[MrMoralAmbiguity]

First, I have Schizoaffective disorder but the psychosis is controlled under Seroquel. I have been researching and experimenting with drugs to alleviate my negative symptoms. By negative symptoms I mean the six A's that also apply to a type of depression known as Abulic Depression: apathy, anergia, amotivation,
avolia ( lack of will power ), anhedonia and affective blunting.

THe first medicine I tried was Remeron. It had no effect but to make my mouth dry and vision blurry and crave sweets.
Then I tried Wellbutrin. It sent me into a delusional state where I was hallucinating everything around me, people, streets, etc. I would slip in and out of delusions. Considering my experience with Wellbutrin I decided to avoid stimulants (that does make sense, right?)

So I did more research and I came up with this:

http://www.psychosocial.com/IJPR_10/Drug_S...i_Rey_Abad.html

The drugs listed are: Citalopram, Alprazolam, Clomipramine, Bromocriptine, FLuoxetine, Nortriptyline, Maprotiline, and FLuvoxamine.

I found lots of research around ssri's and negative symptoms, most of it conflicting, but the best results I could come upon involved Fluvoxamine or Nortriptyline.

I then found this:

http://www.dr-bob.or...msgs/56694.html

So I decided to try the SSRI-Tricyclic combination. I chose to use Fluvoxamine 100mg and Nortriptyline 100mg. I was on the fluvoxamine for one month, then added the NOrtriptyline and tapered up to 100mg. Shortly thereafter I began to hallucinate again so I went off the nortriptyline (my hallucinations were controlled with Seroquel but came back on, I suspect, because of the NOrtriptyline)

There was an improvement in my anhedonia and affective flattening, even after discontinuing the NOrtriptyline, but I still struggle with apathy, anergia, amotivation and avolia. Then I Found this:

http://www.neuropsychiatryreviews.com/aug0...g00_apathy.html

This is the next medicine I am going to try, donepezil. Has anyone heard of it? I found that article interesting because it talks about apathy and depression as related but two seperate mechanisms. This seems true in my experience as I am not depressed, only apathetic. Also when I was younger I could be depressed but not apathetic at times.

Thanks for your input and hope this information is useful to someone because it was hell trying to find information on negative symptom treatments. I did not touch on the supplements (glycine, etc) but I have tried some of them and they are both expensive and barely showed any results.

======

EDIT I did not make this clear in this post (but I did on my post in the Seroquel forum) I do not use drugs anymore. Only for a short time after my psychosis began in a desperate attempt to escape something I didn't understand nor want to believe I had.EDIT I would like to know or be pointed in the right direction for research, about what neurotransmitters certain drugs affect that exacerbate psychosis and what drugs I should avoid in my search for something that helps with negative symptoms.

The drugs that exacerbated my schizophrenia are as follows:

MDMA, Cannabis, large amounts of Caffeine, cocaine, LSD, Wellbutrin and (possibly) Nortriptyline.

Why did these exacerbate my schizophrenia and what drugs should I avoid because of it?

Thanks

Mr. M. A.

This post has been edited by MrMoralAmbiguity: 15 June 2010 - 09:05 AM

[dymphna]

MrMoralAmbiguity, on Fri 11 June 2010 1:15:11 GMT +0000, said:

I would like to know or be pointed in the right direction for research, about what neurotransmitters certain drugs affect that exacerbate psychosis and what drugs I should avoid in my search for something that helps with negative symptoms.

The drugs that exacerbate my schizophrenia are as follows:

MDMA, Cannabis, large amounts of Caffeine, cocaine, LSD, Wellbutrin and (possibly) Nortriptyline.

Why would these exacerbate my schizophrenia and what drugs should I avoid because of it?

Thanks

Mr. M. A.

Somewhere on the internet is an icon of a smiley face bashing its head into a brick wall. I wish to use it right now. I will settle for a face palm.

MDMA: Fries neural pathways

Cannabis: Causes psychosis

Cocaine: Causes psychosis

LSD: Oy - you're seriously mixing LSD with a schizophrenia diagnosis??

Wellbutrin & Nortriptyline: Unless you're dealing with concurrent depression (something along the lines of schizoaffective - which I just read in another post is actually the case), it isn't a matter of what they will or won't do as much as why would you be taking them to begin with?

Essentially, unless your Pdoc is attempting to alleviate some aspect of your negative symptoms with ADs, ALL of the other stuff is actually working against you.

Your best bet for addressing negative symptoms will be to go the route of meds such as Risperdal, Zyprexa and (eek) Clozaril.


Dymphna

[dymphna]

Ok, I started to answer the first post before finding the second post. I don't have time to wade through the second post except to say...


Is there a doctor involved in any of this?


D

[MrMoralAmbiguity]

dymphna, on Fri 11 June 2010 11:44:36 GMT +0000, said:

MrMoralAmbiguity, on Fri 11 June 2010 1:15:11 GMT +0000, said:

I would like to know or be pointed in the right direction for research, about what neurotransmitters certain drugs affect that exacerbate psychosis and what drugs I should avoid in my search for something that helps with negative symptoms.

The drugs that exacerbate my schizophrenia are as follows:

MDMA, Cannabis, large amounts of Caffeine, cocaine, LSD, Wellbutrin and (possibly) Nortriptyline.

Why would these exacerbate my schizophrenia and what drugs should I avoid because of it?

Thanks

Mr. M. A.

Somewhere on the internet is an icon of a smiley face bashing its head into a brick wall. I wish to use it right now. I will settle for a face palm.

MDMA: Fries neural pathways

Cannabis: Causes psychosis

Cocaine: Causes psychosis

LSD: Oy - you're seriously mixing LSD with a schizophrenia diagnosis??

Wellbutrin & Nortriptyline: Unless you're dealing with concurrent depression (something along the lines of schizoaffective - which I just read in another post is actually the case), it isn't a matter of what they will or won't do as much as why would you be taking them to begin with?

Essentially, unless your Pdoc is attempting to alleviate some aspect of your negative symptoms with ADs, ALL of the other stuff is actually working against you.

Your best bet for addressing negative symptoms will be to go the route of meds such as Risperdal, Zyprexa and (eek) Clozaril.


Dymphna

Okay I made this clear on my post under the Seroquel forum but not here: I do not use drugs anymore. I only used them right after my psychosis kicked in in a desperate attempt to escape the voices. You can't judge me for being confused and psychotic and having no idea what was happening to me. But thanks for the benefit of the doubt.

Anyways, you didn't answer my question. I did not ask if these drugs exacerbate psychosis, I say they do, my question still stands, "what neurotransmitters are affected by these drugs that exacerbate my psychosis?" I have used all these drugs after my psychosis started and experienced exacerbation of psychosis.

MDMA = Fries Neural Pathways (I know that, but by what mechanism does it exacerbate my psychosis? What neurotransmitters are affected that cause increased auditory/visual hallucinations?)

Cannabis = I'm aware that cannabis causes psychosis. I smoked for 2-3 years straight before my psychosis kicked in. But by what mechanism did it exacerbate my psychosis when I used it after my psychosis started?

LSD = No, I'm not mixing LSD with schizophrenia. An LSD trip is where my schizophrenia started so I assumed it would exacerbate my symptoms. Halfway through an LSD trip I began to hear voices that have not gone away. Why is that?

Wellbutrin and Nortriptyline = I used these because I found studies saying that they could alleviate negative symptoms. Note my second post. I also tried Remeron but it did nothing and had no effect on my psychosis. My question is till unanswered: Why did they exacerbate my psychosis?

Excess amounts of caffeine = You didn't even attempt to explain this one (well, you didn't really explain any of them, just put me down for struggling with drugs and my diagnosis at one point in time and being curious as to if I can use this information to help me in the future)

My question is still unanswered: By what mechanism do these drugs exacerbate psychosis so I can have a better understanding of my brain chemistry? Is it simply dopamine being messed with or is there something else? (I don't think Nortriptyline affects dopamine)

As for negative symptoms I seriously doubt my best route is AAP. I've been on all of them (except Clozaril, but my doctor says that it is only slightly more effective than other AAPs) and only Seroquel helps with my psychosis but not my negative symptoms. I have a post about this on the Seroquel forum. I don't know if you even looked at the studies I found on negative symptoms, but the fluvoxamine/nortriptyline combination actually did help immensely with affective flattening and anhedonia, I can actually feel emotions and have conversations now. But even after going off the Nortriptyline, the benefits have remained (maybe it was just the fluvoxamine? I dunno.)

dymphna, on Fri 11 June 2010 11:52:43 GMT +0000, said:

Ok, I started to answer the first post before finding the second post. I don't have time to wade through the second post except to say...


Is there a doctor involved in any of this?


D

Yes, I have a pdoctor. He usually just follows my research and suggestions since at this point I am venturing into very theoretical grounds and he doesn't have much experience with a lot of the things I am researching (alleviating negative symptoms).

This post has been edited by MrMoralAmbiguity: 11 June 2010 - 07:52 PM

[therapeuticbrigg84]

large amounts of caffeine would probably have no lasting affects on psychosis, unless it was like 4-5 cups of coffee(especially starbucks.)

i would suggest avoiding anything dopamine related considering you're history with stimulants/wellbutrin. so that would mean no bromocriptine.

drugs i would suggest are xanax(as mentioned), buspar, klonopin. these don't help depression, but do help anxiety especially if you're still taking seroquel. some of the antidepressants you mentioned like luvox, clomipramine, or even a new one like pristiq may be helpful.

fish oil should help, and maybe even trying out some vitamin B Complex.

im sorry i had a much better, more well written answer earlier, but i ended up closing the window accidentally, and it deleted it, hope this helps.

aricept sounds interesting

This post has been edited by therapeuticbrigg84: 11 June 2010 - 07:42 PM

[MrMoralAmbiguity]

therapeuticbrigg84, on Fri 11 June 2010 19:40:02 GMT +0000, said:

large amounts of caffeine would probably have no lasting affects on psychosis, unless it was like 4-5 cups of coffee(especially starbucks.)

i would suggest avoiding anything dopamine related considering you're history with stimulants/wellbutrin. so that would mean no bromocriptine.

drugs i would suggest are xanax(as mentioned), buspar, klonopin. these don't help depression, but do help anxiety especially if you're still taking seroquel. some of the antidepressants you mentioned like luvox, clomipramine, or even a new one like pristiq may be helpful.

fish oil should help, and maybe even trying out some vitamin B Complex.

im sorry i had a much better, more well written answer earlier, but i ended up closing the window accidentally, and it deleted it, hope this helps.

aricept sounds interesting

Around four or five cups of coffee, or a pot of tea, my auditory hallucinations and delusions kick in full gear. Is it because it releases dopamine?

Yeah, I figured I'd have to stay away from anything dopamine related :-( thanks for pointing that out. What I don't understand is why Nortriptyline, an NRI, would exacerbate psychosis. DOes this mean I can't use Straterra?

I do take xanax occasionally for anxiety.

I am not depressed, but abulic depressed (aka Negative Symptoms of Schizophrenia). I chose Luvox because of its effect on the sigma-σ1 receptor (I read some theoretical information that it may helps negative symptoms).

I used to use fish oil for a long time but there was no difference in my negative symptoms.

I also used Vitamin B Complex . . . I was on the whole orthomolecular psychiatry plan for a reasonable amount of time. The vitamins did nothing.

Yes, I'm looking forward to see if Aricept does anything.

I'm just glad you replied :-) but my main questions still remain.

[MrMoralAmbiguity]

Why were my two posts merged? They are different topics.

[Anna]

We frequently merge topics, if they are similar/related.

Don't worry about it, it's not a big deal.

You seem pretty aggravated and agitated, I'd stay away from trying to treat the negative sx for a while, until the positive sx are back under control.

How much seroquel do you take? If it helps the negative sx, you might try bumping it up.... There's some research that it will also help with depression, so I'd go that route first.

Once you are feeling more stable, I'd look at adding another med.

Have you tried any of the mood stabilizers? I'd look at lamictal if it were me..... Depakote can also be extremely helpful with agitated depressive type sx. Not for everybody, but for a reasonable minority. It's a very calming med....

Anna

[therapeuticbrigg84]

nortriptyline as a tricyclic antidepressant is pretty rough and crappy drug compared to luvox which is a more clean ssri.

[MrMoralAmbiguity]

Anna, on Sat 12 June 2010 9:40:28 GMT +0000, said:

You seem pretty aggravated and agitated, I'd stay away from trying to treat the negative sx for a while, until the positive sx are back under control.

Aggravated and agitated? @_@ That's news to me! And, yeah, I'm hoping that coming off the notritrptyline and raising my seroquel will take care of my positive symptoms in a few weeks time.

Quote

How much seroquel do you take? If it helps the negative sx, you might try bumping it up.... There's some research that it will also help with depression, so I'd go that route first.

Already done, bumped up to 600mg from 200mg.

Quote

Once you are feeling more stable, I'd look at adding another med.

Have you tried any of the mood stabilizers? I'd look at lamictal if it were me..... Depakote can also be extremely helpful with agitated depressive type sx. Not for everybody, but for a reasonable minority. It's a very calming med....

Anna

I was on Lamictal for half a year, but have not tried depakote.

therapeuticbrigg84, on Sat 12 June 2010 11:47:57 GMT +0000, said:

nortriptyline as a tricyclic antidepressant is pretty rough and crappy drug compared to luvox which is a more clean ssri.

That's true, but I still don't understand why there's a warning for exacerbating psychosis with Nortriptyline when most of its actions are similar to Seroquel.

[dymphna]

MrMoralAmbiguity, on Sat 12 June 2010 17:11:06 GMT +0000, said:

That's true, but I still don't understand why there's a warning for exacerbating psychosis with Nortriptyline when most of its actions are similar to Seroquel.

Because Nortriptyline is not Seroquel. They aren't even in the same class of medications.

Just because they may have a couple of similar mechanisms of actions does not mean they have all the same mechanisms of actions.

When in doubt, just look at the actual chemical formuli:

Nortriptyline

Seroquel

I'm all about pictures. (you have to scroll past the black box warnings)


Dymphna

[MrMoralAmbiguity]

dymphna, on Mon 14 June 2010 23:33:16 GMT +0000, said:

MrMoralAmbiguity, on Sat 12 June 2010 17:11:06 GMT +0000, said:

That's true, but I still don't understand why there's a warning for exacerbating psychosis with Nortriptyline when most of its actions are similar to Seroquel.

Because Nortriptyline is not Seroquel. They aren't even in the same class of medications.

Just because they may have a couple of similar mechanisms of actions does not mean they have all the same mechanisms of actions.

When in doubt, just look at the actual chemical formuli:

Nortriptyline

Seroquel

I'm all about pictures. (you have to scroll past the black box warnings)


Dymphna

Good point.

[Deep Sea Philosopher]

Don't fuck with my Norepinephrine!

Basically, Wellbutrin/Geodon aggravated my psychosis. Activating the fight-or-flight reflex is what I think the problem is.

[therapeuticbrigg84]

from the guy taking dexedrine says dont fuck with my norepinephrine, well of course, you're taking the smoothest of dopamine drugs in dexedrine, wellbutrin is like the chunkiest so MO is that dopamine affects psyschosis as well, of course norepinephrine does too? but that wouldnt be primetime in drug like geodon, it's only in the background.

[bengaltiger]

Deep Sea Philosopher, on Tue 15 June 2010 5:38:12 GMT +0000, said:

Wellbutrin/Geodon aggravated my psychosis.

I'm nowhere near the psychotic/psychosis spectrum, but this mix would probably take me there.

This post has been edited by bengaltiger: 15 June 2010 - 11:40 AM

[Deep Sea Philosopher]

therapeuticbrigg84, on Tue 15 June 2010 13:09:30 GMT +0000, said:

from the guy taking dexedrine says dont fuck with my norepinephrine, well of course, you're taking the smoothest of dopamine drugs in dexedrine, wellbutrin is like the chunkiest so MO is that dopamine affects psyschosis as well, of course norepinephrine does too? but that wouldnt be primetime in drug like geodon, it's only in the background.

You're right.. since Dextroamphetamine is the enantiomerically pure isomer, it only messes with my Dopamine compared to racemic Amphetamine which messes with both Dopamine and Norepinephrine.

The Dopamine hypothesis in Schizophrenia Spectrum Disorders is still valid, although they have conceded that other Neurotransmittors have a role.

bengaltiger, on Tue 15 June 2010 14:33:45 GMT +0000, said:

Deep Sea Philosopher, on Tue 15 June 2010 5:38:12 GMT +0000, said:

Wellbutrin/Geodon aggravated my psychosis.

I'm nowhere near the psychotic/psychosis spectrum, but this mix would probably take me there.

I worded that wrong.. I was on them seperately. Geodon is the one that affected me the most in terms of how bad things got.

[Jerod Poore]

dymphna, on Fri 11 June 2010 12:44:36 GMT +0000, said:

Your best bet for addressing negative symptoms will be to go the route of meds such as Risperdal, Zyprexa and (eek) Clozaril.

Not Risperdal, but only because of the earlier LSD use that, based upon the posts that were wiped out by my brilliant software kung fun, has apparently resulted in Hallucinogen Persisting Perception Disorder. Risperdal + HPPD = making it worse.

[Jerod Poore]

MrMoralAmbiguity, on Fri 11 June 2010 17:36:06 GMT +0000, said:

Anyways, you didn't answer my question. I did not ask if these drugs exacerbate psychosis, I say they do, my question still stands, "what neurotransmitters are affected by these drugs that exacerbate my psychosis?" I have used all these drugs after my psychosis started and experienced exacerbation of psychosis.

MDMA = Fries Neural Pathways (I know that, but by what mechanism does it exacerbate my psychosis? What neurotransmitters are affected that cause increased auditory/visual hallucinations?)

Pretty much all of them. MDMA is like an MAOI on steroids.

MrMoralAmbiguity, on Fri 11 June 2010 17:36:06 GMT +0000, said:

Cannabis = I'm aware that cannabis causes psychosis. I smoked for 2-3 years straight before my psychosis kicked in. But by what mechanism did it exacerbate my psychosis when I used it after my psychosis started?

See this post.

MrMoralAmbiguity, on Fri 11 June 2010 17:36:06 GMT +0000, said:

LSD = No, I'm not mixing LSD with schizophrenia. An LSD trip is where my schizophrenia started so I assumed it would exacerbate my symptoms. Halfway through an LSD trip I began to hear voices that have not gone away. Why is that?

Hallucinogen Persisting Perception Disorder. The standard treatments include various norepinephrine reuptake inhibitors (that didn't work), other antidepressants, benzodiazepines (usually clonazepam) and antipsychotics. The so-called flashbacks (a useless term) can be any or all of visual, auditory, or emotional.

MrMoralAmbiguity, on Fri 11 June 2010 17:36:06 GMT +0000, said:

My question is still unanswered: By what mechanism do these drugs exacerbate psychosis so I can have a better understanding of my brain chemistry? Is it simply dopamine being messed with or is there something else? (I don't think Nortriptyline affects dopamine)

Answered in both the nortriptyline and Seroquel topics. Dopamine isn't the only neurotransmitter involved in psychosis, otherwise there wouldn't be a need for atypical antipsychotics, the standards would take care of everything.

[MrMoralAmbiguity]

Jerod Poore, on Wed 16 June 2010 16:24:57 GMT +0000, said:

MrMoralAmbiguity, on Fri 11 June 2010 17:36:06 GMT +0000, said:

Anyways, you didn't answer my question. I did not ask if these drugs exacerbate psychosis, I say they do, my question still stands, "what neurotransmitters are affected by these drugs that exacerbate my psychosis?" I have used all these drugs after my psychosis started and experienced exacerbation of psychosis.

MDMA = Fries Neural Pathways (I know that, but by what mechanism does it exacerbate my psychosis? What neurotransmitters are affected that cause increased auditory/visual hallucinations?)

Pretty much all of them. MDMA is like an MAOI on steroids.

MrMoralAmbiguity, on Fri 11 June 2010 17:36:06 GMT +0000, said:

Cannabis = I'm aware that cannabis causes psychosis. I smoked for 2-3 years straight before my psychosis kicked in. But by what mechanism did it exacerbate my psychosis when I used it after my psychosis started?

See this post.

MrMoralAmbiguity, on Fri 11 June 2010 17:36:06 GMT +0000, said:

LSD = No, I'm not mixing LSD with schizophrenia. An LSD trip is where my schizophrenia started so I assumed it would exacerbate my symptoms. Halfway through an LSD trip I began to hear voices that have not gone away. Why is that?

Hallucinogen Persisting Perception Disorder. The standard treatments include various norepinephrine reuptake inhibitors (that didn't work), other antidepressants, benzodiazepines (usually clonazepam) and antipsychotics. The so-called flashbacks (a useless term) can be any or all of visual, auditory, or emotional.

MrMoralAmbiguity, on Fri 11 June 2010 17:36:06 GMT +0000, said:

My question is still unanswered: By what mechanism do these drugs exacerbate psychosis so I can have a better understanding of my brain chemistry? Is it simply dopamine being messed with or is there something else? (I don't think Nortriptyline affects dopamine)

Answered in both the nortriptyline and Seroquel topics. Dopamine isn't the only neurotransmitter involved in psychosis, otherwise there wouldn't be a need for atypical antipsychotics, the standards would take care of everything.

Thanks that about answers it all!