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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by utopizen on January 25, 2011, at 18:14:30
I was hospitalized for 3 weeks after having what may have been an episodic case of paranoia, perhaps even a manifestation of amphetamine psychosis-- who knows. He has a doctorate in neurobiology, so naturally his construction of how to interpret meds affecting my brain is a more "dopamine: turn on. turn off. turn on."
he doesn't want me to go on it under the dopamine theory of schitzophrenia (although I believe it's not schitzophrenia, as I had coherent thoughts and reasoning... just mentioning the theory's name).
anyhow, years ago, I actually was hospitalized, diagnosed with amphetamine psychosis, and released the following afternoon. Before leaving, I had received a 9AM dosing of Desoxyn and a 12 PM dosing, as it happened to be in my bag and the doctor wanted me to not make any changes and simply observe my response I believe. It was a well regarded hospital.
I don't think anything will change his mind, and he's really one of the few docs I can see in the planet that accept insurance at all in my city. The others charge $300 for the first visit; $150-$220 for maintence visits; cash only.
That's how rare psych doctors are in my city, despite the abundance of university hospital schools.
these docs will rx me dexedrine... but it would be nice to just work through a single doctor before getting a second opinion. My pdoc said he needs to prescribe like his peers. I was wondering if anyone has a doc that treats someone with a history of paranoia at some point, or a study that says amphetamine psychosis is not enough of a reason to go from 30mg of dexedrine daily to zero.
I know in heart problems, ABC News showed a kid who I was surprised didn't get cancelled any stimulant therapy when his Adderall caused some sudden cardic arrest or something. Instead, doc merely reduced the dose, and added a beta blocker.
Well, I'm on Risperdal now, and actually am taking the IV for it every 2 weeks. Wouldn't the combo of continued Risperdal therapy + lowering my Dexedrine suffice? Is there any ANY medical literature or case studies on this?
He told me he is unaware of anyone with a paranoia history is going to ever be on a stimulant. Is this true??
Posted by Christ_empowered on January 25, 2011, at 18:36:30
In reply to paranoid episode - now my doc won't rx dexedrine, posted by utopizen on January 25, 2011, at 18:14:30
I was once diagnosed bipolar and put on a mood stabilizer and 60mgs Adderall. I had an "episode" that the hospital diagnosed as amphetamine psychosis but my outpatient shrink diagnosed as a bipolar episode made worse by "uppers". She offered to put me on a lower dose of Adderall, along with a different mood stabilizer, but I was tired of psychiatry at that point so I just walked out of her office.
I don't think its completely unheard of to use stimulants when there's a history of paranoia, but its probably not all that common, either.
Posted by Phillipa on January 25, 2011, at 19:42:33
In reply to Re: paranoid episode - now my doc won't rx dexedrine, posted by Christ_empowered on January 25, 2011, at 18:36:30
I didn't know there was IV resperidol? Is it helping you? Phillipa
Posted by linkadge on January 28, 2011, at 18:16:40
In reply to Re: paranoid episode - now my doc won't rx dexedrine, posted by Phillipa on January 25, 2011, at 19:42:33
Amphetamine psychosis is different from regular psychosis. Amphetamine psychosis is more paranoid, but overal cognition is usually in tact. Ketamine induced psychosis can look much different - more disorganized thinking.
Linkadge
Posted by ed_uk2010 on January 30, 2011, at 13:05:36
In reply to Re: paranoid episode - now my doc won't rx dexedrine, posted by Phillipa on January 25, 2011, at 19:42:33
> I didn't know there was IV resperidol? Is it helping you? Phillipa
That's right. There are no IV formulations of Risperdal, but there is a slow-acting injectable form which is administered by deep intramuscular injection every two weeks.
Posted by phillipa on January 30, 2011, at 19:36:16
In reply to Re: paranoid episode - now my doc won't rx dexedrine » Phillipa, posted by ed_uk2010 on January 30, 2011, at 13:05:36
Ed like prolixin only that was once a month. Thannks!!!! PJxxx
Posted by utopizen on February 6, 2011, at 17:34:37
In reply to Re: paranoid episode - now my doc won't rx dexedrine, posted by linkadge on January 28, 2011, at 18:16:40
> Amphetamine psychosis is different from regular psychosis. Amphetamine psychosis is more paranoid, but overal cognition is usually in tact. Ketamine induced psychosis can look much different - more disorganized thinking.
>
> Linkadgethe most cited study on amphetamine psychosis was done in the 50's... giving people higher doses over a 24-hour period until they got psychotic.
The conclusion was amphetamine psychosis can be "clinically indistingable" from schizophrenia.
I would infer, based on the examples cited in the study, that they would wait to stop giving more of it only once actual schizophrenic states occurred... not just like, paranoia, but actual thought disorders/delirium
after going up enough on the dose like that, with some @ 400mg, the person will not be lucid in thought.
This is the end of the thread.
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