It's true, I abused E for 10 years, usually dropping it every weekend, the first five years twice a weekend, sometimes more, and swallowing large amounts of E. Now I started getting anxious and so the doctor put me on xanax and lexapro, that didn't work so I went to the ER, they put me on Paxil, that caused me to go nuts, ended up in rehab on Loxapine, and antipsychotic, was on that for months, then when I went off it I went into psychosis. Had to be hospitalized. did the E cause this? Or was I already psychotic?
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Mental Health I never had psychosis till I got on antipsychotics
- Thread starter emilseine
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endotropic
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There's no way we can tell you what caused your psychosis, and likely no one can give you a definite answer. If E caused your psychosis though you would be the first case I know of.
crOOk
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It is common for abrupt cessation of neuroleptics use to cause psychosis. It would be untypical for a psychotic state to persists for very long, but it is also possible it was there all along. Eventually you should slowly taper off them, maybe not yet. If your psychiatrists does not know about problems introduced by cessation of neuroleptics, shame on him. If you did this on your own, he should've still told you and you should take your mental health more seriously.
If paxil (and possibly mdma contributed to this beforehand) caused you to become psychotic it is reasonable to believe you are bipolar 1, but were mistaken for unipolar depressed in the ER and therefore treated with paroxetine. It is again a very common reaction for bipolar people to go into psychotic mania on ssri's alone. If you are bipolar, the docs made a mistake given that drug to you. This happens all the time. I wouldn't go too hard on them for their decision to put on on an ssri, since they had limited information about you.
Ideally they/you should still try to taper the neuroleptic now, but go about it very slowly. Switching from a strong to a weaker neuroleptic can help with this. Afterwards, if the presumed diagnosis is correct, they will want to put you onto a phase prophylactic like lithium, lamotrigine, valproate. If you are still depressed, they might want to go with a neuroleptic+ssri over phase prophylactic+ssri, since you have been psychotic twice now.
First of all: Ask your doctor what your diagnosis is, since you do not seem to know that.
Then...
Find out if and how they are planning to take you off the neuroleptic again (they are great for acute scenarios, for long term treatment in bipolar patients not so much)
Find out what the course of action will be after you are off the neuroleptic
Read into your diagnosis and your medication. Not just side effects, there are great forums to hear first hand reports of the benefits as well (e.g. crazymeds)
Decide what you want, but also listen to the experts and have at least some trust. If there is no trust into your doctor, treatment will be tough.
Ask yourself if you consider yourself ill (not just since the psychosis) and whether you want to give it a shot having that treated.
Stay off recreational drugs if you can, at least until all this has been sorted out which will take some time.
Psychotherapy can help with all this, but it might be hard to get for you since you abuse recreational drugs (it can seriously hinder progress)
Good luck for the future!
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pofacedhoe
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or a neuroleptic withdrawal syndrome
crOOk
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Yeah that's what I was saying, too. Both of these statements are probably true. A person who has been on a moderate dose of neuroleptics for a few months will not usually go into full-blown psychosis. Unfortunately the op never describes what kind of psychosis that was, nor does he tell us anything about his potential history of mental troubles, nor does he tell us for how long he was on neuroleptics or which one it was or what the diagnosis in the ER was.
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Toss up
crOOk
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According to urbandictionary that is "a female who trades sex for drugs". It could also be "something used to indicate the closeness of two things as far as greatness". Could you please clarify?
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It could be either (but probably is both)
crOOk
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Ok so next time explaining that across a whole paragraph I'll just say "toss up". Thank you, sir!
crOOk
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Yes, exactly what I said as well. It's the oldest story in the book. Patient X misdiagnosed as depressed, prescribed ssri's, patient rapidly becomes manic, taken off ssri's and prescribed neuroleptics till mania subsides.
THECATINTHEHAT
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You fried your brain with drugs acting on the seretonin receptors.
My advice would be to totally stop fucking around with them and let them recover naturally.
My advice would be to totally stop fucking around with them and let them recover naturally.
Shrooms00087
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Psychosis is a detachment of reality. You become psychotic each time you do any psychedelic.
To the OP:
You have been in and out of hospitals then you say you QUIT the antipsychotics and THEN had a psychotic episode. Why did you quit antipsychotics? Because it seems (through the indication of your timeline) that you should not have quit them.
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I quit one b/c it made my leg shake, it was a stupid decision, then got on abilify and went completely insane. I just want this to end and now I'm on Saphris and it isn't working. I haven't touched any drugs since a year and 6 months ago. Totally been sober.
crOOk
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Most definitely not by any medical definition of the word psychosis. I've been psychotic on psychedelics, I've been psychotic off psychedelics and I've been mentally healthy on and off psychedelics. While there is a wide range of symptoms that make up psychosis, the way I have experienced it and seen it in friends and patients was nothing like the state psychedelics induce whatsoever. Psychedelics used to be called psychotomimetics, but this has turned out to be complete and utter crap.
Could you please not say such crap things like that to someone who is seriously concerned about his mental health? Just stay out of the mental health forum if you don't know jackshit. I do have to agree on abstaining from recreational drugs though, not just serotonergic ones.
This is very unusual though not unheard of. Schizoaffective disorder can follow a steadily progressive course sometimes. Let's hope that's not the case.
You are saying you are psychotic, what does this mean? Do you hallucinate? Do you have delusions, are you well reflected about the delusions? Do you have any disorder of your thoughts? You seem perfectly coherent to me right now. Does this change from time to time or have your symptoms been a constant over the past 1.5 years?
Have you been adhering to the dosing schedule 100% except for that one time you quit?
Have you been given any of the typical antipsychotics like Haloperidol for instance or just the atypicals you mentioned? Typical antipsychotics can sometimes work better and even then the right one has often to be found.
The side effects can suck hard, I've personally only been on two antipsychotics, so I hear you about the urge to quit them. If I understood you right, they weren't working AND giving you severe side effects, correct? It should not be expected from you to keep taking your medication in such a situation and your doctor should try to switch you. For some patients it takes a while to find the right antipsychotic.
I'm still not really clear about how your psychosis manifests and what course it has been taking, it would be nice if you could clarify that.
I really hope this is just a very long episode and nothing you have to cope with for the rest of your life. To me it sounds like you have not found the right antipsychotic yet.
Btw regarding your original question: MDMA and related substance should not cause any permanent psychotic state and neither would ssri's. They can definitely trigger episodes and there are some lasting changes your brain will undergo during extended regular use of MDMA, but they should not do what you are currently experiencing at all. If they did, you would've been more likely to experience gradual changes. It seems very plausible that you have schizoaffective disorder and the serotonergic drugs surely weren't a great idea, but you couldn't have known. Just stay sober and try to find an antipsychotic that works with your doctor.
THECATINTHEHAT
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What makes you think I know jack shit, or am not seriously concerned? The whole point of being so direct was to try and create some reassurance that he is not necessarily naturally psychotic. I was just being honest, I've done the same thing.
I would kindly ask you not to tell me where to post and where not to post just because you don't understand the point I was making. If you don't like what I have posted either politely question me on what I have posted or report me. Do not accuse me of knowing jackshit or try to tell me where I can or can't post, that is not your job. I'm pretty good at responding to such accusations calmly but I'm also liable to respond by being a complete cunt, and I don't like it when I'm like that.
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I've tried Haldol and it just stopped working after a while, horrible side effects too. My psychosis is that I have bad thoughts about wanting to hurt people on a daily basis, even sometimes have urges to act on them but I will never act on them.
crOOk
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Thanks for clearing that up.
If these intrusive thoughts are all the symptoms you experience, you wouldn't fulfil the criteria for schizoaffective disorder. You would not actually be considered psychotic for experiencing them, however horrible it may be.
It would however explain why you were put on an SSRI at first, since that is used to treat intrusive thoughts. If this does nothing, the next course of action would be prescribing an antipsychotic, which apparently has not been sufficient either. If it causes mania or full blown schizophrenia, the next course of action would also be antipsychotics (you see, the pharmaceutical repertoire of modern psychiatry is quite limited), but for a different reason. Antipsychotics can be prescribed for intrusive thoughts, bipolar disorder (mostly during mania), schizophrenia (maintenance and higher doses during episodes) and schizoaffective disorder.
You should absolutely make sure that the right diagnosis has been made and possibly go and try to find an expert in the field where you live or at least get a second opinion by another experienced psychiatrist.
Did the paroxetine simply worsen your existing symptoms (the intrusive thoughts) or did it add a pletora of other symptoms? If you went into a manic/schizophrenic episode, I can see how the diagnosis schizoaffective disorder would be made. If not, I still don't see why you aren't just considered to suffer of intrusive thoughts.
Sorry if I'm asking so many questions, but to even begin to understand what has been going on, one has to hear the full story. If you simply want the initial question answered (was xtc the cause) then I'll get off your back (nobody can tell, but it's extremely unlikely that it did eventhough it surely contributed).
The problem is that there aren't really many treatment options for you right now. Imho you should DEFINITELY try to get psychotherapy if your health insurance covers it. It is indicated for intrusive thoughts, but it might be tricky to get therapy for psychotic disorders, depending on where you live. Psychotherapy has next to no side effects, therefore can only help you and tries to tackle the problem from a completely different side, so you should not miss out on that if there's any chance to get it. It won't be a miracle cure though, but you will very likely see considerable benefits in it.
The other option would be electroconvulsive therapy, if you absolutely cannot live with this and it continues to get worse. It's something that should very carefully be considered since some damage CAN occur. However for some people this IS a miracle cure, side effects or not. If pharmacological treatment options are exhausted, you should speak to your doctor about this and then read read read and decide if you feel comfortable to go down such a road.
You should first try to give yourself some time. This might turn out to be an episode that will eventually subside (sorry, I'm not sure if this is true since you only gave us a very rough time frame).
I also don't know how crippling the disorder currently is for you. Can you work and socialize? Would you have financial support if you don't work? You should try to find some sort of stability, so you can focus on how to get better or at least how to live with the symptoms.
I hope you get better, man! Being psychotic can be very tough on many levels and everyone who has experience with this will feel for you.