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Schizophrenia: The new etiological synthesis

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Re: Schizophrenia: The new etiological synthesis

#101

Post by psychphysic »

comfypotato wrote: post #98
psychphysic wrote: post #95

Earlier quoted context omitted.

I'm not fully convinced here, I bet those long term patients were on antipsychotics nearly all of which have extrapyramidal side effects, pretty identical to negative symptoms.

It’s worth mentioning here that antipsychotics have come a long way since lithium. (Posting from the US with our unfortunate (relative to the developed world) healthcare system.) There’s a handful of antipsychotics and mood stabilizers that have been developed in the last couple of decades that have had unprecedented success with Schizophrenia and Bipolar Disorder. They typically cost $20,000.00 per year before insur…

> Please forgive the Lisp-ish parentheses. I figure it’s halfway acceptable on HN.

Haha it did make me wander if there was an Emacs HN client with paren mode.

> It’s worth mentioning here that antipsychotics have come a long way since lithium.

It's not really related to your comment which is interesting and useful to hear in of its self.

But Lithium is not a antipsychotic it's a mood stabiliser and remains to this day a good one. It remains to this day the best evidenced for suicide reduction and intractable depression.

Mood stabilizers haven't progressed much (valproate a favoured one is now out for fertile women due to risk of ASD and birth defects).

Antipsychotics have shown astounding progress as you say, the reintroduction of clozapine in the 90, introduction of second generations, then Aripiprazole(as a partial D2 agonist was a warning shot we didn't know as much as we thought), quetiapine (made us reassess what a second generation even means as it has even less D2 affinity), pimavanserin (! No D2 but some 5HT-2a activity) And future like SEP-856(!! What the fuck is TAAR1?!).

Represent astounding progress. Should SEP-856 get a market authorization it'll turn decades of the dopamine hypothesis fully on its head.

Re: Schizophrenia: The new etiological synthesis

#102

Post by comfypotato »

psychphysic wrote: post #101
comfypotato wrote: post #98

Earlier quoted context omitted.

It’s worth mentioning here that antipsychotics have come a long way since lithium. (Posting from the US with our unfortunate (relative to the developed world) healthcare system.) There’s a handful of antipsychotics and mood stabilizers that have been developed in the last couple of decades that have had unprecedented success with Schizophrenia and Bipolar Disorder. They typically cost $20,000.00 per year before insur…

> Please forgive the Lisp-ish parentheses. I figure it’s halfway acceptable on HN. Haha it did make me wander if there was an Emacs HN client with paren mode. > It’s worth mentioning here that antipsychotics have come a long way since lithium. It's not really related to your comment which is interesting and useful to hear in of its self. But Lithium is not a antipsychotic it's a mood stabiliser and remains to this da…

I lump the two groups of medications together because I’m under the impression that lithium was the most popular option for schizophrenia/bipolar 50 years ago (typically associated with the diagnoses that result in the need of a mood stabilizer or antipsychotic today). Not to mention depression. Am I missing something here?

I also assumed that lithium would have been responsible for the comment to which I was replying talking about the side effects of the medications. (Lithium is known to significantly alter personality over the long term, yes? (Once again, often worth the alternative.)) The intended use of my comment was to clarify that the side effects of drugs prescribed for schizophrenia/bipolar have calmed down a lot.

You sound knowledgeable, and I’m expressing my curiosity. It’s such a soft science relative to something like cancer that I really have no idea what’s going on (I’m just a code monkey). I’m really not aware of any popular antipsychotics being prescribed 50 years ago, but I’m open to having my ignorance fixed.

Even if you did call my comment useless :(

Re: Schizophrenia: The new etiological synthesis

#103

Post by WhackyIdeas »

IAmGraydon wrote: post #28
WhackyIdeas wrote: post #17

Fascinating. I self-diagnosed myself with schizophrenia once. A horrible 6 months locked in an alien world where all I could think about was time and space (at about a million miles a second). I would hear chatter in my head and was convinced I was overhearing random conversations people were having and was even certain of the locations they were having these conversations. The idea that we all shared one consciousne…

What you are describing sounds like a protracted psychotic break. Schizophrenia doesn’t just come one day and disappear 6 months later.

I think what helped me brake out of too is that I learned to accept (and not fight) the possibility that we are all living in an illusion, and that we are all sharing the same consciousness and that it’s the job of all our senses; eyes, ears, etc to keep us efficiently preoccupied. Maybe I was just struck by philosopher lightening! Haha!

Re: Schizophrenia: The new etiological synthesis

#104

Post by psychphysic »

comfypotato wrote: post #102
psychphysic wrote: post #101

Earlier quoted context omitted.

> Please forgive the Lisp-ish parentheses. I figure it’s halfway acceptable on HN. Haha it did make me wander if there was an Emacs HN client with paren mode. > It’s worth mentioning here that antipsychotics have come a long way since lithium. It's not really related to your comment which is interesting and useful to hear in of its self. But Lithium is not a antipsychotic it's a mood stabiliser and remains to this da…

I lump the two groups of medications together because I’m under the impression that lithium was the most popular option for schizophrenia/bipolar 50 years ago (typically associated with the diagnoses that result in the need of a mood stabilizer or antipsychotic today). Not to mention depression. Am I missing something here? I also assumed that lithium would have been responsible for the comment to which I was replyin…

Oh god so sorry! I meant useful. I found it useful to read of your personal journey.

Regarding Lithium for schizophrenia, I believe it's use only is to manage affective (mood) changes rather than psychosis.

Personality change is very hard to objectively consider. Personalities change with time, so it's harder to compare if a drug will alter someone's personality compared to being untreated for decades in an objective way.

All that said, it's commonly described that people feel different on some medications and I think that has to be accepted. Even if it's hard to objectively measure, and hard to quantify.

We often think of mental illness as distinct from personality (yet we also often see personality disorders as mental illness a paradox).

Of course then we should expect treatments will alter personality.

That said we seem to see personality changes claimed with a number of medications, from antiepileptics to statins used for cholesterol, and beta blockers.

Re: Schizophrenia: The new etiological synthesis

#105

Post by teshigahara »

gavinray wrote: post #29
teshigahara wrote: post #23

Earlier quoted context omitted.

I have PTSD from extremely bad psychedelic trips and this comment made me cringe (my PTSD must be getting better because I think at one point it would have given me a panic attack). I don't think I could have handled 6 months of that.

You're not the only one, how many of us out there?

Seems like we were the only ones!

I wouldn't have been surprised if there was more though. I think the kind of people on here probably think too much/overanalyze stuff to begin with and my impression is that trait doesn't mix super well with psychedelics.

At least I feel like the fundamental cause of my PTSD inducing trips is wanting to explain the inexplicable.

Hope everything's going well for you though. I think it's especially hard to have this kind of PTSD because people don't take it very seriously and it's either socially embarrassing or triggering to try and talk about it to begin with.

Re: Schizophrenia: The new etiological synthesis

#106

Post by comfypotato »

psychphysic wrote: post #104
comfypotato wrote: post #102

Earlier quoted context omitted.

I lump the two groups of medications together because I’m under the impression that lithium was the most popular option for schizophrenia/bipolar 50 years ago (typically associated with the diagnoses that result in the need of a mood stabilizer or antipsychotic today). Not to mention depression. Am I missing something here? I also assumed that lithium would have been responsible for the comment to which I was replyin…

Oh god so sorry! I meant useful . I found it useful to read of your personal journey. Regarding Lithium for schizophrenia, I believe it's use only is to manage affective (mood) changes rather than psychosis. Personality change is very hard to objectively consider. Personalities change with time, so it's harder to compare if a drug will alter someone's personality compared to being untreated for decades in an objectiv…

Thanks for the clarification!

Re: Schizophrenia: The new etiological synthesis

#107

Post by teshigahara »

School-Cotton wrote: post #59
WhackyIdeas wrote: post #27

Earlier quoted context omitted.

It begun for me after smoking weed one night - in a flash I was outside my body with an extreme panic attack and the sudden belief that I was inside essentially a game. This first panic attack lasted around an hour or two. It was horrendous. Your PTSD is something you can manage, I have it too. It gets better and weaker as the years go on. For myself, this all happened 18 years ago but it made me a stronger person.

Cannabis is a very strong (and often unpleasant) psychedelic for someone I know — rivaling LSD if not stronger. I’ve heard of this being true for other people too; I wonder how common it is.

This is true for me, mainly because the major effect of psychedelic drugs for me is completely 'internal' to my mind. Actually most of my trips are basically just extensions of the last one because I just revert to the same (psychotic) thought patterns. It's a pretty awful place to be which ultimately led to me getting PTSD after smoking a joint and believing some awful stuff about my existence.

Re: Schizophrenia: The new etiological synthesis

#108

Post by WhackyIdeas »

psychphysic wrote: post #99
WhackyIdeas wrote: post #97

Earlier quoted context omitted.

That was just my very first, introductory panic attack. I did have another which lasted a very very long time when I was outside, but I was given a shot of adrenaline for that one. The thousands of others have been under 15mins.

You were given a shot of adrenaline for a panic attack?

Not exactly. More like a solo first time trip on 5 acid tabs going horribly wrong. It wasn’t meant to be a solo trip, but my ‘friends’ abandoned me. I tried to go outside because I was absolutely freaking out walking around a busy town, thinking I could distract myself. Then shit hit the fan even worse. It was a terrible trip, put it that way. So more like an extreme long lasting panic attack on top of visual hallucinations. I was 19 and dumb clearly masochistic!

Oh fun fact: When an ambulance was called and they basically dragged me into the hospital bed. As they injected me with adrenaline, that scene from Matrix happened to me as real as day (obv not tho) of when Neo touches the mirror and it goes up his arm and over him - I hallucinated that it was happening to me, watching the cold metalic liquid travelling up my arm. It was quite out there stuff!

Re: Schizophrenia: The new etiological synthesis

#109

Post by psychphysic »

WhackyIdeas wrote: post #108
psychphysic wrote: post #99

Earlier quoted context omitted.

You were given a shot of adrenaline for a panic attack?

Not exactly. More like a solo first time trip on 5 acid tabs going horribly wrong. It wasn’t meant to be a solo trip, but my ‘friends’ abandoned me. I tried to go outside because I was absolutely freaking out walking around a busy town, thinking I could distract myself. Then shit hit the fan even worse. It was a terrible trip, put it that way. So more like an extreme long lasting panic attack on top of visual halluci…

None of this makes sense.

Venous delivered adrenaline is used to close down peripheral circulation during cardiac arrest to encourage the poor flow to perfuse the heart, lungs and brain. Maintaining tissue viability until recovery.

Intramuscular adrenaline is used in anaphylaxis.

Either makes sense in the context you describe. I must be missing something.

Are you misremembering stuff?

Re: Schizophrenia: The new etiological synthesis

#110

Post by WhackyIdeas »

psychphysic wrote: post #109
WhackyIdeas wrote: post #108

Earlier quoted context omitted.

Not exactly. More like a solo first time trip on 5 acid tabs going horribly wrong. It wasn’t meant to be a solo trip, but my ‘friends’ abandoned me. I tried to go outside because I was absolutely freaking out walking around a busy town, thinking I could distract myself. Then shit hit the fan even worse. It was a terrible trip, put it that way. So more like an extreme long lasting panic attack on top of visual halluci…

None of this makes sense. Venous delivered adrenaline is used to close down peripheral circulation during cardiac arrest to encourage the poor flow to perfuse the heart, lungs and brain. Maintaining tissue viability until recovery. Intramuscular adrenaline is used in anaphylaxis. Either makes sense in the context you describe. I must be missing something. Are you misremembering stuff?

I have been certain for 17 years that they said it was adrenaline.

If it wasn’t adrenaline, what else could it be? I went in and out of waves of in outside this world to inside the room to outside this world and inside the room. Until I was firmly inside the room and out if the trip. It was fast.

And it was into my vein, they tied a rubber hose around my arm. I watched the needle go in. And I had to hide my arm for weeks cause it looked like I injected - all bruised and stuff. Few holes. Must have missed with me moving about.

I also have a vivid memory of the heart beat monitor showing 240!

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