Posted by SLS on September 22, 2014, at 8:41:58
In reply to Re: Switching from Seroquel to Geodon (weight loss), posted by Athene on September 22, 2014, at 0:29:12
Thanks for the explanation. I'm not a doctor, but it sounds like your condition is a bit complex. Chronic trauma early in life may have set you up for presenting with a cluster of psychiatric phenomena that do not fit neatly into a diagnosis of classic bipolar disorder I. As described, your first psychotic episode sounds a lot like bipolar I disorder mania. Depression in bipolar disorder does not always resemble that seen in unipolar major depressive disorder, especially if it occurs as a mixed-state. Bipolar depression is difficult to distinguish from unipolar depression. A few studies indicate that bipolar depression more often resembles atypical unipolar depression, and is less likely to include appetite loss and agitation.
It is possible that a history of chronic trauma early in life - "developmental PTSD" - is what triggered and continues to drive mood instability. This instability is now biological in nature, but may still be modifiable by psychotherapy via neuroplasticity. I guess the most conservative approach would be to mitigate the potential for the emergence of psychosis using medication while addressing psychosocial issues through psychotherapy.
http://en.wikipedia.org/wiki/Complex_post-traumatic_stress_disorder
http://www.positivehumandevelopment.com/developmental-ptsd.html
Latuda (lurasidone) is an antipsychotic that demonstrates antidepressant effects in bipolar depression. It is officially approved by the U.S. FDA to treat schizophrenia and bipolar depression, although it is currently being studied for mania. It is perhaps the least likely neuroleptic antipsychotic to produce weight gain and negative metabolic effects.
Saphris (asenapine) might be worth a look. It is an antipsychotic that has both antimanic and antidepressant properties. I know someone who is doing very will with it. She is able to lose the weight she gained while taking Seroquel. Saphris seems to be very capable of treating psychosis that presents with paranoia.
- Scott
Some see things as they are and ask why.
I dream of things that never were and ask why not.- George Bernard Shaw
poster:SLS
thread:1071382
URL: http://www.dr-bob.org/babble/20140914/msgs/1071402.html