Psycho-Babble Medication Thread 6750

Shown: posts 1 to 9 of 9. This is the beginning of the thread.

 

Menninger's diagnosis

Posted by Jim on May 28, 1999, at 17:38:45

I just got back from an evaluation at Menninger's and was diagnosed as having a shizoaffective disorder. Previously I'd been diagnosed as having major depression and social phobia. They want me to enter in-patient treatment at Menninger's for a few weeks, and then transfer to a half-way house. They want to try me on neuroleptics. My main symptom so far has been anxiety and extreme social sensitivity, and an inability to get along with others, or distrust of others. On the other hand, at times it seems like I'm too trusting of others, as I've been robbed more than once by people I trusted. My most disturbing symptom is intense anxiety. Sometimes it's almost unbearable. Would neuroleptics help in controlling that anxiety, if used for a long enough period of time? They haven't helped when I've taken them before on a PRN basis. Does the diagnosis make sense? I've had a very spotty work record due to my inability to function with people. I'm now 45. Should I get a second opinion from another hospital. It really isn't very practical as my Dad was paying for it and I don't think he's disposed to go to another hospital for a second opinion. Does anyone know if Menninger has a bias toward diagnosing schizophrenic illnesses? It really freaked out my parents when they heard the diagnosis. Any advice would be appreciated.

 

Re: Menninger's diagnosis

Posted by Jim on May 28, 1999, at 23:29:47

In reply to Menninger's diagnosis, posted by Jim on May 28, 1999, at 17:38:45

This kind of answers my own question regarding the antianxiety reducing potential of neuroleptics. It's from a link on Dr. Bob's site: http://www.rci.rutgers.edu/~lwh/drugs/chap04.htm#The Tranquilizers (Phenothiazines)
The rest of the online book is very good, too.

The Tranquilizers (Phenothiazines)

Chlorpromazine was not, perhaps, the perfect lytic that Laborit was seeking, but it was close. When administered to patients prior to surgery, the effect was
remarkable. The drug did not cause heavy sedation, thus allowing the patients to remain aware of their environment. They could carry on conversations, answer the
physician's questions, and clearly were in contact with their environment. But the drug did cause a certain indifference to stressful stimuli, greatly reducing the normal
preoperative fears, reducing the amount of anesthesia that was necessary to conduct the surgery, and most importantly, reducing dramatically the likelihood of death
resulting from surgical shock. Virtually all of these effects are caused through action on the brain rather than the peripheral nervous system. It was an autonomic
stabilizer that worked by virtue of changing the perception of the environment. It was, in the words of Laborit, a Pavlovian deconditioner--stimuli that previously
elicited fear were as benign following chlorpromazine administration as they would be if experimental extinction had taken place.

 

Re: Menninger's diagnosis

Posted by PattyG on May 28, 1999, at 23:41:04

In reply to Menninger's diagnosis, posted by Jim on May 28, 1999, at 17:38:45

I can't imagine that you could "top" Menninger's Clinic! From what I understand, it is quite costly aside from being a top notch facility. I'd say you are probably fortunate to have been able to be a patient there.

 

Re: Menninger's diagnosis

Posted by Elizabeth on May 29, 1999, at 0:51:37

In reply to Re: Menninger's diagnosis, posted by PattyG on May 28, 1999, at 23:41:04

Jim,

I think you should go with their recommendations, but insist on talking to them about why this diagnosis (which I think is a little weird too) and have them explain the reasons before you commit to any medication changes. So anyway, give it a chance!

 

Re: Menninger's diagnosis

Posted by Dwight on May 29, 1999, at 0:54:12

In reply to Re: Menninger's diagnosis, posted by PattyG on May 28, 1999, at 23:41:04

Just because the clinic has a great reputation doesn't mean your diagnosis is always accurate. It's very common to get different diagnoses from different psychiatrists. You seem highly intelligent to me. What do you think is your condition? I really don't like labels. What's important is that you find a medicine that works for you.

> I can't imagine that you could "top" Menninger's Clinic! From what I understand, it is quite costly aside from being a top notch facility. I'd say you are probably fortunate to have been able to be a patient there.

 

Re: Menninger's diagnosis

Posted by Dwight on May 29, 1999, at 1:04:21

In reply to Menninger's diagnosis, posted by Jim on May 28, 1999, at 17:38:45

Jim, I was wondering if you've ever tried Nardil before. That can be great for Social Phobia. Also the Schizoid Personality Disorder and Avoidant personality disorders. If your main problem resides in the social spher, I wonder why they diagnosed use as schizoaffective. I thought that was more of a general emotional instability.

> I just got back from an evaluation at Menninger's and was diagnosed as having a shizoaffective disorder. Previously I'd been diagnosed as having major depression and social phobia. They want me to enter in-patient treatment at Menninger's for a few weeks, and then transfer to a half-way house. They want to try me on neuroleptics. My main symptom so far has been anxiety and extreme social sensitivity, and an inability to get along with others, or distrust of others. On the other hand, at times it seems like I'm too trusting of others, as I've been robbed more than once by people I trusted. My most disturbing symptom is intense anxiety. Sometimes it's almost unbearable. Would neuroleptics help in controlling that anxiety, if used for a long enough period of time? They haven't helped when I've taken them before on a PRN basis. Does the diagnosis make sense? I've had a very spotty work record due to my inability to function with people. I'm now 45. Should I get a second opinion from another hospital. It really isn't very practical as my Dad was paying for it and I don't think he's disposed to go to another hospital for a second opinion. Does anyone know if Menninger has a bias toward diagnosing schizophrenic illnesses? It really freaked out my parents when they heard the diagnosis. Any advice would be appreciated.

 

Re: Menninger's diagnosis

Posted by Jim on May 29, 1999, at 23:10:15

In reply to Re: Menninger's diagnosis, posted by Dwight on May 29, 1999, at 1:04:21

> Jim, I was wondering if you've ever tried Nardil before. That can be great for Social Phobia. Also the Schizoid Personality Disorder and Avoidant personality disorders. If your main problem resides in the social spher, I wonder why they diagnosed use as schizoaffective. I thought that was more of a general emotional instability.
>
No, I've never tried an MAOI, and a doctor in Boston once recommended one for me in the mid-1980s. He was a several hour trip from where I was living at the time and I was afraid of the side effects of the MAOIs so I didn't try it, but other people I've met on the Net, including Elizabeth, have thought that I should try one, too, and I personally think it sounds like a good idea. I don't know what their reasons for diagnosing me as shizoaffective were, and I think the fact that I mentioned I was having suicidal thoughts might have had something to do with it. Maybe they wanted a strong diagnosis to convince my parents of the need to hospitalize me. I don't know. I mentioned that I'd have mild OCD symptoms, which he told me represented "magical thinking." I have to admit, I have been unstable emotionally during a lot of my life, but I've never felt that I've been out of touch with reality or anything like that, which, to me, anyway, is what the "schizo" part of schizoaffective implies. And I agree with the person who said that just because the hospital has a good recommendation doesn't mean that their always correct with their diagnosis. I think that's especially true in the field of psychiatry, where there are no obvious markers to determine what condition a person has. I don't like labels when it comes to psychiatry, and that's the reason why. I really have nothing against trying these newer neuroleptics, which have few side effects from what I understand, but I've seen at least a dozen psychiatrists during the last 30 years, most of them for periods of more than a year each, and none have recommended neuroleptics, except for one in Mexico who recommended a small dose of Zyprexa (2.5 mg/day) for social anxiety. I guess I'll follow Elizabeth's advice and give them a try, but I would like to know how they arrived at that diagnosis, and I'd like to know if any of the doctors there would consider trying me with an MAOI, like the doctor in Massachusetts recommended. Do MAOIs have any effect one way or the other on anxiety? Thanks for all the responses. They've been helfpul. It's hard to decide what to do. They want me to go into the hospital for 4 to 6 weeks and then to a "halfway" house, but have said, since I objected so strongly to the hospital, that I could start out in the "halfway" house. They've said they could monitor my meds more closely in the hospital, but I don't see why that has to be the case, even if it's the way their system is set up. I'd rather have daily ten minute appointments with a med doctor than pay the daily hospital bill. It really doesn't make sense, and I think part of it has to do with the fact that I expressed some suicidal thoughts, but when it comes down to it, I'm quite sure that I'm not going to commit suicide. I've made it through these 45 years, I can make it now. My fear is that they'll use the suicidal thoughts as an excuse to keep me locked up indefinitely. Does anyone know the law regarding that? Elizabeth?

 

Re: Menninger's diagnosis

Posted by Dwight on May 30, 1999, at 1:36:27

In reply to Re: Menninger's diagnosis, posted by Jim on May 29, 1999, at 23:10:15

Nardil is very good for social anxiety and some forms of depression. I don't know if it works as well for other anxiety disorders. If the dose is high enough it lowers social inhibitions. It does have a lot of side effects: weight gain and insomnia are the ones that bother me the most. But I would think that the anti-psychotics would have just as many side effects, and maybe more harmful in long run. Why not try Nardil first. Also high doses of Klonipan might help with the anxiety.

> No, I've never tried an MAOI, and a doctor in Boston once recommended one for me in the mid-1980s. He was a several hour trip from where I was living at the time and I was afraid of the side effects of the MAOIs so I didn't try it, but other people I've met on the Net, including Elizabeth, have thought that I should try one, too, and I personally think it sounds like a good idea. I don't know what their reasons for diagnosing me as shizoaffective were, and I think the fact that I mentioned I was having suicidal thoughts might have had something to do with it. Maybe they wanted a strong diagnosis to convince my parents of the need to hospitalize me. I don't know. I mentioned that I'd have mild OCD symptoms, which he told me represented "magical thinking." I have to admit, I have been unstable emotionally during a lot of my life, but I've never felt that I've been out of touch with reality or anything like that, which, to me, anyway, is what the "schizo" part of schizoaffective implies. And I agree with the person who said that just because the hospital has a good recommendation doesn't mean that their always correct with their diagnosis. I think that's especially true in the field of psychiatry, where there are no obvious markers to determine what condition a person has. I don't like labels when it comes to psychiatry, and that's the reason why. I really have nothing against trying these newer neuroleptics, which have few side effects from what I understand, but I've seen at least a dozen psychiatrists during the last 30 years, most of them for periods of more than a year each, and none have recommended neuroleptics, except for one in Mexico who recommended a small dose of Zyprexa (2.5 mg/day) for social anxiety. I guess I'll follow Elizabeth's advice and give them a try, but I would like to know how they arrived at that diagnosis, and I'd like to know if any of the doctors there would consider trying me with an MAOI, like the doctor in Massachusetts recommended. Do MAOIs have any effect one way or the other on anxiety? Thanks for all the responses. They've been helfpul. It's hard to decide what to do. They want me to go into the hospital for 4 to 6 weeks and then to a "halfway" house, but have said, since I objected so strongly to the hospital, that I could start out in the "halfway" house. They've said they could monitor my meds more closely in the hospital, but I don't see why that has to be the case, even if it's the way their system is set up. I'd rather have daily ten minute appointments with a med doctor than pay the daily hospital bill. It really doesn't make sense, and I think part of it has to do with the fact that I expressed some suicidal thoughts, but when it comes down to it, I'm quite sure that I'm not going to commit suicide. I've made it through these 45 years, I can make it now. My fear is that they'll use the suicidal thoughts as an excuse to keep me locked up indefinitely. Does anyone know the law regarding that? Elizabeth?

 

MAOIs and anxiety

Posted by Elizabeth on May 30, 1999, at 4:34:07

In reply to Re: Menninger's diagnosis, posted by Dwight on May 30, 1999, at 1:36:27

Jim,

Nardil is pretty much the gold standard drug for social phobia, and I found it terrific for other random anxiety as well.

Parnate - helpful, not as much so. (I've been having a lot of trouble with school as a result of residual anxiety.)

Marplan is what's behind door number three. :-)


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