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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by Youri5 on March 13, 2008, at 9:23:55
Hi All,
Two years ago I had a Psychosis, the first time so far.
I was put on Risperdal.
We soon found out that I was Anhedonic and i was diagnosed with Depression. We first tried Cipramil (a SSRI), but that had no effect.
So we tried a TCA, Nortrilen which helped a bit.Since it only helped a bit I was diagnosed with Schizophrenia (Desorganised form).
After that we changed Risperdal for Clozapine, which also helped a little with the Anhedonia (could be because I stopped Risperdal or because of the Clozapine. That remains unclear).
My question is: can an antidepressant work partially, so that it is possible that I'm not Schizophrenic but still only Depressed?
Greetz, YouriF
Posted by Sigismund on March 13, 2008, at 11:17:24
In reply to Depression only or also Schizophrenic, posted by Youri5 on March 13, 2008, at 9:23:55
Do you think the drugs that you need to treat your schizophrenia could be contributing to your depression?
(If the answer to that was 'Yes', I'm not sure what would follow.)
A one-off psychosis is not a compelling reason to take APs for life?
Posted by Youri5 on March 13, 2008, at 11:42:46
In reply to Re: Depression only or also Schizophrenic » Youri5, posted by Sigismund on March 13, 2008, at 11:17:24
I'm not sure if the AP drug is contributing to my depression or helping me or whatsoever.
I'm thinking about stopping the AP.
Posted by Phillipa on March 13, 2008, at 12:55:57
In reply to Re: Depression only or also Schizophrenic, posted by Youri5 on March 13, 2008, at 11:42:46
Talk to your doc first and see what he thinks Phillipa
Posted by Quintal on March 14, 2008, at 5:51:30
In reply to Depression only or also Schizophrenic, posted by Youri5 on March 13, 2008, at 9:23:55
This is interesting because I had my first psychotic episode a few months ago, and only narrowly escaped being diagnosed with Schizophrenia. If I hadn't know anything about mental health (and therefore be careful in what I revealed) I'd have been diagnosed with Paranoid Schizophrenia no messing. As it was I ended up with the Bipolar label, but that was only because of a comment my dad made during one appointment. This diagnosing business is nowhere near as clear-cut as it seems from a distance, and neither are the boundaries between Bipolar Disorder and Schizophrenia.
I don't understand why you were diagnosed with Schizophrenia when your anhedonia (which may have been drug-induced and is more of a mood problem anyway) failed to respond to a TCA. Why not Bipolar if anything? Many people only get a partial response to an antidepressant - it's very common.
Q
Posted by Youri5 on March 14, 2008, at 9:45:49
In reply to Re: Depression only or also Schizophrenic, posted by Quintal on March 14, 2008, at 5:51:30
Well, I became Ahedonic before the meds, so my diagnosis is probably accurate.
But what Sigismund pointed out might well be true:
the Clozapine could be contributing to my depression!
Posted by Youri5 on March 14, 2008, at 11:36:13
In reply to Re: Depression only or also Schizophrenic, posted by Youri5 on March 14, 2008, at 9:45:49
Good that your diagnosis is okay Quintal, then u can get the right tratment.
I have had several 'working diagnoisis', also Bipolar (which I'm sure I'm not).
But that you say that a partial response to AD's is common makes me doubt my diagnosis again.
I'll have to talk about it with my PDoc.
Posted by Sigismund on March 14, 2008, at 16:57:01
In reply to Re: Depression only or also Schizophrenic, posted by Youri5 on March 14, 2008, at 9:45:49
Maybe you were both schizophrenic and anhedonic before meds?
Maybe the meds that will help your schizophrenia will make your adhedonia worse?
Is it a question of trade-offs between some improvement in one and a worsening of the other?
Is there anything that could help your adhedonia that does not make schizophrenia worse?
Or maybe, as you seem to suspect, your schizophrenia does not really need (so much) drug treatment now?
Posted by jms600 on March 14, 2008, at 17:08:20
In reply to Depression only or also Schizophrenic, posted by Youri5 on March 13, 2008, at 9:23:55
Have you thought of trying a med that treats both psychosis and depression? I believe Flupentixol is an antipsychotic drug that is also given for mild to moderate depression.
Posted by Youri5 on March 15, 2008, at 6:00:50
In reply to For argument's sake, posted by Sigismund on March 14, 2008, at 16:57:01
Yes, I truly believe I can do without AP's
To help my Anhedonia...
...some add-on AD maybe?
Posted by youri5 on March 15, 2008, at 8:13:49
In reply to Re: For argument's sake, posted by Youri5 on March 15, 2008, at 6:00:50
Hi, Sigismund
I've been thinking about your questions and it's got me thinking.
I want to make a distinction betwen Shizophrenin Anhedonia and Depressive anhedonia.
It feels like the clozapine is helping me a bit with the Schizophrenic anhedonia, but also contributing a bit to my depression.
Maybe i could try (if when I stop the clozapine and my schizohrenia gets worse) an AP with AD funtion too (like jms said).
Posted by Sigismund on March 15, 2008, at 16:09:04
In reply to Re: For argument's sake, posted by youri5 on March 15, 2008, at 8:13:49
Amisulpride is an AP that in low doses is said to be of some use with anhedonia.
You might like to keep that in mind.
Posted by Youri5 on March 16, 2008, at 12:00:32
In reply to Re: For argument's sake, posted by Sigismund on March 15, 2008, at 16:09:04
Thanks for the tip.
My previous pdoc prescribed me the clozapine to combat the anhedonia (my current is not).
Anyone else who heard that clozapine can help decrease negative symptoms?
(my current pdoc mentioned something like that there are 2 schools, 2 different opinions about Anhedonia).
Posted by nfc on March 21, 2008, at 7:39:43
In reply to Re: For argument's sake, posted by Youri5 on March 16, 2008, at 12:00:32
youri
i've been dx w/ skits and am now on abilify. try and see if you pdoc will prescribe u that. i was on 3mg risp previously and it introduced alot of anhedonia. hate that med. its good for short term acute psychosis but for long term should switch to something like abilify.
nfc
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