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Nearing W/D Supersensitivty Psychosis: Permanent or No?

Nearing W/D Supersensitivty Psychosis: Permanent or No?

Postby radioinmyhead » Oct 13, 2012 7:19 am

So recently, I was turned down by a local, relatively prominent p-doc for assisting meds w/d or whatever you want to call it. The p-doc cited that he was concerned about "supersensitivty psychosis" and seen too many ending up hospitalized.

From the books and blogs I've read, I thought his excuse was a cop-out; obviously, the p-doc was contradicting the business he advertised.

From Whitaker's Anatomy of an Epidemic:

Supersensitivity Psychosis

In the late 1970s, two physicians at McGill University, Guy Chouinard and Barry Jones, stepped forward with a biological explanation for why the drugs made schizophrenia patients more biologically vulnerable to psychosis. Their understanding arose, in large part, from the investigations into the dopamine hypothesis of schizophrenia, which had detailed how the drugs perturbed this neurotransmitter system.

Thorazine and other standard antipsychotics block 70 to 90 percent of all D2 receptors in the brain. In an effort to compensate for this blockade, the postsynaptic neurons increase the density of their D2 receptors by 30 percent more. The brain is now "supersensitive" to dopamine, Chouinard and Jones explained, and this neurotransmitter is thought to be a mediator of psychosis. "Neuroleptics can produce a dopamine supersensitivity that leads to both dyskinetic and psychotic symptoms," they wrote. "An implication is that the tendency toward psychotic relapse in a patient who has developed such a supersensitivity is determined by more than just the normal course of the illness."

A simple metaphor can help us better understand this drug-induced biological vulnerability to psychosis and why it flares up when the drug is withdrawn. Neuroleptics put a brake on dopamine transmission and in response the brain puts down the dopamine accelerator (the extra D2 receptors). If the drug is abruptly withdrawn, the brake on dopamine is suddenly released while the accelerattor is still pressed to the floor. The system is now wildly out of balance, and just as a car might careen out of control, so too the dopaminergic pathways in the brain. The dopaminergic neurons in the basal ganglia may fire so rapidly that the patient withdrawing from the drug suffers weird tics, agitation, and other motor abnormalities. The same out-of-control firing is happening with the dopaminergic pathway to the limbic region, and that may lead to "psychotic relapse or deterioration," Chouinard and Jones wrote.

....

...Finally, Chouinard quantified the risk, reporting that tardive psychosis seemed to develop at a slightly slower rate than tardive dyskinesia. It afflicted 3 percent of patients a year, with the result that after fifteen years on the drugs, perhaps 45 percent suffered from it.

Pgs. 105-107


So my question: The psychosis likely to arise from withdrawing from neuroleptics and lead people to hospitalization... would this "psychosis" be permanent... or a temporary thing that shall pass?

Can anyone here that can give some insight?

Was the p-doc trying to scare me off?

Thank you for reading this,
=r
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Re: Nearing W/D Supersensitivty Psychosis: Permanent or No?

Postby SystemsApproach » Oct 13, 2012 7:44 am

radioinmyhead wrote:So my question: The psychosis likely to arise from withdrawing from neuroleptics and lead people to hospitalization... would this "psychosis" be permanent... or a temporary thing that shall pass?

Can anyone here that can give some insight?

Was the p-doc trying to scare me off?

Thank you for reading this,
=r


Hi radioinmyhead; I think that it is so individual & complex. You need a lot of help & support. Some people can & do get successfully medication free without such help; but I wouldn't say it's very many. Some people can't get medication free whatever they try. These areas are not a case of either/or. So many things impact our state of health. I would say that for a percentage of people; they cannot successfully get off medication; especially neuroleptics (anti-psychotics), once taking them; & a percentage will go into a permanent withdrawal psychosis. The problem is that after such experiences that medication then doesn't work as well. & there is a very real danger of suicide & accident in such states.

I was hospitalised & heavily drugged at the age of 17 - & upon discharge successfully came off all medication for 4 years. Then at the age of 21 I went onto prozac; & I feel combined with other factors again ended up hospitalised. I managed to again stop all the medications. Then at the age of 25 I was again hospitalised & put on a very high dose of anti-psychotic medication. I stopped it after a year, became totally psychotic & was again hospitalised. I refused all medication for a time, & eventually agreed to a low dose. I had 2 more attempts to stop taking it; with disastrous consequences & some of the worst illness/psychosis of my life.

For the past 8 years I have maintained taking a low dose of this medication. For whatever the reasons & whys & wherefores; I remain stable, functioning & live an independent life on this medication. Ideally I'd like to be successfully off it, but that has not been possible; & I very much doubt that it would now be possible. I'm not willing to risk another very severe episode of psychosis.

I think that a lot depends on a lot of your own individual factors in your own condition & life. Yes, some people get successfully medication free - But others don't. Some people go round & round in a cycle of breakdowns, severe mental illness, & hospitalisations because of messing around with medications.

There is no real way of knowing what the outcomes will be unless you try it; & there are some very real potential risks. At the end of the day it is your life & your choice. & as sad as it may be - you won't find anyone that will take any kind of responsibility for that choice or the consequences to it.
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Re: Nearing W/D Supersensitivty Psychosis: Permanent or No?

Postby radioinmyhead » Oct 13, 2012 8:07 am

There is no real way of knowing what the outcomes will be unless you try it; & there are some very real potential risks. At the end of the day it is your life & your choice. & as sad as it may be - you won't find anyone that will take any kind of responsibility for that choice or the consequences to it.


Thank you for responding SystemsApproach. I'm sorry w/d hasn't completely worked out for you.

But I see your point.

I don't know what to think when I hear any p-docs' advice on these matters as if they were prophets or something. What gives p-doc to forecast such things?

Sadly, p-docs will more than likely insist or pressure me or anyone else like me to take meds. By then, I have surrendered my life and choice to my p-docs for a life of less than mediocrity.
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Re: Nearing W/D Supersensitivty Psychosis: Permanent or No?

Postby SystemsApproach » Oct 13, 2012 8:19 am

radioinmyhead wrote:I don't know what to think when I hear any p-docs' advice on these matters as if they were prophets or something. What gives p-doc to forecast such things?


I'd think that there are 3 main tiers to it all, but also many complexities. Most psychiatrists are operating under the whole brain disorder > label > drug mentality. Also what they come into contact with is people being unwell. Their opinions are coloured by it all. Secondly is the fact that our societies & culture is largely coloured by all the same mentality; where is there the space & time to go mad & be fully supported through it all? Without being labelled & drugged.

Thirdly is I feel the facts of these conditions. Some people just cannot function or cope without medication. Maybe in a more humane World more people would be able to live & cope medication free? But this World isn't it.

All that said some people can & do live medication free - there is the potential & possibility of doing so; it's just there are no guarantees. A lot I feel depends of actual levels of support/circumstances, nature of the underlying condition, & specific withdrawal reactions. There are multiple variables & a constellation of factors involved.

Good luck with it all - whatever you decide.
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Re: Nearing W/D Supersensitivty Psychosis: Permanent or No?

Postby triciafishDE » Oct 13, 2012 2:04 pm

If you let the fear of psychosis scare you. Then you are more likely to go psychotic. Even on meds one can go into psychosis.

The doctor wants you as a patient.
In my state a psychiatrist MD or nurse practitioner won't see you unless you are on meds....

What causes you to go psychotic?
There must be a fear relation to it if you are truly schizophrenic.
Learning to eliminate your triggers is key.
Some illegal drugs cause psychosis too.

When you come off of neuroleptics, it is wise to not drink too much caffiene or other dopamine stimulants...like cigarettes.

Fear nothing. Trust in God. Easier said than done.
Learn who you are and what your triggers are.
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Re: Nearing W/D Supersensitivty Psychosis: Permanent or No?

Postby silverelf » Oct 13, 2012 8:48 pm

Just as the brain up-regulates dopamine receptors, it can down-regulate them (in fact down regulation is part of many drug cravings). It makes no sense that it would do one but not the other. The brain is a complex system always seeking homeostasis. Pump it full of dopamine/adrenaline by snorting cocaine every night and it will start shutting down dopamine receptors. Give it an SSRI for many years and it will start shutting down serotonin receptors. Etc Etc Etc.

The dopamine system is actually one of the quicker to change (but of course, every anti-psychotic is doing more than just affecting dopamine). There is no such thing as a "permanent state" in a human brain. The brain is being changed by all in put all the time. It can change by changing diet, by meditating, by watching a ton of internet porn, by the internet in general, by learning new things, etc etc.

Pdocs don't want the risk of a lawsuit in many cases, because they aren't supposed to take people "off drugs" they are just supposed to put them on. Sad but true. Especially a new patient. Simply no upside in it or the doctor. If you get better, you stop seeing them. If you get worse, then he has to explain why he took a patient off of meds that he did not know, etc.

Many people have gotten off antipsychotics. Many other people have reduced their med levels significantly and found a dose that they felt was useful and minimized the harm it was doing to their bodies. many have tried and failed and then done it succesfully another time.
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Re: Nearing W/D Supersensitivty Psychosis: Permanent or No?

Postby radioinmyhead » Oct 14, 2012 1:58 am

TF:What causes you to go psychotic?
There must be a fear relation to it if you are truly schizophrenic.
Learning to eliminate your triggers is key.
Some illegal drugs cause psychosis too.


Not quite psychotic as in hallucinatory, but rather tend to be more "paranoid"/anxious based on past experiences and PTSD.

My bigger fear is acute chronic pain/fibromyalgia symptoms, and/or gut problems... When I tried latest GEN A/P like Geodon, Abilify, Seroquel... It felt like hot pins on my skin, I had strange feverish headaches... Literally felt like the ends of my skin and muscle nerves were burning off like candle wick.

SE:Just as the brain up-regulates dopamine receptors, it can down-regulate them (in fact down regulation is part of many drug cravings). It makes no sense that it would do one but not the other. The brain is a complex system always seeking homeostasis. Pump it full of dopamine/adrenaline by snorting cocaine every night and it will start shutting down dopamine receptors. Give it an SSRI for many years and it will start shutting down serotonin receptors. Etc Etc Etc.


Yeah, but ironically I was reading an NIH.GOV study article (last night after posting this) about how D2 receptors are killed off ... or something rather, I couldn't understand all of it, but that's what it looked like it read. (google: supersensitivity psychosis antipsychotics... or something)

From what I understand, in plain speak, drugs are mostly artificial poisoners. If a good portion of neurons are "killed off" by toxins, I *hope* neuroplasticity also means regenerative growth, not just rewiring changes. A few years ago, when I started discussing Whitaker and stuff, a former therapist mentioned, "Drugs are good for the brain because they provide cellular growth." ... I was like, oookay.

Pdocs don't want the risk of a lawsuit


This I understand. But it's a bunch of crock when pdocs and their books are advertising the turn of tide against pharma, but won't take you under his care for your w/d goals.

IMHO, pdocs have one or two decades of longer shelf life than pharma, if pharma ever goes under... because then it'll take pdocs to assist care for one or two age-generations of patients to wean off meds... then pdocs have to do the unspeakable thing in their profession-- ACTUALLY LISTEN TO PEOPLE'S PROBLEMS!!!? *GASP*

Simply no upside in it or the doctor. If you get better, you stop seeing them. If you get worse, then he has to explain why he took a patient off of meds that he did not know, etc.


Now this is an interesting point. Because the same could be made for alternative holistic practitioners who could keep their patients forever for "health maintenance." (I've had this happen to my family.)

Furthermore, I just spent $60 this month for Breggin's new book from Amazon: Psych. W/D... Haven't read it yet. But skimming through the Table of Contents, it looks pretty depressing, because every section for meds have: "Reasons to W/D" ... The "reasons" mentioned in ToC seem to imply that validity for W/D is if there's a severe adverse medical effect...

Which points to a medical approach, or as Moncrieff might put it "disease-centered model", which seems to be a major bias, even for those pdocs claiming to willing to help patients off meds.... And reading Breggin's ToC, he seems to have that "disease-centered" bias too... BUT I'm just making an offhand presumption by glancing the ToC. So don't take my word for it... But if it is true, that would be pretty depressing.

But the main question to get into pdocs' heads is: Does/did Patient X really need meds in the first place for actual social interpersonal problems which pdocs tend to write off as "biological disorder"? (which for me, 20 yrs ago I would claim to be my case)

Have anyone else read Breggin's latest book yet? I'm curious to hear what they have to say.
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Re: Nearing W/D Supersensitivty Psychosis: Permanent or No?

Postby SystemsApproach » Oct 14, 2012 5:37 am

radioinmyhead wrote:From what I understand, in plain speak, drugs are mostly artificial poisoners. If a good portion of neurons are "killed off" by toxins, I *hope* neuroplasticity also means regenerative growth, not just rewiring changes. A few years ago, when I started discussing Whitaker and stuff, a former therapist mentioned, "Drugs are good for the brain because they provide cellular growth." ... I was like, oookay.


We can factor in epigenetics, brain plasticity, relational/inter-personal/environmental concerns, diet & exercise, meditation, & all the rest. Thing is that 'we' still don't fully know what is going on with it all here with the brain in relation to everything. Some things the brain I think recovers from very well, but that doesn't mean it recovers from everything. I think that there is the potential for permanent alternations in brain structure & function with these chemicals. & it's also very individual - a plethora/constellation of factors. For whatever the reasons; some appear to cope with medication withdrawal, while others don't.

Having good support, healthy relationships & routines, good diet & exercise & a balanced lifestyle, would appear to help things. But as we know, given how very often 'our' lives were that in part lead to all these difficulties, it's very often not very easy to suddenly create some kind of wonderful healthy & happy life & then withdraw from medication. A lot of us are trying to deal with dysfunctional/broken familial dynamics, stress & trauma, difficult living/social conditions, difficult life circumstances, etc etc. It does all become endless catch 22's.

A lot of being able to address the above also in part requires money - & how many of the Mad have loads of money?

I feel that it is very hard to create in our lives the support & conditions necessary to best help us withdraw from medication. This is in part the problem. You need as restful, stress free & a healing & nurturing environment & people around you as possible. Self help, books, on-line support, & all the rest that we can do ourselves only goes so far imo. People need genuine & actual real help & support, from understanding, caring & compassionate people.

My own experiences were that I was stuck in the drug scene & dysfunctional family dynamics for years. For past 11 years I've moved away from it all to a degree - been clean & sober & living independently. & despite a few good people in my life - largely I'm alone & isolated; & trying to deal with a lot of difficulties. I've tried everything that I can - I don't know how people are meant to magically create all the help & support needed for all this? Some people get lucky I suppose?

Which points to a medical approach, or as Moncrieff might put it "disease-centered model", which seems to be a major bias, even for those pdocs claiming to willing to help patients off meds.... And reading Breggin's ToC, he seems to have that "disease-centered" bias too... BUT I'm just making an offhand presumption by glancing the ToC. So don't take my word for it... But if it is true, that would be pretty depressing.

But the main question to get into pdocs' heads is: Does/did Patient X really need meds in the first place for actual social interpersonal problems which pdocs tend to write off as "biological disorder"? (which for me, 20 yrs ago I would claim to be my case)

Have anyone else read Breggin's latest book yet? I'm curious to hear what they have to say.


I've read a few of Breggin's books, but not his last one. I see 'mental health' conditions as being a multiple & complex mix of individual & environmental factors across a very wide range/spectrum; & very much entwined. Across physiological/biologic, psychological, emotional, relational/inter-personal, social, environmental, spiritual & many factors that impact well being.

It would make sense in relation to the original experiences that people have; that prognosis is very much dependant on the way these experiences (the person) is responded to. I would think it sensible to treat & view these experiences as very often having a primary psychological/environmental basis; although to greater or lesser degrees it would also make sense that there are complex interrelated physiological concerns, especially regarding trauma, & early brain development. That said, in the vast majority of cases; if a comprehensive psychosocial approach is used, most would I feel make a full recovery. Some however may not.

But the reality is that the majority get labelled & drugged - & this turns the condition into something different. After years of drug treatments & not comprehensively addressing the underlying causes/condition - then I feel that these conditions do become a lot to do with physiological/biologic processes. A disease-centred model/condition is created.

First episode psychosis is a totally different kettle of fish to someone with a 20 year or more history of multiple breakdowns, hospitalisations, & drug treatments. The response manifests/creates a disease process. The irony of it all.

It's worth re-posting all this -

"Although out reach and crisis services are needed, without a 24/7 front end system sanctuary like Soteria, CooperRiis, Diabasis House, the Open Dialogue or the sanctuary - folks don't have a chance to avoid having their potentially transformative psychosis being aborted with medications and a Schizophrenic diagnosis being laid on them for the rest of their lives. Loren Mosher on alternative approaches to psychosis, was agreed that all the sanctuaries like Laing's Kingsley Hall, John Weir Perry's Diabasis House, Soteria, Burch House, Windhorse, the Agnews Project. And the med free, no restraints, no diagnosis, open door Ward sanctuary; plus the Euorpean and Scandanavian Open Dialogue places- well they ALL basically do the same thing. They provide the necessary and sufficient conditions for a person to go through a psychotic process and come out the other side-'Weller than well'- as Karl Menninger famously said. By being held in the healing crucible of a caring, open hearted setting, the psyche naturally sets it's own course and heals from the early wounds that made a dramatic psychosis renewal necessary in the first place. If instead, a person is labelled as having a diseased brain and medicated into emotional numbness and submission, then the energy and power and symbolic expression of the purposive psychosis simply falls back into the unconscious. Then whenever a loss or trauma happens, the person de-compensates into an ever more amorphous emotional and fragmented daze of so-called chronic psychosis where renewal and healing is far more difficult."

- Icarus forum poster

_____________________________________________


“I have now, after long practical experience, come to hold the view that the psychogenic causation of the disease is more probable than the toxic [physico-chemical] causation. There are a number of mild and ephemeral but manifestly schizophrenic illnesses - quite apart from the even more common latent psychoses - which begin purely psychogenically, run an equally psychological course (aside from certain presumably toxic nuances) and can be completely cured by a purely psychotherapeutic procedure. I have seen this even in severe cases”.

- Carl Jung


"Those people who, through their expression of pain or confusion, fall into the arms of the 'helping professions', perhaps becoming psychiatrically diagnosed as psychotic or neurotic or 'inadequate personalities', have in my experience almost all arrived at their predicament through an entirely comprehensible, rational and (of course with hindsight) predictable process.

If you run over a pea with a steam roller you don't blame the pea for what happens to it, nor, sensibly, do you treat its injuries as some kind of shortcoming inherent in its internal structure, whether inherited or acquired.

Similarly, if you place the (literally) unimaginably sensitive organisms which human babies are in the kind of social and environmental machinery which we seem bent on 'perfecting', it can be no real surprise that so many of them end up, as adults, as lost, bemused, miserable and crazy as they do.

The only surprise, perhaps, is that so many pass as 'normal',"

David Smail
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Re: Nearing W/D Supersensitivty Psychosis: Permanent or No?

Postby triciafishDE » Oct 16, 2012 2:43 pm

I haven't seen Breggin's latest book.

But I think you have good insight.

The best thing to do is go with your gut. That's what I did and it worked. Sometimes titrating too long just makes it that.....longer! You know what is best for you and your body.
Don't let fear get the best of you. Trust in God.

Withdrawal can be hell. Benzos are the worst.
BUT every body is different.
Some have a more drug friendly body. I don't, i'm supersensitive to drugs and alcohol.

Would the Dalai Lama take antipsychotics? I think not. Neither would Jesus.

There is only fear or love.
God is love, the government, doctors, satan...are fear! ;)
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Re: Nearing W/D Supersensitivty Psychosis: Permanent or No?

Postby radioinmyhead » Oct 17, 2012 6:45 am

Thanks for the love, tricia :)

i get a kick when you suggest i have a "drug-friendly" body... it sounds good n' all, but not so good when docs think you can take on more, you know what i mean?

on the other hand, i'm pretty sensitive to alcohol too... quality local brew tap beer could make my eyes dry out and really thirsty after one serving.
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Re: Nearing W/D Supersensitivty Psychosis: Permanent or No?

Postby - » Oct 17, 2012 9:42 am

i did a 50 % drop of klonapin and seroquel. The seroquel was pooping ot and the drop which i take at night was GOOOOOD, smaller doses of seroquel aid in sleeping which is great b/c now im on 100 (was on 700 in March thanks to hopspital dr) I did a taper off that every days until down to 200, stayed on 200 for about 4-5 months. The clonapin drop was hell, you pay dearly on the back end of benzo with super sized panic. The dr and I talked about it and I said lets not be dumb where I have a seizure and after the first week, i felt better and now feel great. Have to say the Medical Marijuana community is saving my life. My p doc is a holistic dr as well so I've been blessed. I think I can manage on these smaller doses. I dropped like 10 lbs too, could be from stress
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Re: Nearing W/D Supersensitivty Psychosis: Permanent or No?

Postby silverelf » Oct 22, 2012 2:55 pm

It may well be that some receptors are killed off, but it seems every year we are learning that the brain is much more resilient and plastic than we thought, not less. And you have the combined history of many many people that went off anti-psychotics and recovered. Sometimes slowly. But recovered.

There are a number of drugs that are thought to increase neurogenesis. Ironically, one of the strongest is ketamine:
http://www.ncbi.nlm.nih.gov/pubmed/22635046
http://www.npr.org/blogs/health/2012/10 ... onnections

(though ketamine also can cause irreversible lesions in mouse brains, so not all is well in NMDA antagonist land:
http://en.wikipedia.org/wiki/Olney's_lesions)

I think the biggest thing to be wary about is what systems_approach mentions about repeated psychotic episodes. It is highly likely that the more times something like that happens, the more the brain is predisposed to sort of tip in that direction in the future. Another reason why I generally think that slow withdrawals of psych meds make more sense than cold turkley ones.
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Re: Nearing W/D Supersensitivty Psychosis: Permanent or No?

Postby silverelf » Oct 22, 2012 2:58 pm

(also, it is always worth pointing out, that possibly the MOST neurotoxic drug out there is alcohol. We know for a fact it can cause many function brain changes/damage, the withdrawal process itself can be fatal, etc etc etc. Yet there are millions of people who were using alcohol daily and/or in extremely high doses who have come off and are living happy and stable lives and think it is the best decision they ever made)
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