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Suggest Treatment For Severe Fatigue In A Person With Resistant Schizophrenia

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Posted on Sat, 25 Jun 2016
Question: I have been taking psychiatric medications for 10 yrs and it has been a roller coaster ride. To make things worse i have ended up taking medicenes for treatment resistant schizophrenia while my first diagnosis was psychotic episode. I have been abused, i have screwed up in terms of changing doctors and medicenes.problem was i was just a 19 yr old kid when they put me into psychiatry..didnt know..noone told or warned me...a psychiatrist could have been responsible and told all the side effects and how psychiatry works. Its a shame how psychiatry is done.from my side there have been minor mistakes. Now for last 2 months i have seen many psychiatrists in search of a good fit to help me taper iff the medications. Due to more stressors i have lost sleep over 2 months sleeping 2 hrs a day average. I stopped 10 mg escitalopram in 10 days time and clozapine 25 mg in 1 months time. Sinve then it has been a horrible 2 months. Now i am takinf 100 mg amisulpride which is stsrting to cause problems after using it for 2 years.my prolactin and cholesterol is high. I feel very bad.i think i am having minor akathisia. I have some chest pains lasting a second or two. Mu breathings a bit difficult. Today restaring nexito after stopping for 1.5 months. Sleep is my main issue.2nd is weight and huge breasts. unwell feeling in head(sleeplesness?). What do i do from here.should i start parkin.what do i do about amisulpride which my body is starting to find irritable. I never had severe panic and anxiety attacks before staring medicenes.niw i have everything.i was called a genius.now i am useless . How man else lives are ruined like this? Can anyone help me rcover and live free.if i cant i will go back to medicene...but atleast try for gods sake. Amisulprise is making me moody and giving me insomnia.
doctor
Answered by Dr. Shubham Mehta (1 hour later)
Brief Answer:
Aripiprazole.

Detailed Answer:
Hello
Welcome to HCM.
I have gone through your details thoroughly. I understand your concerns.
The main issues which are bothering your currently are drug induced side effects and insomnia.

It's unfortunate that you have not been informed about the side effects of psychotropic drugs in past.

Almost all antipsychotic drugs can cause weight gain. The two antipsychotic drugs which are relatively safer in this aspect are aripiprazole and ziprasidone. In my opinion, aripiprazole is a better option for you as it does not affect prolactin levels too.

Amisulpride is known to cause prolactin elevation and weight gain in some cases. You can gradually decrease the dose over 2 weeks.

Aripiprazole can increase anxiety and akathisia initially. You can take low doses of Clonazepam simultaneously for short term, to manage both side effects as well as insomnia.

If aripiprazole works for you, it can prove to be a effective treatment option.

As these are prescription drugs, kindly discuss these issues with your doctor and proceed accordingly.

Hope this helps.
Thanks.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shubham Mehta (13 minutes later)
wason arip for last 3 weeks to bring down prolactin from 79. not working at all..extreme anxiety, sleeplessness and didnt know it.. but akathisia..is it reversible? stopped the 1.25 mg arip yesterday. i think arip stays a long time and may take 2-5 days for it to leave system before i can get good sleep . current meds from today.
1-0-1 (50mg amisulpride) , 1/2 -0- 1/2 (nexito 5 mg restrted...isthere a point to restating ? am i too late...is it better to suffer and get off nexito ...or do i do a slow taper this time?) , (0-0-1/2 lorazepam 1 mg)
i dont think arip is gonna work. didnt work last 4 times. it caused me to be hospitalized forcibly at sh hospital paynkulam after which i became very ill. sleeplesness started after psychiatric treatment there. unless u say arip will get adjussted after 1 month of insomnia aanxiety etc..i dont think i should continue with arip.
how do i get off amisulpride. and to be honest end it with that. i dont want to switch..just do the safest fastest taper. and stop all meds and replace with( diet-psychotherapy-counselling-ayurvedic psychiatry from kottakal- exercise- friends- family is screwed bit i have 3 people who are supportive). just tell me the fastest taper method and what all i should prepare and do to retrain brain to function without the drugs.i know it is going to be hell to stop. is there an inpatient service to stop the meds like in usa? at this point i am looking at 10 yrs of alternative interventions to recover from 10 yrs of psychiatry. i think its doable if i am lucky.
doctor
Answered by Dr. Shubham Mehta (23 hours later)
Brief Answer:
Amisulpride does not cause discontinuation symptoms.

Detailed Answer:
Hi again.
Sorry for late response.

Yes, akathisia caused by aripiprazole is reversible when the drug is stopped.

There is no point in starting nexito again if there are no depressive symptoms.

Amisulpride 100mg is a relatively low dose and discontinuation symptoms with this drug are unusual. I think you can reduce it by 50mg every week.

There are no rehabilitation centers here but your Psychiatrist can help you in this.

You can simultaneously start with alternative treatments like Ayurveda etc.
As these alternative treatments show their effects, your brain will get adapted to work without drugs.

Do keep your doctor informed about this.
I wish you well.
Thanks.
Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Shubham Mehta

Psychiatrist

Practicing since :2008

Answered : 2144 Questions

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Suggest Treatment For Severe Fatigue In A Person With Resistant Schizophrenia

Brief Answer: Aripiprazole. Detailed Answer: Hello Welcome to HCM. I have gone through your details thoroughly. I understand your concerns. The main issues which are bothering your currently are drug induced side effects and insomnia. It's unfortunate that you have not been informed about the side effects of psychotropic drugs in past. Almost all antipsychotic drugs can cause weight gain. The two antipsychotic drugs which are relatively safer in this aspect are aripiprazole and ziprasidone. In my opinion, aripiprazole is a better option for you as it does not affect prolactin levels too. Amisulpride is known to cause prolactin elevation and weight gain in some cases. You can gradually decrease the dose over 2 weeks. Aripiprazole can increase anxiety and akathisia initially. You can take low doses of Clonazepam simultaneously for short term, to manage both side effects as well as insomnia. If aripiprazole works for you, it can prove to be a effective treatment option. As these are prescription drugs, kindly discuss these issues with your doctor and proceed accordingly. Hope this helps. Thanks.