Posted by med_empowered on August 31, 2008, at 16:07:10
In reply to Re: Oh, I am so very sorry, everyone!, posted by Nurse Hot Flash on August 31, 2008, at 9:56:03
hey! Sorry about your son's situation. Has your son's doc thought about maybe reducing the number and/or dosage of antipsychotics? Sometimes if a benzo or anticonvulsant mood stabilizer is used (or both, I imagine), the dose of neuroleptic(s) can be lowered w/o losing adequate control over symptoms.
It seems to me that using something besides another antipsychotic w/ the abilify might be a good call...Abilify is pretty high potency; @ 30mgs, you're looking at over 90% D2 blockade...it seems to me (as a total non-expert who just happens to have taken the same meds) that the Zyprexa is basically functioning as a tranquilizer/sedative. I would imagine the benefits would mostly be from the sedation and maybe from the serotonin-antagonist effects. Also, I would think that a low dose of Zyprexa might help smooth out akathisia/agitation from the Abilify (and lots of docs *still* mistake antipsychotic-induced problems for an exacerbation of the underlying illness).
Has your son's doc talked about some sort of psycosocial treatment, like CBT or vocational rehab? That sort of thing might help bring your son out of his rut.
Sometimes stimulating drugs help when there are a whole lot of negative symptoms. That's probably not an option until the positive symptoms have been under control for a good while, but...Provigil and Ritalin have both been used with good results in some people. I imagine the new dopamine agonists might also be useful.
Also, sometimes depression looks a whole lot like negative symptoms. Neuroleptic-Induced Dysphoria and the Neuroleptic-Induced Deficit Syndrome can both also look like "negative symptoms." NID and NIDS are supposedly more common with older antipsychotics (especially high-doses of high-potency ones), but the atypicals can also cause social withdrawal, dysphoria, suicidality, etc., so its not as if the problem is limited to, say, Haldol and Prolixin.
Good luck!
poster:med_empowered
thread:849242
URL: http://www.dr-bob.org/babble/20080822/msgs/849507.html