![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by B2chica on August 18, 2005, at 9:40:45
can you have schizophrenia without the hallucinations/voices?
can you describe what kinds of disturbances you encounter?
b2c.
Posted by xbunny on August 18, 2005, at 10:07:35
In reply to different types of schizophrenia???, posted by B2chica on August 18, 2005, at 9:40:45
> can you have schizophrenia without the hallucinations/voices?
> can you describe what kinds of disturbances you encounter?I would have thought so, you could have delusions, thought insertion, messages, paranoia etc as well as negative symptoms such as blunted or inappropriate effect. I think there is a diagnosis of schizophrenia with only negative symptoms called residual schisophrenia though usually one would have it after having 'recovered' from a psychotic episode. Theres also the schizophrenia spectrum disorders schizoid personality disorder which includes antisocial aloofness and schizotypal personality disorder which includes semi psychotic 'magical thinking' neither need to have voices or hallucinations. So in short yes I would think so!
Buns
Posted by B2chica on August 18, 2005, at 11:54:43
In reply to Re: different types of schizophrenia???, posted by xbunny on August 18, 2005, at 10:07:35
thanks xbunny
i do have some schizoid personality and definately schizotypal personality disorder. mostly i have these weird thoughts that don't come from me (but their MY voice inside my head saying them-not external), also i have my thoughts in my head overlapping eachother, it gets SO bad sometimes i think i'm going nuts, i have my tricks to get through them but i get very dysphoric during this type of episode. i'm on zyprexa now and don't have these anymore.
they originally dx me with Bipolar 2 and PTSD and ADD so i thought what i was having was 'racing thoughts' but i'm not sure cuz they go fast but their so many of them and their all saying different things. i also did tend to get a little paranoid, not like the gov is after me or such but about other people-what they want or if they want to hurt me, i even get afraid to go outside sometimes-it's like i feel emotions from other people, i always thought i was just empathic and that was it but now i'm wondering cuz it's mostly gone from meds i'm on now. my T recently just changed my DX from bp2 and ptsd and ADD to only PTSD but im still on the same meds from pdoc (he still has me as the three (however, he's told me often that he didn't think it was really bipolar but MDD and ptsd and extreme anxiety.
i'm afraid to ask if they think i'm schizoaffective or am schizophrenic cuz i don't want them thinking i'm a hypochondric or am trying to dx myself (or paranoid which would put me as schizo haha). and i guess as long as the drug works it shouldn't matter right.
but just curious.
thanks for the quick response!i'm heading out on vacation and won't be back for a week. i'd like to see if there are other responses when i get back.
thanks again
b2c.> > can you have schizophrenia without the hallucinations/voices?
> > can you describe what kinds of disturbances you encounter?
>
> I would have thought so, you could have delusions, thought insertion, messages, paranoia etc as well as negative symptoms such as blunted or inappropriate effect. I think there is a diagnosis of schizophrenia with only negative symptoms called residual schisophrenia though usually one would have it after having 'recovered' from a psychotic episode. Theres also the schizophrenia spectrum disorders schizoid personality disorder which includes antisocial aloofness and schizotypal personality disorder which includes semi psychotic 'magical thinking' neither need to have voices or hallucinations. So in short yes I would think so!
> Buns
Posted by TomG on August 18, 2005, at 12:03:13
In reply to Re: different types of schizophrenia???, posted by xbunny on August 18, 2005, at 10:07:35
B2,
I'm glad you brought this up. My diagnosis is simple schizophrenia although it has been removed from the DSM. Here is a good definition of my diagnosis:"An uncommon disorder in which there is an insidious but progressive development of oddities of conduct, inability to meet the demands of society, and decline in total performance. Delusions and hallucinations are not evident, and the disorder is less obviously psychotic than the hebephrenic, paranoid, and catatonic subtypes of schizophrenia. The characteristic "negative" features of residual schizophrenia (e.g. blunting of affect, loss of volition) develop without being preceded by any overt psychotic symptoms. With increasing social impoverishment, vagrancy may ensue and the individual may then become self-absorbed, idle, and aimless."
That pretty much describes me to a T. All the negative symptoms and none of the positive. I've had some basic paranoia, but it really isn't that complex. I usually just think people are talking about me in social situations, instead of thinking the C.I.A. is following me and sending me messages about an upcoming alien invasion.
Like xbunny said, the new diagnosis is that comes close to this is residual schizophrenia. This is the criteria from the DSM:
"A. Absence of prominent delusions, hallucinations, disorganized speech, and grossly disorganized or catatonic behavior.
B. There is continuing evidence of the disturbance, as indicated by the presence of negative symptoms or two or more symptoms listed in Criterion A for Schizophrenia, present in an attenuated form (e.g., odd beliefs, unusual perceptual experiences)."
It looks to me like you don't need to have had a prior episode of overt positve symptoms, but I may be wrong.
Unfortunately, and I have found this to be true, the prognosis is poor for this type, and is usually the most resistant form of schizophreia to pharmacalogical intervention. I just can't find any sustained help from medication. Geodon helped for awhile, but quit on me.
Hopefully this helps.
Tom
Posted by bigscreen on August 18, 2005, at 16:25:20
In reply to Re: different types of schizophrenia???, posted by xbunny on August 18, 2005, at 10:07:35
thats my problem in 2002 i was taking paxil and i went to this weight dr and he gave me phentermine. that made things real bad. i started having thoughts of hurting my youngest son not the other 2 kids but just him. i was put on zoloft 50mg and i was fine. about 2 months ago those thoughts came back now i am taking effexor starting at 37.5mg and risperdal which is 1 mg. are these good medications for me. i also have racing thoughts
Posted by xbunny on August 18, 2005, at 17:42:41
In reply to Re: different types of schizophrenia???, posted by TomG on August 18, 2005, at 12:03:13
Hi
> My diagnosis is simple schizophrenia although it has been removed from the DSM.
> I just can't find any sustained help from medication. Geodon helped for awhile, but quit on me.Have you tried sulpride or amisulpride? there supposed to be the nuts for negative symptoms. Both worked for mine but didnt do much for the positive ones. Since I have been taking flupenthixol and mirtazapine I havent really had negative symptoms either (nor much positive ones).
Buns
Posted by Phillipa on August 18, 2005, at 17:45:00
In reply to Re: different types of schizophrenia???, posted by xbunny on August 18, 2005, at 17:42:41
Yes lots of types of schizophrenia. I think most have been covered. Have a good time on vacation. Fondly, Phillipa
Posted by med_empowered on August 18, 2005, at 17:53:47
In reply to Re: different types of schizophrenia???, posted by xbunny on August 18, 2005, at 17:42:41
schizophrenia is a kind of odd disease in that it has historically been diagnosed based on widely varying criteria and understood in hugely different terms. One *big* difference today is that in the US, lots of people who are diagnosed as schizophrenic would most likely be diagnosed as having some form of bipolar disorder in Europe and other areas where the ICD is favored over the DSM. In the US, shrinks have long stood by the "split" between bipolar (thought to be mostly, if not completely, a mood-disorder) and schizophrenia (conceived of as a mostly psychotic disorder w/ "secondary" mood issues popping up in some cases). The division between bipolar and schizophrenia is now thought to be much fuzzier than it was in the past; lots of shrinks have written about cases where a patient presents as bipolar and shifts into a disorder characterized by schizophrenia-type psychosis...also common are cases diagnosed as "schizophrenia" which then present with heavy mood components, sometimes to the point that the diagnosis is changed to bipolar, and the patient is found to be responsive to mood-stabilizers (some people with schizophrenia/schizoaffective have good responses to mood-stabilizers, making the bipolar/schizophrenia split all the more confusing). Anyway, I guess I'd say that these days, with atypical antipsychotics in use for schizophrenia, bipolar, anxiety, depression, and so on, it makes sense to have a more flexible view of mental issues....with so many psychiatric drugs being used for just about everything across the board, and lots of docs learning to medicate based on symptoms, not diagnosis per se, your exact diagnosis isn't as important as it would have been in the past. Plus, there's evidence that there may be considerable overlap in mentall illnesses; keep in mind that the DSM is created and updated based on committee vote, not ground-breaking research, so it should really just be considered a guide and clinician's "cliff notes" for mental illness, not the bible of mental health.
Posted by TomG on August 18, 2005, at 18:51:26
In reply to Re: different types of schizophrenia???, posted by xbunny on August 18, 2005, at 17:42:41
I haven't tried sulpiride or amisulpride mainly because I'm in the U.S. I have found one Canadian source for amisulpride, but my doctor is the one standing in the way. I talked to Sanofi-Aventis offices in New York and London. The New York office said there was no plan to bring either to the U.S. and the London office said they may be able to provide it to me under 'special circumstances'. My psychiatrist hasn't ever heard of it if you can believe that. He won't go along with using a foreign drug, so I may have to go somewhere else if I am intent on using either one.
As for mirtazapine I'm hearing and reading more and more evidence of it being an effective augmenting med along with a neuroleptic especially for negative symptoms. I am kind of anxious to combine it with the 20mgs of Geodon that once worked for me. I have taken mirtazapine in the past alone, and it definately helped in reguards to motivation, but it didn't clear the mind and bring back emotion and rid apathy like the Geodon once did. I feel like I'm on the brink of finding an effective combination, but who knows what it will be. I just finished my second trial of Abilify reaching only 5mgs this time before the akathisia set in. The first time I started at 15mgs, and I was climbing the walls. Now I'm down to 1.25mgs Abilify, Wellbutrin XL 150mgs, and Seroquel 100mgs. Unbelievably, I take all that at night and sleep like a baby. I tried taking the Abilfy and Wellbutrin during the day and both made me sleepy. All these trials of meds with no results are really getting boring as if I'm not apathetic enough. Who knows?
Tom
Posted by TomG on August 18, 2005, at 19:00:11
In reply to Re: different types of schizophrenia???, posted by med_empowered on August 18, 2005, at 17:53:47
I believe in everything you have said. One reason it has been so hard at reaching a solid diagnosis for me is that at one time I exhibited bipolar symptoms. I had hypomania from Prozac and another time got it from using LSD. At other times I have cycled into wild hypomania from the stressors of a job. It has been an evolving disease in my opinion. And to further back it up I even responded to lithium allbeit for 5 days, but it was definately a response. It could have possibly been a placebo response. When I go back and look it over as a whole though schizophrenic negative symptoms have been predominant throughout my life possibly even going back to pre adolescence, but I know what some hypomania feels like, so there is some crossover like you said.
Tom
Posted by B2chica on August 24, 2005, at 19:48:25
In reply to Re: different types of schizophrenia???, posted by med_empowered on August 18, 2005, at 17:53:47
>>...lots of shrinks have written about cases where a patient presents as bipolar and shifts into a disorder characterized by schizophrenia-type psychosis.
this is Exactly what i feel has happened with me.
thanks for all the info.
b2c.(and vacation was wonderful p.)
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
[email protected]
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.