Posted by ed_uk2010 on January 27, 2015, at 16:38:36
In reply to Re: Multiple mechanism with Zyprexa and some atyp, posted by Lamdage22 on January 27, 2015, at 14:04:16
>It just goes and goes and goes.
Like rapid thoughts? Were you depressed at the time? Or more manic/overactive/excited? What were the delusions like?
>If it wasn't psychosis but something else, would it be treated any different?Delusions are a form of psychosis, but they can occur as part of mood disorders, as well as primary psychotic illnesses like schizophrenia.
In schizoaffective disorder, delusions occur *mainly* during depressive, manic, or mixed episodes, but also occur when mood is relatively normal *on occasion*. If delusions or hallucinations *never* occur except in the setting of highly abnormal mood, the diagnosis of schizoaffective disorder is not normally applied, and a mood disorder with psychotic features is diagnosed instead eg. major depression with psychotic features ie. 'psychotic depression', or bipolar disorder with psychotic features. Some doctors may diagnose schizoaffective disorder even when delusions only occur during mood episodes, if the delusions are highly bizarre and resemble schizophrenia.
>would it be treated any different?
Schizoaffective disorder is virtually always treated with antipsychotics, other meds can be used as well but not in the absence of antipsychoics.
Treating psychotic depression, and bipolar disorder with psychotic features usually involves antipsychotics, but not absolutely always.
If you don't mind, it would be useful to know something about the delusions. And in what way did you lose control?
Delusions which occur in mood disorders are most commonly related to the mood state eg. during severe depression, someone may have the delusion that they are actually dead.... during mania, someone may believe they are the president. Delusions in schizoaffective disorder are less likely to be clearly related to the mood state, but they can be... they also tend to be more bizarre eg. someone might believe that they can read everyone else's mind, or that people can read their mind... or that their thoughts are being sent to people by the radio, for example. This type of bizarre delusion unrelated to mood is typical of schizoaffective disorder and is uncommon or exists only very briefly in primary mood disorders. The presence of bizarre delusions is strongly suggestive that antipsychotics are needed. Constant or at least very frequent hallucinations, most often voices, are much more typical of schizoaffective disorder than mood disorders - and normally respond only to antipsychotics.
.............
People with a history of psychosis should avoid dopaminergic drugs eg. amphetamines, cocaine, methylphenidate, Parnate, dopamine agonists (eg. Requip, Mirapex) and possibly bupropion. These drugs may induce psychosis. Large amounts of alcohol are also a very bad idea. Cannabis should be avoided. I'm sure you already know all this but I thought I'd write it anyway!
By the way, how do you respond to Lamictal?
poster:ed_uk2010
thread:1074889
URL: http://www.dr-bob.org/babble/20150102/msgs/1075645.html