I am a former meth user, clean and sober now but still in psychosis with delusions. My dr prescribed Latuda but it made me so nauseated and my mood so down that I told her that I would rather not take it if I don’t have to.
I still have delusional thoughts and see things I know others do not but they are not upsetting me. I wonder if they might just go away without any meds at all with time. And how would I know if I started meds without trying?
When I discussed this with my dr. she just said that she can’t force me to take meds and said the things I see and hear might go away or they might not.
I’m not a psychiatrist nor do I consider myself to be an expert in the matter. My background is chemistry (completed premed curriculum but don’t want to be a doctor) and some biochemistry.
From the perspective of DSM-5, if you are psychotic for months (or years) after using substances then it is not a substance-induced psychotic disorder, it is schizophrenia or whatever other diagnosis. Substance-induced psychotic disorder/mood disorder, etc. should wane with clearing of the offending substance. We can argue about this nosologically, but the DSM-5 (for all its limitations) is quite clear that if you have symptoms more than a month after drug use, then it’s not a substance-induced disorder.
The rationale of not treating rests upon the premise of avoiding condemning the patient (you) to a long-term course of a highly distressing, potentially dangerous drug. If you take an antipsychotic, you don’t know if the psychosis cleared from the antipsychotic or from sobriety, and you will probably have to continue a drug that carries a high risk of causing either tardive or diabetes. If you are willing and able to tolerate the effects of psychosis more so than the effects of the medication and can do so safely, this is a very sensible route. This is often the approach taken in an early psychosis clinic.
When people without mental illness take an antipsychotic, it disrupts what would be a normal functioning system. Hence that’s why resident physicians that experimented with antipsychotics (used to happen a few decades ago, doesn’t happen now) - e.g. take Haldol 2 mg and be sick for 3 days. Sure it can help while they’re psychotic, but then the question is will it screw them up once the substance-induced psychosis wears off? I don’t know the answer to this myself. In theory it should, but I’ve read some case reports that people do OK after being treated even if it was substance induced.
One challenge with this approach is that our entire mental health system is organized around “Did you take your meds?” as being the solution to everything. Mental illness is not analogous to diabetes no matter how much the sales force for the pharmaceuticals would like to promote it as such.
I’ve never done meth. It sounds awful. Glad you are clean. How long have you been sober?
If your psychosis is not dangerous to you or others, not just in terms of violence, but not losing your housing, taking care of yourself, and so forth, it’s your choice.
There’s some evidence that long episodes of untreated psychosis damage the brain. It’s not definitely proven, but it seems like a distinct possibility. When they’re talking about duration of untreated psychosis, it’s in the months and years.
While you’re figuring it out, be kind to your brain. There’s some good evidence for high DHA/EPA (a gram or more daily) vitamin D, and B vitamins.
There’s also been studies showing if you have a drug induced psychosis, the chances of having a diagnosis of schizophrenia or bipolar in the next 5 years are close to 50%.
With a single-episode of psychosis, my doctor has told me it’s generally a good idea to stay on an antipsychotic until you’re stable with no symptoms for at least a year and a half. This gives your brain a chance to heal fully from whatever caused the psychosis. Like @twinklestars said, some studies have shown that untreated psychosis can lead to loss of gray matter in the brain. If you recover from a single episode of psychosis, but then relapse, your chances of developing a permanent psychotic disorder are much greater. This is why most doctors recommend tapering off your meds slowly when it’s time to come off of them.
My doctor told me all of that back when I was only being treated for a single episode of psychosis. Mine wasn’t drug-induced, so maybe the answer is different for you. It stands to reason that your brain could benefit from some help in relearning healthy functioning.
It’s also worthy noting that there are dozens of wildly different antipsychotics to try. Just because one was horrible for you doesn’t mean they all will be. It took me a few tries, but now I’m on a med that takes away all my hallucinations and delusions, but doesn’t make me gain weight, feel sick, or sleep too much. Genesight offers a DNA test that can tell you which meds you’re likely to respond well to with the fewest side effects. There is some debate over how accurate it is, but it might be better than blind trial and error.
I never abused methamphetamines, but I did heavily abuse ordinary amphetamines over a quarter century back (I was in debt and figured if I took enough stimulants I wouldn’t have to sleep and I could work two full-time jobs plus part-time). If it was the uppers that did it to me, I’ve got bad news for you: 26 years on and I’m still having hallucinations and delusions. Can’t function well without my head meds.
When I was in active addiction it was awful. I felt afraid and threatened but that has passed after having been clean for a period of time.
My counselor tells me not to talk about what I see and hear with anyone but her and close family members because they will think I am crazy. The thing is that I feel pretty good without the meds but see and hear things that others do not.
With the meds, I am nauseated and feel down with no energy but see and hear less of the stuff.
Work and trying to pay bills put me onto meth, too. I thought I was accomplishing more even when I was just screwing up and wasting materials and time. I can’t tell much of a difference in productivity on or off the meds.
On the meds, I’m nauseous and have no energy to get started and off them, I’m unorganized and don’t finish what I start.
I get calm by listening to Ralph Smart youtube meditation videos. They are uplifting and have helped me find my path as a lightworker.
Wow this is cool @ninjastar it proves that psychosis is like a Brian trauma that can be given a chance to heal with meds. So if a drug induced psychosis can be fended off with meds until it heals; gives me hope that if they come out with the right med in the future it’s possible to give the brain a chance to fully recover from sz.
I don’t have the energy right now, but if you’re interested, look up scholarly articles and peer reviewed studies on neuroplasticity in adults. There’s one where they taught people with gray matter shrinkage juggling, and after six months, they had regained almost all their gray matter. The effects lasted as long as they kept practicing for. Brain damage isn’t as permanent as we once thought.
If you want to take advantage of the neuroprotective effects of fish oil and cognitive training, all you really need is to look for a DHA/EPA supplement that has about 2 grams of DHA/EPA, about 60% DHA and 40% EPA (roughly). There are several on Amazon. Life Extension makes a good one that isn’t too pricey.
As far as cognitive training, if your psychiatrist’s office does not offer it (I don’t think most do) the only consumer accessible program that I know of that has been proven in schizophrenia is BrainHQ.
It doesn’t have to specifically be juggling. Any activity that requires concentration and hand-eye coordination will do, theoretically. Playing an instrument, baking, and playing a sport are also fine choices.