Psychiatrist's experiment: No more antipsychotics.

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Well, it's official. My psychiatrist has gone insane. When I was last inpatient, I was started on Saphris. I have gained weight on it, and so naturally, as I knew she would, Dr. G, my psychiatrist, stopped the Saphris. She has also decided, with the help from my last inpatient doctor, that I no longer need antipsychotics. That I am too young for them. Um, lady, should you not have decided that 10 antipsychotics ago? Usually I respect and like my psychiatrist, but I'm not sure I feel comfortable with this decision. She said if I am really struggling, I can make another appointment to come and see her (it takes at least two months to get an appointment with her, so if I start to not be able to handle hearing things again, I will be screwed, because I am NOT going back to the hospital) and she will restart me on a low dose of Haldol, because I didn't gain any weight on that. I was on that for a little over a year... It worked, then it stopped working, and I was up to 10mg. I don't think a "low dose" is going to help.

I am scared. I was used to having a little bit of quiet. I was only really hearing things when I was really stressed on Saphris. It's going to go back to how it was when I was on no medication. I almost hurt someone, and I had two almost fatal overdoses. I'm still on 1,250mg of Epival, a mood stabilizer, as she says if I become manic again it could be a whole new game and very dangerous. As for the voices? I guess those aren't considered dangerous enough to her anymore. I mean, I haven't hurt myself or anyone else in almost two years now. But that's because I've been on meds. I think she may be making a big mistake here, but lucky for her, it'll be me that deals with the consequences, not her...

Although, I did get my official diagnosis: Schizoaffective disorder. She did not listen to the inpatient doctor's diagnoses of BPD and Bipolar type 2.

I know why Dr. C, my last inpatient doctor, pushed for no meds. She thought it was impossible that I had Schizoaffective, that it was just "pseudo psychosis"... But surely Dr. G, can't think that if she's still writing Schizoaffective disorder on everything. If she thought it was pseudo psychosis, she wouldn't think it was Schizoaffective.. That wouldn't make sense, would it? I really do not understand how Dr. G can think I have Schizoaffective and not want me on meds for psychosis.

This is going to be.... Interesting, to say the least.

You might be pleasantly surprised. I sometimes need medication when my depression is out of control (dx psychotic depression). However, I find that I am able to remain off antipsychotics about 99% of the time. It's only when things get really bad that I use them short-term (usually about a month or two and then go off of them).

If your mood is stabilized, you might find that you don't need the antipsychotics.

How old are you?

I am diagnosed with Schizoaffective: Bipolar type. I've had two manic episodes and a lot of depressive episodes, but Epival really helps both my mania and depression. I am twenty years old, but I have been on some form of antipsychotic since I got ill when I was seventeen. I've even been on Clozapine. How do you deal with voices without antipsychotics? I've done a lot of DBT-- inpatient, in an outpatient intensive therapy group for six months, and in the mental health treatment facility I lived in. But I have issues using distractions and things like that when I start to hear things. I can't focus. They get too loud.

First of all, you're lucky to get it diagnosed early. The earlier the better.

As for the voices, it all depends. It's different for each person. Basically, when I get them I cannot deal with them. They are always very realistic and I can't distinguish them from reality. My family usually steps in and gets me on meds when I need them. There is no turning them off or tuning them off. They take over my life.

You say DBT? Are your voices associated with trauma? I'm just asking because that seems like an unusual therapy choice.

There is plenty of evidence that many people get over their voices. It's actually the exception to the rule to have to be on antipsychotic for the rest of your life. It depends on what is causing them.

I was officially diagnosed at age eighteen, by the top doctor at our city's psych hospital while I was inpatient. My psychiatrist just agreed, and has agreed ever since. She's never changed my diagnosis since then. When I was sixteen I was diagnosed with Borderline Personality Disorder. That's why I did a lot of DBT. But it was found that at the end of it, I no longer met the criteria for BPD. Some psychiatrists I get whilst inpatient during crises still think I have BPD, but most don't. And my psychiatrist thinks I never had it. No one ever agrees.

That's how I am off meds too. I get voices almost all the time off meds though. Sometimes I can deal with them, sometimes I can't. I also see Bob, Sig, and Stan. Two cats, one shadow man. And they all talk to me. And sometimes I see and feel bugs crawling on me. I think the CIA is following me, are in my closet, people are reading my thoughts, people are laughing at me or following me. I'm just not very... erm... stable... off meds.

Do you have them now?

I would say follow the doctor's advice, but if they come back (or get worse) just let her know. Some people are able to deal with their voices - however others are not. You might want to research Hearing Voices Network. Unfortunately, they are a little biased and have an anti-medication slant which I disagree with. I truly believe that some people simply can't function without anti-psychotics. However, some people are able to cope with them in different ways. Some people find it helps to set aside time to talk to them.

For me, what helped was to stop listening for them. It seemed I was in the habit of always trying to figure out what they were saying. When I went on meds the first time, I had an epiphany. I just decided "I'm not listening to them anymore." However, that line of reasoning may or may not be helpful to someone in the active stages of psychosis.

If your insight is intact, you might be able to cope. If your insight is not intact, you will probably need the meds.

I only didn't take the antipsychotic this morning. So far I've just heard some ringing and mumbling, nothing I can make out. Usually I can tell they're not real. At least when I was taking meds I could. It's been a long time since I haven't been on some kind of antipsychotic, but when I wasn't on anything, I thought my "friend", Bob, the cat, told me to take a lot of medicine... I thought Bob was real (he obviously isn't... I don't think) and I did it. I landed myself in the paediatric ICU for two days, and the psych ward for seven. That's the last time I remember hearing things off meds.

I'd be inclined to think Schizoaffective disorder is a better dx. Based on what you say you don't meet the criteria for BPD, and if you always heard voices i don't really understand why could any psychiatrist confuse schizoid symptoms with BPD. I tell you from personal experience because i have BPD and i meet 100% of the characteristics and i'm not even close to hearing voices.

As for your doctor's experiment, i believe he is trying this: There are cases where people with schizoaffective disorder that stopped taking medication after a medication period, didn't show symptoms after discountinuing the medication. Since you are saying you gained weight, the meds are having negative effects on you and i believe he doesn't want you to have secondary effects unless there is no other choice. He is risking you hearing voices again, but he suspended medication because he doesn't see hearing voices for some time as dangerous as he sees the secondary effects, because you are young and being overweight carries its risks, specially if it starts as young age.

Hes probably taking a chance on you not hearing voices again after stopping the medication after evaluating pros and cons of discontinuing medication.

Forgive me if what i'm about to say is wrong, i'm just going to give an ignorant comment based on the little i've read of you: I believe you should take the risk of hearing voices for a few months (until you get doctor's appointment if things go wrong), despite of it being extremely annoying and disturbing, instead of risking shortening your life expectancy by some years plus reducing your life quality because of weight problems.

I used to self harm. First bite, then scratch, then, as I got older, cut. But it was because I couldn't figure out how to put what I was feeling into words when I'd bite or scratch. Cutting was because I heard voices telling me to do so. I think that was the main reason for the BPD diagnosis. I didn't gain any weight on Haldol, which I also had no voices on for a year and a bit. Dr. G says if I can't handle the voices, actually she said just plain if they come back, that she will restart a low dose of Haldol. I'm not sure why; it stopped working. But maybe it will work again. I think she's running out of options. I'm just nervous about the length of time it takes to get an appointment; that could be a problem if things get bad.

First of all, "schizoaffective" is a common false diagnosis for people who have Asperger's (along with narcissism). It's important for us to have friends and do things, but we simply need more down time than neurotypicals.

Secondly, if you are Bipolar II and hear mumblings, then you absolutely need meds. Lamictal might be enough. Or, you might need to add something like Zyprexa. What you are describing in your posts suggests that going cold turkey will be dangerous. If I were you, I would get another psychiatrist immediately. You need to treat this as an emergency situation.

Remember this statistic: I would estimate that 90% of professionals are simply faking it. Only 10% really know what they are doing. You need to find a psychiatrist that is in that 10%.

With the proper meds, you should feel not just "sort of getting by" but "excellent." You need a good psychiatrist.

Last night was kind of scary... It probably was because I was tired, and not because I stopped the Saphris, but I saw a man at the foot of my bed, and things dancing around in a circle with someone mumbling again. Definitely not ready to get used to that again.