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TOPIC TITLE: psychosis
Created On 6/4/05 11:02 PM
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Lippa
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11/18/06 3:52 PM
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in addition I can recommend a good book for carers. 'The Royal Society of Medicine: Your Guide to Schizophrenia' by Dr Adrienne Reveley has just been published in the UK. Order via www.mentalhealthshop.org. the section on services will not be fully applicable in Nwe York but it will give you an idea of what to look for.
 
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Sarah
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11/19/06 9:35 PM
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Dear Dr. Lippa,

My daughter takes 831 mg EPA each day. My guess is I should ask her to take 2 more capsules so that it can reach 1 gram. She is doing quite nicely on the risperdal Boruch Hashem. I would need to get someone to do everyday tasks with her so that she can get into "Living Properly" again.

I found a website called www.mindyourmind.ca which is interactive. I would need a similar site for helping with cognitive behavior therapy, etc.

Take care!

Sarah


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Daven to Hashem - He always listens to you!
 
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Lippa
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11/20/06 4:30 PM
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Sarah
I'm so pleased your daughter is doing better now. she should indeed be taking at least 1 Gm EPA a day.
Having CBT for psychosis from a website would be a bit like trying to learn to swim from a website: theoretically possible, but much quicker and easier done face-to-face. there must be pychologists in or near your area who have had experience of CBT for psychosis: ask around until you find someone. BUt don't accept someone who hasn't had at least some training/supervised experience in CBT for psychosis, because the technique is different from CBT for depression.
Regards
Lippa
 
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Sarah
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11/20/06 5:44 PM
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Dear Dr. Lippa,

Thank you for your reply. What I really meant was, a website with games, to get the mind back to where it was before the psychosis. e.g. for learning difficulties if one practices on one's difficulty, one gets used to the task and it becomes second nature, so too for rehab from psychosis, I would have thought that the experts could have developed certain skills and cognitions which could become second nature if one practiced on them.

My other query is "Should I encourage my daughter to wake up earlier than her usual time which is 10 a.m. to go to a volunteer Kosher Meals on Wheels cooking group twice a week (as she does better when she has tasks to accomplish) or should I wait until she is ready to get up earlier on her own accord and then have her go to the group by herself?

Thanks

Sarah


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Daven to Hashem - He always listens to you!

Edited: 11/20/06 at 5:46 PM by Sarah
 
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Lippa
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11/21/06 1:37 PM
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parents and carers walk a tightrope at this point in someone's recovery. on the one hand you want to see your daughter moving on, and on the other hand she may be quite scared of what the future will hold, and prefer to keep the status quo.
the issue of waking-up times is a very common one: she would be well advised to try to get up at around the same time each morning, not just on the two days a week that the group is held. perhaps there is something else rewarding she could do on the other 4 mornings? (Give her Shobbas to sleep in later...).
best to explain to her why you would like her to get up earlier, and offer to help by waking her each morning for the first few weeks until she is established in the new pattern. taking night-time medication earlier in the evening can also help, so the sedative effect wears off earlier next morning.
the idea of a volunteer group sounds good, not too demanding but not so boring it is not worth getting up earlier for!
can't help you on games web-sites I'm afraid, but it sounds like a good idea so do let us all know if you come across a useful site.
 
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Sarah
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11/21/06 7:44 PM
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Dear Dr. Lippa

I asked my daughter about the volunteer cooking group and it seems that she isn't ready to get up earlier so I will drop it for now. I ordered a few books which I hope will help my daughter i.e. :
Healing the Mind the Natural Way by Lazarus, Pat
Cognitive Therapy and the Emotional Disorders by Beck, Aaron T.
Dangerous Grains by James Braly M.D.; Ron Hoggan M.A.

If I find interesting games on-line I will let you know iy"H.

Kol Tuv

Sarah


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Debbi
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11/21/06 11:43 PM
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http://gamehouse.com/

this website has games you can either play online, or purchase for offline use.

hope this helps.

debbi
 
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SaraSmith
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11/22/06 5:15 AM
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i think they are spyware when you download them. just somethingto look into...
 
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Sarah
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Hi Everyone!

I found http://www.gamesforthebrain.com/ is an excellent website. You don't even have to download the games but play on-line.

Sarah


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gad
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11/25/06 9:59 PM
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Sarah, thank you.

I recommended it to someone who found it very useful.

Have a Gut Voch
 
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chocolatemoose sarag
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1/20/07 10:56 AM
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my name is Sarah also

 
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Sarah
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Hi Everyone

Here is an update on my daughter and her condition.

I purchased Mind Over Mood by Dennis Greenberger and Christine A. Padesky which gives exercises on Cognitive Therapy. I heard that they are creating a book for people with schizophrenia but it has not yet come out.

I am also trying Energy Healing for my daughter.

I am interested to hear of what other people with schizophrenia have found useful to help with this condition.

Kol Tuv

Sarah


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Sarah
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I was told by my daughter's psychiatrist that my daughter would need Structured Activities her whole life.

Could anyone recommend how I would go about this?

Sarah


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Lippa
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Sarah
the psychiatrist probably means that your daughter needs to have her day structured rather than be left Hefker, without any definite fixed activity. Best to check with the psychiatrist to be sure this is what he/she means.
if so, she will benefit from either a job or voluntary work, not necessarily all day and not necessarily 6 days a week. a voluntary activity such as a Tehillim group or regular shiur would also be very good, as it would encourage her to be with other 'normal' people and mixing in a 'normal' environment.
In the early days of recovery, some people recovering from serious mental illness find it best to attend some form of Structured Activity provided by a mental health service, e.g. a day hospital or day centre. here there are lower expectatiions and there is help if someone's self-esteem is still low after having been ill. if such an activity is availlable locally it is always worth going along to look at it before deciding, as some places are not suitable for people coming out of their first episode (as they are mostly for people who are long-term mentally ill, and this can be quite discouraging).
She shold be matzliach in all she does.
Lippa
 
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Sarah
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Dear Dr. Lippa,

Thanks again for your reply. You are so right. The psychiatrist meant to have her day structured. My daughter is applying for a volunteer job in the local Jewish library which is rather large. I thought this would mean getting her to go out of the house for a few hours like twice a week and that the job would come through straight away. She has to fill out a double-sided questionnaire, wait for the interviewer to call her in a few weeks time as she is away and then she can go for it.

I guess all good things are worth waiting for.

I really dislike that she goes out with mentally ill people with a group leader but I feel this is better than nothing.

I tried arranging a shiur over the phone by having a seminary girl call my daughter and read from the book "praying with fire" for the current day, but so far have not succeeded.

Have a Simchas Purim

Sarah


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Sarah
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6/21/07 9:48 PM
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Dear All,

So the shiur never panned out, neither the volunteer job at the library but she does volunteer in the local golden agers club and she has started an art group in the hospital in which she is doing very well. However it seems that the medication is dulling her mind, I have to be specific in what I ask of her and she seems to be relying on me too much. She needs to become more independent. How to accomplish this in the short time that I am home is somewhat difficult. She just bought a computer so I hope she finds some resources on-line. Can anyone recommend a safe site where she can be comfortable sharing information with people like herself? Do any club houses in the States have a web-site?

Sarah


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gad
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6/22/07 5:11 AM
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Although this is not exactly what you asked for, but it may be good for her.


http://s9.invisionfree.com/Jewish_Womens_Forum/


Have a good Shabbos.
 
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Lippa
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6/22/07 1:13 PM
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dear Sarah
Very sorry to hear that things are still not right for your daughter. it may be the illness 'dulling her mind', but it could also be the Risperdal. perhaps her psychiatrist would consider adjusting the time of the dose so any sedation occurs at night?
She also needs stimulating mentally, so I was pleased that she has at least a few things to do. what about physical activity e.g. a gym?
good Shobbas
 
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Sarah
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6/26/07 8:13 PM
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Just checked out this site. It is quite interesting.


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Sarah
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Dear Dr. Lippa,

My daughter does take the Risperdal at night but the effect lasts throughout the day. I can't really pinpoint what it is - I found that she was better on the 2 mg instead of 4 mg which she is now taking. The psychiatrist's idea was to lessen the amount of the hallucinations - she feels women (doctors?) touching her and experimenting on her. I find that her character was more pronounced before and now again my daughter answers "I don't know" to most questions and "I don't know how to do that" to a task, etc.

I shall have to see what the psychiatrist says when we meet in a couple of weeks time. As regards gym, her volunteering took the place of that on Mondays and she did not enjoy it anyway. I wish I could find some easy exercises for her to do at home and that she should do them every day. I know how much benefit one can get from exercises.

How is England nowadays? I heard they have a new Prime Minister now.

Regards

Sarah


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Daven to Hashem - He always listens to you!

Edited: 6/26/07 at 8:28 PM by Sarah
 
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Sarah
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Dear FrumSupporters!

This topic is continued in "Dr. Lynn's" Forum under "psychosis in schizophrenia forum"

Best wishes to everyone.

Sarah


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Lippa
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9/3/07 5:46 PM
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where is this forum? I can't see it on the Navigation drop down list. Is it on another website?
 
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gad
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Sarah
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Dear Dr. Lippa,

I haven't heard from you for a long time so I decided to continue in this forum. My daughter is doing B"H fine. She is on the road to recovery and has had her first and only episode of psychosis since May 2005 which makes it just over 2 1/2 years. The first year was a disaster as she was on the wrong medication for her and she was like a zombie. The second year was hard work but much better on the transition to risperdal. Now into her 3rd year, my daughter is on orthomolecular psychiatry as well as traditional psychiatry meaning she takes 4 mg risperdal together with effexor and propanolol and procyclidine. The orthomolecular helps the side effects of the traditional meds. My daughter is also on thyroid + iodine and adrenal gland enhancer.

She is doing much better in the last few weeks. She is much more talkative.

I find that her not being aware of her spacial awareness is a big problem. She bumps into people when shopping with me or stands in the way. I don't know how to help her with this problem.

I am trying to teach her to become more independent. I showed her how to get her traditional medication herself from the pharmacy and the next time she will go to the psychiatrist herself and I may write down some topics for discussion on a paper that she will take with her.

My daughter has quite a busy schedule during the week.

Sunday: personal trainer takes her swimming
Monday: she volunteers in a seniors association (computer work)
Tuesday: meets with her religious worker (like a case manager) then has a group on different topics such as stress reduction, etc.
Wednesday: Art group in hospital. Music lesson at home in the evening.
Thursday: meets a cognitive therapist
Friday: sometimes goes to another group.

She also sometimes does exercise with the personal trainer if timing allows.

I would like her to take on more tasks on becoming independant, etc. but my daughter does not feel ready to do so e.g. bring Negel Vasser to her bedroom at night, to daven Brochos and Shema every morning, to put away her clothes either to hang them up or put in the washing, to wear make-up, etc.

Her psychologist thinks that my daughter has sleep paralysis - she feels doctors touching her and injecting her and when she turns on her side in bed the feelings usually disappear. I wonder if you have heard of this?

A Gutte Voch

Sarah


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Edited: 1/12/08 at 11:34 PM by Sarah
 
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Lippa
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Sarah
GUt Woch
B"H your daughter does seem to have turned the corner, thank you for updating me.
Just a couple of comments on what you have said. you quite rightly want her to be more independent, and I expect that she also wants this, although after such a serious illness she may also want to be looked after. Her cognitive therapist is probably telling her to take one step at a time, not to take on too many tasks at once. for example you listed a nunber of tasks you would like her to be doing herself. this is great, and exactly what she needs. But she needs to have done one of these tasks and be confident that she can do this each day, before trying the next. have a word with her therapist if she allows this, as you need to be saying similar things.
You ask about sleep paralysis: I have certainly heard of this condition, but it must mean something different on this side of the Atlantic. What you describe your daughter experiencing is not what we would call sleep paralysis, but it could be one of a number of things, e.g. some lingering psychotic symptoms, nightmares. the psychological sequelae of what must have been a traumatic experience for a frum girl (e.g. being in hospital). I am sure her therapist knows what she means by sleep paralysis.
I wish her a continued Refuah Shlamoh
Lippa
 
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Sarah
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Dear Dr. Lippa,

I was just about to hit the Reply when everything disappeared. I will try to be more careful this time.

Thank you very much for your quick reply and good wishes. I think I did not explain myself very well. It was the psychiatrist who suggested I do not push my daughter over the menial tasks I would like her to do but I was in touch with Rabbi Dr. Abraham J. Twerski in the beginning of my daughter's illness and he suggested that everyone should daven brochos and shema and wash Negel Vasser in the morning. I guess my daughter had a very difficult time before she was hospitalized when she tried to daven brochos but could not because the voices were bothering her and she thought she had to daven before eating so she fasted basically for two days.

My daughter's cognitive therapist addresses the trichotillomania (eyebrow and eyelash pulling) but helps her with other issues as well. About the sleep paralysis she gave a very technical document to us to read and I think that you are correct in your assumption that this lingers from her traumatic hospital stay when she wanted to leave and they shackled her by her hands to the bed and injected her.

About your suggestion "Your Guide to Schizophrenia' by Dr Adrienne Reveley" does this book cover getting the schizophrenia patient to think more constructively and about handling spatial awareness etc.?

Thank you for your continued support.

Kol Tuv

Sarah


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Edited: 1/13/08 at 8:46 PM by Sarah
 
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Lippa
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the book certainly deals with the patient's cognitions. I am afraid I have not looked at it since it first came out, so I do not remember if it covers problems with spatial awareness. I doubt it, however, as this is thought to be quite a rare phenomenon.
 
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Sarah
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Dear Dr. Lippa,

Do you know how we can rectify the spatial awareness problem or at least alleviate it. Another daughteer has a friend who had meningitis when younger and she also had this problem.

Thank you.

Sarah


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Lippa
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I am sorry, but this is a bit out of my field. If she were one of my patients I would be seeking advice from an Occupational Therapist, or from a psychologist specialising in this area. In the UK they usually work in what we call Rehabilitation services. Your daughter's psychologist should be able to point you in the right direction.
 
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Sarah
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Dear Dr. Lippa

The truth is I forgot to mention the Spatial Awareness Problem but I will have my daughter speak to her Occupational Therapist in her art group.

Thank you

Sarah


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Sarah
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Dear Dr. Lippa

Well a lot has happened since January. Re. the last post here, my daughter's occupational therapist has not seen a spatial awareness problem with my daughter in her group but there is definitely one. I was out shopping with my daughter and waiting in line at the grocery store when my daughter passed the shopping cart over the woman's leg who was not finished putting away her items. Of course I was very embarrassed but my daughter did have the decency to apologize. Many times she makes transactions and forgets to thank the cashier. She always forgets to take paper tissues to wipe her nose and does not realize before she is going to sneeze.

We recently did a food intolerance testing and she is only allowed 17 foods from the 90 something foods. We cut out gluten, milk, eggs and many more items and have been into this diet for over a week now. I have heard from a mother who had her ADHD son tested and after 3 months of being on his diet, the hospital receptionist could not recognize the boy as he sat so still during his wait for the dr. I do believe that my daughter has food intolerances because the gastroenterologist did notice some inflammation internally and could not figure out the cause. He attributed it to Irritable Bowel Syndrome.

For Shabbos I made some delicious rolls from non-gluten grains and no egg recipe.

It does bother me that my daughter's groups are mostly with other mentally ill people. Her volunteering on Mondays is with senior citizens so that is okay but my daughter still sleeps a lot during the mornings when I am not home and I believe that if she had an activity to go to, she would be much better off. It is extremely difficult to find something like this for her that she would like to do.

By the way her trichotillomania is cured and she looks so much better.

That's my news for now.

Kol Tuv

Sarah


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Lippa
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thank you so much for updating me. B''H that your daughter has continued to improve.
Back in January '07 i made a couple of suggestions about activities which involve normal people, not only those with a mental health problem. perhaps now that your daughter has improved she could try these or similar ideas. she seems to need some form of motivation to get up in the mornings, like most people, although even the small dose of meds she is on might contribute to sleepiness in the mornings. (I hope she is still on meds: diets can be helpful but are NOT a substitute for medication).
Regards
Lippa
 
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Sarah
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Dear Dr. Lippa,

Thank you for your reply. It's so wonderful that you take the time to write. I really would like my daughter to do some activity with "Normal" people but there is not much being offered in our neighbourhood. Last night we both went to a meeting entitled "Reclaiming your life after Mental Illness" which was presented by 5 women who had mental health problems 3 bi-polar and 2 schizophrenia. A few of them lived in a setting for people with mental health issues who support each other emotionally. One or two of these women out of the 5 seemed to be completely well although they still claim to be on medication. What I got out of this meeting was that all women worked on themselves to get to where they are now. My daughter sees that other people also have difficulties to deal with.

Of course my daughter never stopped taking her meds. Today she said she felt very anxious. She realizes that her anxiety appears when she is alone. We are waiting for the drugs abilify or geodon to appear in Canada in a couple of months and then my daughter's psychiatrist wants to switch from risperdal hopefully to the abilify. Do you get these drugs in the U.K. and what have you heard about them?

Thanks again.

Sarah


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Lippa
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Sarah
we have abilify which is called aripiprazole as its chemical name. Geodon is also a trade name, but i don't know what its chemical name is, and the trade names vary from one country to another. so i don't know if we have it in UK.
Abilify is a very interesting antipsychotic. i have been in psychiatry for over 30 years and have never prescribed any other antipsychotic like it. firstly it rarely has the side effect of drowsiness, which almost all the others do. secondly it rarely makes people put on weight. as you know that can be a terrible problem. finally, it seems to work very well indeed in some people and not at all in other people.
the changeover period from another antipsychotic needs to be long, and i will take several months over this.
Hope all goes well
Lippa
 
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Sarah
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Dear Dr. Lippa,

This is very informative.

Thank you once again. I will keep you informed once we have tried it.

Kol Tuv

Sarah


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Lippa
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Sarah
Here is some more information on aripiprazole, recently published as a summary of a paper: Sullivan G, Bienroth M, Jonesc M, Millar H, Ratna L & Taylor D 2007. Practical prescribing with aripiprazole in schizophrenia: consensus recommendations of a UK multidisciplinary panel Current Medical Research and Opinion 23(7) pp 1733-1744. Dr Taylor is very rel;iable.


Dr David Taylor, Chief Pharmacist at the South London and Maudsley NHS Foundation Trust, along with colleagues, has written a paper on the use and effectiveness of aripiprazole (known by the brand name Abilify) in schizophrenia, following the recommendations of a UK multidisciplinary panel.

Aripiprazole is an antipsychotic drug and differs from other antipsychotics (see glossary for a definition) in the make up of the drug and in the benefits for service users. Taking aripiprazole can have beneficial effects on mood, quality of life and cognition. It has lower sedative effects on service users than in other drugs and is less likely to make service users put on weight.

As aripiprazole was approved by NICE in 2004 for use in schizophrenia, a multidisciplinary panel was set up in the UK in October 2006 to discuss and provide practical guidance regarding the potential benefits and risks of prescribing aripiprazole.

The panel recommended that aripiprazole should be considered as a treatment option for people with newly diagnosed schizophrenia, service users who are experiencing unacceptable side-effects with other antipsychotic drugs and those in relapse, who have experienced inadequate management or side-effects with other antipsychotic drugs. Aripiprazole may also be a good alternative for service users who are experiencing weight gain on other antipsychotics.

The primary goal at the start of the aripiprazole treatment is to ensure the service user completes the first few days of treatment, with support from other medications, if needed. Sickness, insomnia and agitation may occur in 10-20% of patients, but this is manageable and can usually be resolved during the first three to seven days of taking the new drug. The dosage of any previous antipsychotic prescribed should remain the same until the aripiprazole treatment starts working and then the other antipsychotic should be tapered off slowly over several weeks or more.

The panel concluded that patients are more likely to stay on the their medication if using aripiprazole – and if they are on any other antipsychotic type of drug – and get long term benefits if they are involved in the decision making process on which drugs to take and have the support of a well informed care team. The panel found that service users who are given information on the effects of coming off medication without supervision and the long term benefits on staying on a course of medication, are more likely to continue with treatment.

It is important that everyone involved in the service users care understands the clinical and drug decisions in starting or switching to aripiprazole and the expected outcomes. The care team should be well informed on potential adverse effects and monitor for these.

The panel also recommended that it is important to let the family know that a service user may be more alert than when receiving other antipsychotic drugs, as this may be different from their previous experiences with antipsychotic drugs. The service user should also be advised to avoid caffeine to help aid a normal sleeping pattern.

The panel advised that some patients may find the first few weeks of taking aripiprazole difficult, but over the longer term, many find it better than using other antipsychotic drugs. Long term use of this drug may result in real benefits for service users, as aripiprazole has a favourable physical health profile compared to other drugs. Service users taking aripiprazole may therefore be better able to take part in social activities, work, education and cognitive behavioural therapy, all of which would contribute significantly to their quality of life.

Involving an informed multidisciplinary clinical care team in the treatment decision, establishing a good therapeutic relationship with service users and carers and planning how to manage adverse events that may happen during the start of treatment, together can all increase the likelihood of service users getting long term benefits from aripiprazole.

 
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Sarah
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6/1/08 10:29 PM
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Dear Dr. Lippa

Thank you so much for your quoting research on abilify. It really is quite exciting!

Wishing you a Shavuos Sameach.

Kol Tuv

Sarah


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Sarah
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7/1/08 2:17 PM
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Hi Everyone,

I just finished reading a book entitled "Rickie" by Frederic Flach M.D. her father. It is a book about a recovered schizophrenic girl. It was published in 1990 and talks about orthomolecular therapy and visual therapy and visual perception training by Dr. Melvin Kaplan in Tarrytown, U.S.A. Apparently some schizophrenics have a loss of depth perception which is cured by wearing eyeglasses made with prisms. I would like to hear from anyone who knows about this therapy.

Thanks

Sarah


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Sarah
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8/31/08 8:52 PM
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Hi Everyone!

We are trying a new medication called Zeldox which is the same as Geodon. The Abilify is not covered yet in Canada. The complete changeover should take a couple of months but it is better than going cold turkey which would shock the body.

I am hoping that the Zeldox will solve the voices problem and the side effects problems of weight gain and insomnolence (unrestful sleep = waking up in the middle of the night).

The prescribing psychiatrist is happy with the results of this medication which is new in Canada and which she prescribed to two patients so I hope we will also have good results.

Kol Tuv

Sarah


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RuchamaShayna
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1/8/09 1:50 PM
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This is a book you all should read. If any of you have been diagnosed or have a loved one diagnosed, it is a very important book to read because it explains that it is usually not so weird or so hopeless when someone is diagnosed, and that a lot of medication is not the way to go--it may be okay to use for a very short time, but it's really not good to use for long, and it is usually a bad idea to use medication as the only way to get better. It won't work. An excellent support system works much better than medication for most. I know this is true, becasue I've been through this. The author of this book has been curing so-called "hopeless cases" since he was in COLLEGE, and he is not the only one who can help.

I copied this from his website for you. I read this book and found it very helpful, and I think it will help you, too.

Toxic Psychiatry:
Why therapy, empathy, and love must replace the drugs, electroshock, and biochemical theories of the “new psychiatry.”
by Peter Breggin, M.D.
Paperback published 1991 by St. Martin's Press

Toxic Psychiatry remains Dr. Breggin's most complete overview of psychiatry and psychiatric medication. It has influenced many professionals and lay persons to transform their views on the superior value of psychosocial approaches compared to medication and electroshock.
 
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Sarah
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1/8/09 8:38 PM
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Dear Ruchama Shayna

I will definitely look at this book. Thanks for writing and have a Good Shabbos.

Sarah


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Sarah
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1/10/09 8:27 PM
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Dear Ruchama Shayna

I ordered this book on-line. I don't know when I will receive it because it is being shipped for free via the US.

How is it possible to go off meds? Surely the psychosis will return?

My daughter received cognitive behavior therapy for her trichotillomania but she is very anxious again and pulling out her eyebrows. She knows that this is stupid of her but finds it difficult to stop. I hope she is able to go for more therapy.

Take Care

Sarah


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Lippa
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1/11/09 12:44 PM
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'Toxic Psychiatry' is indeed a book which patients and families often find helpful. It reminds us of the importance of a psychological approach and the need for psychological and psychosocial therapy, whatever the mental illness. But it is a very one-sided book, selectively quoting negative research on medication and ignoring the huge amount of research and clinical experience showing the long-term benefits (in some conditions, such as schizophrenia) of long-term medication.

As should be obvious, what works for one person (and illness) may not work for another. A combination of psychological input and medication is almost always required for serious mental illnesses such as schizophrenia and bipolar disorder. But when a patient is very psychotic (for example, thought-disordered or preoccupied with paranoid delusions and hallucinations) it is, in my view, pointless (if not worse) to rely only on techniques such as analytic (psychodynamic) psychotherapy or CBT, because people who are very psychotic are not able to focus on the work needed for such techniques to be successful. The time for such work is later, once the person is able to concentrate and see in perspective again. initially psychological support for patient and family is most helpful.

Please note: I make these comments in response to a recent posting, because I would not want anyone with a serious mental illness to read the book and unilaterally decide to stop medication. I will not get into a discussion of which of the two approaches to adopt, psychological or medication, because there is no need for an 'either or' mentality. There, I have said my bit and have no more to say.
 
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Sarah
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1/11/09 7:03 PM
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Dear Dr. Lippa

Thank you once again for helping us. I am upset with the zeldox because my daughter has put on weight, says things that are obvious, no matter if I am busy reading something or not. She argues constantly thinking that she is always correct and thinks she needs to have the last word.

She claims the sleepiness is better in the mornings but I don't see it. At this time of year, December-January when groups are put on hold for 2 weeks and she doesn't have her usual schedule I find she is always worse. Her social worker wants her to become more independent and therefore she answers me back.

My daughter feels people touching her just before she goes to sleep. What is this condition called?

She hears voices lightly towards evening she says.

My daughter has also stopped taking thyroid because her orthomolecular GP who specializes in Mental Health went on a sabbatical and I did not want the replacement naturopath to treat my daughter (knowing that anti-psychotic meds are necessary for her). My daughter's face became very puffy again.

I often wonder how people in certain countries can help their schizophrenia by leading a country life or being treated without medication. I definitely think that these meds numb the mind and cause many other problems which were not there in the beginning.

My daughter says that I am a bad mother when things don't always go her way. Her psychiatrist has told her that I am a very good mother.

We seem to be going around in a vicious circle.

Sarah


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RuchamaShayna
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1/21/09 3:53 PM
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Hi. I'm responding to the post about the book. I agree with you that people should never just go off medication because they decide it would be best. In fact, Dr. Breggin addresses this throughout his book--he believes that the withdrawal symptoms from stopping a medication at once could be very serious and it should never be done alone or at once. I'm glad you cleared that up. I would hate for anyone to have read my statement and decide to stop taking medication--this could be very dangerous. I suggested the book because I think it's very important for people to understand that mental illness is unlikely to be helped or cured with medication alone. A system of caring and understanding must exist to help soothe and calm the mind. Whether this is done with or without medication, or with a gradual lowering of the doses and types of medication, is up to the patients and their doctors, but their doctors must be consulted. If they don't agree with the doctors’ method of treatment, they should find other doctors who are more in tune with their thoughts and feelings.
 
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temizo
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8/7/09 11:16 AM
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I was reading a book that is not really about this topic, but a very short chapter was about how to interact with people dealing with an illness like this, and based on my very lengthy and close relationship with someone diagnosed, I know that there is excellent advice in Chapter 12, which is 4 pages in length, so I would like to post the information here, along with some of my own thoghts from my experience. The name of this very good book is Make Peace With Anyone, by David Lieberman, PH.D.



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temizo
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8/7/09 11:16 AM
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Here is the information:

When interacting with someone suffering from a mental illness, you must know:

Everyone suffering from a mental illness wants one thing: peace of mind.

The sufferers thoughts are confused, their lives are disrupted, they don't feel in control, no matter what their behavior at times might suggest. They never feel at ease. There is no calm. Therefore, when you interact with them, you should do so in a way that will give them some kind of autonomy over their own lives and some kind of calm. You may not be able to cure anyone, but you can make your relationship with them much better, which can only help their emotional health. You can at least not cause them to be worse by becoming so aggravated by your conversation or by your presence.

People with this type of severe mental illness usually try to make their lives stress-free, because any and all types of stress makes their condition worse. A lot of normal, day to day life, because of everyday triggers and stress, is just too hard for them to consistently deal with. No matter what they can sometimes do, for them it is much more difficult and stressful than you, living in reality, can probably imagine. What happens, though, is that by trying to rid themselves completely of any stress, by avoiding people or places, or by doing less, there is much more stress that appears all the time. This is because the more people shy away from the real world, the more they go away from and lose touch with reality, thereby creating a downward spiral into more madness, since they don't have the normal real-life background with which to judge their lives, and they only look at things in absolutes, evaluated by their more and more limited perspective. So what can you do? According to David Lieberman, there are 3 phases.



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temizo
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8/7/09 11:17 AM
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Phase #1: Make them feel special

This is so they won't feel out of control and helpless, as most sufferers do.

You can make them feel special by:

A) Demonstrating that you really like to be around them.

When people think that it is difficult for you to be around them, that a mere conversation is torture for you, or that you need to muster up all your energy and strength just to see them, they will feel bad about themselves, the bond will break between you, and they will be less mentally stable and lest trusting of you as a friend and ally, as a result. So appear glad.

This won't always be easy. Try to smile before you see them, so you will already have a smile on your face. Try to think of something nice to say before you see them. Try to come up with ways, in advance, that you will stay calm and composed and relaxed no matter what they say or do. People with this type of illness are usually repetitive for long amounts of time with their words and behavior, so you can think in advance on how you might respond, since you might know in advance what they might say. Demonstrating that you really like to be around them can take a lot of effort at first, but stick with it. Even if you can sometimes appear glad to be with them, there will be a lot of good.

B) Demonstrating that you appreciate their ideas and their time.

When you have a conversation with them, you must really pay attention and listen when they speak. Show you care about them as individuals. When they give you advice or share their ideas, say "Thank you” to them for trying to help you, no matter if you agree or disagree with their opinion. Tell them how glad you are to be with them. Tell them you value their thoughts, ideas, and the time you share. Ask for their opinions. Show them respect.

This could be difficult, so it might help if you in advance decide how much time you will spend with them on each, or some, visits or talks. This way, when it's difficult, you know you only have to listen for a short time (or longer time, if that's what you decided) before you leave the conversation. Pre-plan your exit as well, so that it doesn't get disruptive. It may or may not help, depending on the people or situation, to state in advance that you have a meeting or appointment or a phone call you couldn't get out of, so they know how long they've got for this talk. You can let them know that you will be back for more conversation, so they don't feel unwanted or disrespected. If they give you advice and insist you take it or demand to know if you will take it, say you need to think about it just like you think about any advice that any good and smart and caring person gives you. Let them know you love them and respect them and value their advice and ideas, and that you need time to think about what they’ve said, in order to see if their idea is right for you, or if you are able to implement it at this time. If you don’t take their advice, let them know that you appreciate it nonetheless, and that maybe you can implement their idea another time, or that it made you think about something and it led you to a new idea you think might work better for you in this situation. Whatever you decide, make sure to let them know you listened to and thought about the idea and you appreciate their help. If they tend to carry on, think of a way---in advance, perhaps—to gently, but firmly, change the subject.

C) Demonstrating care and concern for their needs and comfort

You can do this in many ways, depending on the people and situation. Even small ways--especially small ways--done with care, attention, and compassion, will show them that you care. For example, bringing them a glass of water if they seem thirsty or a tissue if they sneezed or sound stuffed up, will make them feel good about themselves and with their relationship with you.

You don't want to be overbearing, and if the person has paranoid delusions, you must be careful, of course, so as not to arouse false suspicion. But if the person is not in a paranoid state, and really does not mind being cared for, and if you won't go overboard in your care or in your need to explain that you are doing something nice since you are really nice, this tip will work wonders in improving your relationship and letting them realize that they can trust you and that they are loved.



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temizo
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8/7/09 11:19 AM
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Phase #2: Demonstrate trust

People with mental illness learn not to trust what they think and feel, no matter what it may appear, no matter how many times they assert false ideas as fact. They are told that they are wrong about their ideas, and they don't know what to believe about most anything anymore. Therefore, if you show them that you trust them, they can begin to feel valuable and confident again.

You can demonstrate trust by:

A) Asking them for their opinion and advice.
This shows that you trust their judgment and value their thoughts and ideas. It shows them that just because they are sick, they are not stupid, incompetent, or always wrong. This shows them that they have worth, and that you believe they are worthwhile. Most important, it gives them a chance to give, which is something most people with mental illness can't do or don't get a chance to do. Giving leads people to feel good about themselves and about others, too. Volunteering in any way they can leads to better mental health, stability, and confidence.

Be careful not to push it. Don't try to always ask for advice. Don't force them into giving. Pay attention to what you think they need, whether it’s to give of their ideas or time and care, and take it slowly. They've probably been ill for a while, and people don't usually get better overnight, so take it easy.

B) Including them in a project or assignment of yours.

Ask them to help you with something for yourself or someone else. Mental illness causes the sufferers to think about themselves all the time, because everything is a question, a problem, a fear. Those suffering from mental illness can become very self-absorbed and forget that there are other people who need help, too. When you involve them in doing good for others, they have less time and mind space to focus so intently on themselves, leading to a much more real and healthy outlook on life.

Don't lecture them about all the people suffering "as much" or "more than" they are. Those with mental illness are truly suffering, even though it’s sometimes hard to see, and they don't need to hear you downplaying their suffering while suggesting they don’t care. This type of talk will only make them feel bad about themselves and it will break their trust in you, as they may think: "What kind of loving friend or family member insults others? I must not really be loved or understood. No one cares about me. No one is good. No one can be trusted. They are all in it against me.” So be gentle in your approach, like you would with a child just learning about helping others. Make it nice and fun. Make it about the person who needs help, not about you or the ones suffering from mental illness. And like everything else, take it slow. If you give it time, it will happen.



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temizo
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8/7/09 11:20 AM
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Phase #3: Instill a sense of independence

You should help them feel that they really are in control of their own lives, even thought their confused and chaotic minds are telling them that this is not so.

You can help them feel that they may live as they choose by:

A) Allowing them to be in charge of their own lives, as much as possible.

As much as they can be in control of their lives, allow and encourage them to do so. Many times, people try to take complete care and control over those suffering from mental illness, and this control only causes the sufferers to feel more dependent, insecure, and out of touch with the world and reality. Allow them to be in control of their own lives as much as they can.

Don't push them to take care of themselves if they can't or if they think they can't. This advice is only for dealing with people who can take control of their lives and who say they can do so or who never came out and said it but only need a little push. If you suggest that they can care for themselves and they resent your suggestion or become afraid or belligerent, this is not advice you should take at this time and you should continue to let others take care of them for now. Of course, this should all be discussed with their mental health care provider, as all people and situations are different.

B) Asking them to do something and letting them be in charge from start to finish.

Let them plan and execute an entire project or idea. This will lead to good feelings for themselves and for your relationship. They will trust you more. People with mental illness who have people they can trust will end up getting along better with people and will demonstrate improved mental health.
Do not interfere. If asked for a bit of advice or help, provide it, as you might for anyone, but stay out of the way. Let them do it on their own. Show them that you trust them and believe in them, and that you know they can do it.


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