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Old Jun 23, 2020, 03:32 PM
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bpcyclist bpcyclist is offline
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Member Since: Sep 2019
Location: Portland
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Quote:
Originally Posted by bluebicycle View Post
I'm confused and concerned about you. Why would your pdoc add a stimulant if the AP increase doesn't work? You say, in your words, that you're always very psychotic, so wouldn't a stimulant be counterintuitive? Also, I'm surprised your pdoc is saying, "well, we'll try a stimulant if this antipsychotic doesn't work in a few days." While antipsychotics can take a matter of hours or days to kick in, they typically take more than a few days. (See here: The “delayed onset” of antipsychotic action — an idea whose time has come and gone)

I think you need a new pdoc if he's not telling you to wait at least one week. As a doctor, you know that's wrong, especially since APs are likely not an effective way to treat bipolar depression for more than 6 months: Antipsychotic Treatment for Bipolar Disorder Not Always Effective After Six Months | Brain & Behavior Research Foundation

I'm not trying to come across as an @ss, but I think your pdoc's plan is not something that a psychiatrist would typically recommend for someone who is very psychotic all the time. Most research studies (especially those coming from the NIH, NHS, etc.) suggest using a mood stabilizer to help with depression. If mood stabilizers don't help, then an antipsychotic combined with an antidepressant is recommended. It's clearly stated here (WebMD)and here (Harvard University).
Thank you, blue. Yeah, not really sure I understood it all. He said my prefrontal D2 receptors are broken or something and the only way to fix that now is more Abilify or possibly a stimulant, if the Abilify doesn't do it. Not sure really about all the rest. He did say that in his experience, stimulants in low doses rarely cause psychosis, if ever. He says he has never seen that, himself. But i am just the messenger here. Maybe the Abilifry will work or something.
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