Posted by bleauberry on April 21, 2010, at 17:59:29
In reply to Psychotic depression, posted by Carmine on April 20, 2010, at 9:59:37
I've had psychotic depression before on a few ocassions. In every instance, all antipsychotics were NOT useful in ending it. For me, what was useful was something docs don't usually think about. SSRIs. Zoloft for example. Paxil maybe.
Serotonin is inhibitory. Psychosis is runaway excitation. Instead of just trying to block the excess excitation via an antipsychotic, while it is still going on the whole time anyway, stop it with serotonin. Gaba also can play a role in there, from a benzo like klonopin, xanax, and friends.
I know that is a different take than you were expecting. Doctors don't mean to, but I think over time they get in a rut...psychosis equals antipsychotic....depression equals ssri...ya know? I personally think that is a very restricted blind way to view a complex matter.
Anyway, my last psychotic delusional episode was ended in about 24 hours with a single dose of zoloft. No amount of zyprexa or seroquel did that.
For longterm control, I personally feel you should be looking at a combination of an antipsychotic combined with either an ssri or a tca.
You have to dig for them, but there are case studies on pubmed that back up these opinions of mine.
poster:bleauberry
thread:944176
URL: http://www.dr-bob.org/babble/20100416/msgs/944421.html