Roll Call.....#30

Well the pill is just as good if your fine remembering to take it I think they're all like 99% effective

I'm pretty good with pills so I'll just stick to the pill.

Yeah there have been a few studies looking at long acting injectables vs oral and occasionally there is some difference but often there isn't any difference...it depends on the meta analysis...here is a review of that...

http://www.jclinepi.com/article/S089...ext#back-bib14

The one that really bothers me is the one that got funded by NIMH showing no difference in relapse because that should be a pretty definitive study....although I have seen some which suggest not necessarily a change in symptoms but in hospitalization....

I'll say the jury is still out on that but it doesn't look like a compliance issue. One of the problems is they are looking at hospitalization...not symptoms...so if you gave me enough antipsychotic that I couldn't get out of bed for 14 hours and I was still dragging after that I would certainly stay out of the hospital because it's not like I could even leave the house. At this point you're talking chemical restraints instead of healing and that's one of the areas I don't agree with. I know with at least one person here they kept increasing her dose beyond therapeutic levels and once you're on depot you can't just wean yourself off....it's beyond coercive to me it's more like a rights violation....it would I think be different if there were crimes involved but we're just talking people who think differently.

I think the actual problem is the genetics are so heterogenous....every gwas study thats been done pulls up different genes so depending on your ethnicity you probably have something slightly different than anyone else. I know for me I don't have a dopamine issue I have a metabotropic glutamate receptor issue...now that can impact dopamine downstream but Ketamine and thus glutamate can cause psychosis that isn't treatable by any antipsychotic other than clozapine....so it's not the typical D2 pathway that most APs treat because clozapine is the weakest d2 binder... Get someone without a dopamine issue at all and you've got someone treatment resistant. There is in fact one mutation in the metabotropic glutamate receptor that is associated with Val/val at COMT which is highly treatment resistant back wards kind of stuff. Problem is those guys are already clearing dopamine really fast due to enhanced COMT activity so reducing dopamine signaling doesn't help them. It just a matter of not having the right drugs yet and the nmda receptor is hard to work with because you need to increase rather than decrease signaling and yet it can be excitotoxic so you can't do much other than target the glycine modulatory site which so far is having minimal impact.

Frankly it's a mess and I'm just super thankful that the meds worked for me at all considering I also have val/val COMT and a slightly different grm3 mutation...I think it's due to a second mutation in zfn804a that counteracts some of the COMT functionality so I'm not already maxed out on dopamine clearance....but until this gets down to the point of getting a genome sequenced and getting meds based on that I don't think we're going to dent that 30% treatment failure rate...

Inspirational quotes time! Made this one while going home from Alabama:

"From a young age I knew that the world was a harsh, barely hospitable place. You have what you have, you are who you are, and you live where you live. Cherish that. Others have worse."
-amazingblob

lol... Ok, what laid that?

i really hope this new pdoc doesnt wanna put me on another depot. or im gonna freak out. ive had it up to here with this clinic. and thinking about ending it if he suggests a depot. its beyond crazy how much i was put on. 100mgs. thats not even right. i mean for me.

im on oral meds right now and still hear a little voices and some paranioa but its seemingly manageable right now.

hopefully when my dad goes in there with me (becaues THEY WANT him to) he can back me up.

I was searching for tiny Sussex eggs they said it was a teenager one so you could get one that small....

Have you talked with your dad about backing you up?

Also don't even think about ending it...too many people care about you and you'd be letting the system win...you don't have to do what they suggest...if you tell them no they aren't going to be like fine you get no meds.....they want to treat you....make it on your terms...guidance is one thing but you should be able to say I can't handle this, let's try an alternative...

i dont mean end it like suicide i mean end it let find a new therapist and pdoc AGAIN. ending the relationship with clinic i mean.

but i talked a bit about it with my dad. im gonna talk to him more about it tonight if i can and again the day we go to see the new pdoc

Oh ok well that's good...glad I misunderstood...I'm hoping this new pdoc ends up being excellent for you....maybe you'll get a rebel pdoc

If not then better to leave this clinic in the rear view...

i have a feeling all the pdocs there are the same. its just my gut instincts tell me its not going to be good.

We'll you won't know until you try....better to go in with an open mind I think....maybe you'll get lucky? Still depending on when you need meds you could schedule a back up appointment with someone else...you can always cancel if the guy ends up being OK...

my dad thinks my pdoc dropped me because of maybe the clinic/therapist calling her from the clinic. remember they made sign a form saying they need open communication with my pdoc? thats when things started to get bad.

That's exactly what I think as well...

i think they are running a game to get me back on injections. which i just talked to my dad about and he said he doesnt think i need to be on injections so so far hes on my side a bit. thankfully.

i remember you saying that

Your an atheist? Are you still? I thought you got into shamanism(excuse the spelling)

Everyone is different. I had baseline sympthoms that always popped up , refining my cognitive processes was simply never going to work without getting a particular hallucination under control. I could have had the best outlook in the world but still the hallucination would come. So i had to take meds to stop it , once the hallucination stopped , i began to improve. If i stop the meds the hallucination will just come back. Schizophrenia for me always felt like an organic illness , that needed meds to adjust it. As i get older im hoping that i can reduce my meds , as the half life increases, hopefully! But who knows , if i can live for as long as possible with little med collateral damage then a new novel treatment can come on board and improve my symptoms further.

I'm so pissed off with my pdoc and can't wait until I get my new one next year. How difficult is it to diagnose someone properly? Whatever this problem is that I have it's dominated my life for the past 5 years and during that time the only diagnoses he could give me was psychosis, but said he doesn't know specifically what psychotic disorder it is but that schizophrenia is a 'possibility'. So annoyed...after 5 years and several second opinions he still doesn't know? seems totally incompetent to me.

It was a struggle to leave the flat today. The voices were telling me. "Don't go!" But the empty fridge and the home empty of food were reminding me, I needed to go. For a while I had a struggle. One that if someone else had seen, they'd raise an eyebrow to. But eventually I left the flat. I felt like I was being stalked the entire time.

Was an atheist from high school through my first episode...the day before I took risperidone I prayed for the first time in many years to God for help...that med worked immediately...so I never heard God speak to me but I told him that I would believe in him if he helped me. Now it could have just been the med but I can't come up with a good reason not to believe in God....I never specified a religious choice...I never said I'd go to church....just that I would believe. Why take a chance? It's not costing me anything to believe...

Shamanism....yeah that's more of a spirituality thing....no specific God is implied...just the idea that there are spirits and an afterlife of some sort...it's more of a fun thing for me than something structured more like meditation or visualization....I have no idea if any of that is real or not but it let's you access parts of your mind and concepts you normally wouldn't so I enjoy it....I haven't even done anything with that for like 6-8 months I just haven't changed my tag here.

It's been 3 years and 2 pdocs for me...still no diagnosis other than psychosis...they can't tell me if I'll get sick again or not....how helpful? ¯\\\_(ツ)_/¯

But you were OK right? My therapist was always like next time remember this outcome...you felt bad before but everything worked out OK so maybe everything will work out OK next time too so maybe you can worry less.

I can't function due to overwhelming panic.....This has got to stop!