosis, which can happen with anything that sedates. As Didgee said, it puts you in a near-sleep/dreaming state, where it is common to have hypnopompic/hypnagogic hallucinations, and feeling unreal/'out of touch with reality'. We get lots of people post here with dissociative experiences (usually because of anxiety, rather than benzo use though) that they are terrified are signs of psychosis/sz, because they can feel kind of similar.

The other issue with benzos is that they lower inhibitions so there is an increased risk of impulsivity, SH and suicidality. They can also cause blackouts during these times too, so people come too and find that they have done some really dangerous things to themselves without conscious intent. It also can affect memories being stored: I was prescribed benzos one time, years ago, around exam revision and was warned that I might find it harder to revise and remember the info with benzos in my system.

Anyway, all that to say that these are recognised possibilities with these types of drugs, as Didgee said, but, as ever, individual milage varies.
I will put it in my bullet journal when I take Diazepam for anxiety to figure if there is a correlation between taking the medication as needed and symptoms that arise from it. Such as those you mentioned (hallucinations, impulsivity, suicidal or SH behaviours). It is worth noting I don't take it often; a package of 30 pills can last me for 3-4 months or more. It doesn't sedate me either. I don't need it often these days, as my anxiety is under much better control lately. Or I can find ways to cope with it.

Quote:
Originally Posted by WeepingWillow23 View Post
Re: 2 APs - I know that it's a lot more common in the US, and other places, than it is in the UK to prescribe 2 APs. Polypharmacy is kind of frowned upon here, even though there is sometimes a need for it (though I am still horrified by some of the polypharmacy that I see across PC that really feels way OTT to me). It causes a lot of issues with side effects and not knowing which drug is helping/causing a side effect. If it's done, you should only increase one at a time to try to figure out if it's helping/worsening side effects, but I frequently see people who've gone into hospital on, say, 5 drugs, which all get stopped cold turkey, and then they're released on 4 different drugs a few days later! Their neutrons must not know which way is up!!! How is the patient or outpatient pdoc supposed to know what is withdrawal effects from what drug, starting side effects from which new drug, and which ones might be helping, and what's the underlying illness situation!?? It's baffling!

Anyway, the current recommendations (in the UK, at any rate) is that two APs just increase side effects that aren't worth the minimal/no additional benefits of the additional AP. The ONLY exception is that the addition of aripiprazole MAY improve negative symptoms that might be worth the additional side effects, but it's still kind of iffy because negative (& cognitive) symptoms are the hardest to treat and don't really respond much, if at all. And that high doses may be needed at first, but should then be reduced to lower maintenance doses when stable.

I do want to add though that I don't personally think that you are currently in a place to drastically mess with your APs. I'd recommend taking whatever therapy you can get to work on your emotional regulation and distress tolerance skills, and then, when stable, start lowering/coming off meds until you're at the right pros:cons level. That would give you the best chance of being able to successfully able to lower the dose/number of meds, and stay on that lower amount. But, obviously, that's a discussion you need to have with your pdoc.

All the best

*Willow*
Thankfully the hospitals I've been to have never drastically changed my meds as you were talking about. I was always baffled and dumbstruck by that too. Its actually very irresponsible of said health care providers if you ask me.

The one good thing that came out of adding Abilify was that it improved my ability to stay away. Less sedation. I am grateful for that. I can stay up 12-14 hours normally, and if required, 16. Much better than in the past.

As much as I want to come off of one of them (Zyprexa in particular), you are probably right that waiting till I am more stable is probably for the best.

I really hope therapy helps me out here. I've been without counseling since March. Wow. Maybe that's why I have so much trouble since the hospitalisation; no mental health support from professionals to differentiate and work through things. I begin with a new p-nurse later this month after I get back home. Perhaps there we can begin really identifying what is what, rather than playing guess work. It's very good for my mind to talk to people here and just get things out. But I do wonder how much of it is bad that I don't know which way is up or down in terms of my symptoms. Two pdocs in a row said I am still needing to be in treatment and that I need the APs. I guess I have to trust their judgment. I meet a third pdoc later this month. Hopefully I will be able to stick with him for a while. Its all confusing as hell, not knowing what is what right now. I don't always know what or who to trust.

Thank you for taking time to talk things out with me.
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Old 05-07-2018, 06:17 AM #25
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Default Re: Zyprexa: Weight, Appetite among others

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Re: 2 APs - I know that it's a lot more common in the US, and other places, than it is in the UK to prescribe 2 APs. Polypharmacy is kind of frowned upon here, even though there is sometimes a need for it (though I am still horrified by some of the polypharmacy that I see across PC that really feels way OTT to me). It causes a lot of issues with side effects and not knowing which drug is helping/causing a side effect. If it's done, you should only increase one at a time to try to figure out if it's helping/worsening side effects, but I frequently see people who've gone into hospital on, say, 5 drugs, which all get stopped cold turkey, and then they're released on 4 different drugs a few days later! Their neutrons must not know which way is up!!! How is the patient or outpatient pdoc supposed to know what is withdrawal effects from what drug, starting side effects from which new drug, and which ones might be helping, and what's the underlying illness situation!?? It's baffling!
I agree with this. Polypharmacy is the worst approach. Not only does it cause disabling side effects (that can be mistaken for psychotic symptoms), it can kill. I personally knew two people who died prematurely due to excessive weight gain from antipsychotics. One was 28 and the other was 40.

Medicating every symptom even day to day worries is excessive and doesn't promote recovery at all. Medication is only one part of recovery. Solely relying on it will promote dependence on the service and stagnation in emotional development. Ideally medication should help with symptoms so you can function in the world, not disable and isolate you (I sound like my psychiatrist).

P.S. I haven't been able to find the article. I'll keep trying.

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Old 05-07-2018, 09:56 AM #26
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Default Re: Zyprexa: Weight, Appetite among others

I'm really way too emotional about this polypharmacy topic to talk about it rationally, but I'm glad to see it's being discussed. Until someone shows me specifically what "chemical imbalance" is being corrected, I'll try to find other ways to cope.

...but if I get diagnosed with Didgee Disorder, I'll probably just give up.
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Old 05-08-2018, 03:07 AM #27
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...but if I get diagnosed with Didgee Disorder, I'll probably just give up.
What is this supposed to mean?
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Old 05-08-2018, 07:02 AM #28
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What is this supposed to mean?
I'm so sorry. I didn't mean to offend you. I was just being silly, and I can see how inappropriate that was.

Please forgive me.
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Old 05-08-2018, 07:16 AM #29
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Default Re: Zyprexa: Weight, Appetite among others

I am on Risperdal (for 9 years) and Zyprexa (for 5 years). I have gained a lot of weight since the Zyprexa was added. I am beginning to worry but I cannot live with the symptoms if they returned, they would ruin my life. Double-edged sword here my friends. I will talk with my pdoc, maybe I can wean off of the Risperdal.....I believe the Zyprexa is more effective against my symptoms, but I can't be sure.
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No need to apologise! I figured something was going on.
That's good as I'm not going to be around PC as much the next couple of weeks. I didn't want you to think that I was annoyed with you or something.

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Hmm, I could look into this a bit more. I know that worrying my wife and partner are mad at me and continually asking that could be related to OCD. I was diagnosed with it many years ago and did a lot of treatment for it. I feel the thoughts are rather quite intrusive, and ones that I must act on by asking, else they won't go away. It happened with my partner and I in 2012, around the time I received treatment for said condition. I need to get ahold of the book Brain Lock again and re-read the skills it taught and practice them.
Whether this is 'standard' reassurance seeking behaviour, or OCD in nature, I think it's worth exploring where the worry comes from. I would imagine that it has it's routes in low self-esteem... I think that knowledge is power and when you understand where an unhelpful belief comes from, it's much easier to challenge it. Eg when I heard these 2 voices regularly and I realised that they were repeating old messages from my grandmother, they lost most of their power to upset me, and they eventually went away completely when I no longer believed what my grandmother had always told me about myself.

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Hmm, that is a good point. I looked at you from two extremes...Though even whilst I was on the extreme that you were after me, I still saw you as very intellectual and insightful. I just thought it was being used against me.
It's not the intellect being present or not that I meant by splitting, but believing that the intellect was being used for 'good' and then for 'evil', so to speak. That is the two extremes that I was referring to if it wasn't clear before.

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I will put it in my bullet journal when I take Diazepam for anxiety to figure if there is a correlation between taking the medication as needed and symptoms that arise from it. Such as those you mentioned (hallucinations, impulsivity, suicidal or SH behaviours).
As I said, diazepam doesn't have those effects on me either, but it's something to be aware of with that class of medication, and I think tracking it could be a good idea as it might have some effect, good or bad, or even trigger for its use, that you haven't noticed before.

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Its actually very irresponsible of said health care providers if you ask me.
I agree.

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The one good thing that came out of adding Abilify was that it improved my ability to stay away. Less sedation. I am grateful for that. I can stay up 12-14 hours normally, and if required, 16. Much better than in the past.
That's good to hear. It's so important to be able to live a life on the medication, or IMO what is the point of them as a tool?!

Quote:
Originally Posted by Findingreason View Post
But I do wonder how much of it is bad that I don't know which way is up or down in terms of my symptoms.
Perhaps mindfulness will help here? Observe the thoughts without judging them as 'good' or 'bad'. Sometimes uses a mindfulness meditation whereby you put the thoughts onto leaves in a stream and watch them flow away.

Quote:
Originally Posted by Findingreason View Post
Its all confusing as hell, not knowing what is what right now. I don't always know what or who to trust.


Congratulations on passing your exam and being accepted onto the course. I'm glad that it didn't go as badly as you feared it would.

*Willow*
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