My antipsychotic response according to Selfdecode site

It’s a mixed bag.

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Firemonkey: always at the cutting edge of knowledge.

Aren’t you on a small, subtherapeutic dose of antipsychotics, I seem to remember you saying you were, also that you were just on a mood stabilizer, I think lithium, right–for many years… If so what value does knowing this information have for you? You don’t even need large/significant doses of medication, you should only suffer from minimal side effects…

I am on 25mgs Risperdal consta. Therapeutic does being 25 mgs,37.5 mgs, and 50 mgs.

Yes it was lithium, but what does that have to do with what I am on now?

Did you upload your raw genetic data there? Did it cost anything?

These genetic code<->meds whizzery do’s companies are bogus. Please don’t take them seriously folks. There’s absolutely no evidence they work.

The only method that works, unfortunately, is good old fashioned trial and error.

But who am I to talk, it’s your money folks!

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Yes ,I uploaded my 23andMe raw data. $19 a month

So do you feel like it’s accurate, do your responses match up?

I think it’s fairly accurate.

This is what it says ,

How reliable is the SNP Analyzer?

The SNP analyzer is a way to aggregate information, often from contradicting SNPs. You shouldn’t use the information as factual, but rather as something to look more into. Often, there will be SNPs that contradict each other in the SNP analyzer. This is because people are made up of millions of SNPs that often do contradictory functions and it’s the totality of these functions that decide what your biology is like.

The SNP analyzer aims to integrate information from a certain function to come up with a clearer picture. You should rely on it as a rough estimation of what you’re like.

You could say it gets you in the ballpark.

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I’ll check it out and if it’s cheap enough I’ll try it! Thanks.

I used LiveWello to interpret my results but it doesn’t give a whole lot of response to medication things.

I won’t post all the details it gives me for antidepressants and lithium but for those it says .

Antidepressant Response: D -
You have a worse response to antidepressants

Response To Lithium: B -
You have a better response to lithium

Just to show that the results may not always be on the ball here are 2 results to do with lifestyle.

Relationship Status: A +
You do better in relationships

Social interaction difficulties are probably the most prominent thing with me. Over 60 years I could count the number of friends I’ve had on one hand.

Response To Stress: B +
You have a better response to stress

I actually have a poor response to stress although meds have reduced the emotional reactiveness to it.
Before I was on meds adverse/stressful situations would see( and/or) increased emotional volatility,irrational outbursts and paranoia, flu like symptoms/derealisation . I don’t do well under pressure.

If you were fine on just lithium for years then you don’t suffer from psychosis. Why not just stop antipsychotics entirely if you don’t need them, they are terrible for your health.

My nurse practitioner had me do medicine tesitng through Genesight. I apparently have poor reactions to a lot of antipsychotics with only two that should work well in my system. Same goes for antidepressants/antianxiety meds.

Here is the risk history as culled from my psychiatric notes:

Risk history- delusions, ideas of self harm/suicide ideation,impulsivity /lack of impulse control(risk history) History of non compliance in the past. I can’t remember this.

Treatment related indicators- Failure to attend appointments (risk history and current(then))

Person circumstances indicative of risk: severe stress(risk history),

Behaviour indicative of risk:
deliberate self harm,alcohol/drug abuse (risk history)

Another risk assessment. Things ticked yes or both yes and no

Previous suicide attempt (y) admitted to a low/medium unit(y) Evidence of being dangerously impulsive to others(y and n) Has the client expressed but not demonstrated aggressive behaviour(y) Has the client threatened physical/psychological harm(y) Has the client expressed paranoid delusions featuring certain individuals(y and n) The client is unable to adequately communicate need(y and n)

Also mention of confused and paranoid thinking and problems expressing myself clearly especially when angry/agitated/frightened

I am not sure why some are y and n.

I have to point out that any so called “aggressive” behaviour was directed at mental health staff not other patients. Much of the “aggression” was simply disagreeing verbally with the nurses etc with whom I had a less than good relationship(faults on their side and mine,although as is typical It was all dumped on me as the patient. Psychiatric teams often talk of the need for personal responsibility whilst themselves engaging in a collective lack of responsibility).

“Antipsychotic” Effect

In terms of lithium’s specificity, probably one of the most perplexing effects of lithium has been its “antipsychotic” capacity. Both acute and long-term “antipsychotic” effects have been described best by Garver and his group (Garver et al. 1984, 1988) in schizophrenias and schizophreniform psychoses, and illustrated on schizoaffective psychoses by many others (e.g., Angst et al. 1970; Lenz et al. 1987; Lenz et al. 1989) and can commonly be seen clinically. During treatment with lithium alone, a dramatic clearing of psychotic symptoms has been seen in acute psychoses (schizoaffective and schizophreniform), even in mood incongruent ones, and in many patients, continued treatment with lithium alone could prevent further episodes. Garver et al., for example, treated a large consecutive series of mood incongruent psychotic episodes with lithium only. These patients were diagnosed as having DSM-III affective, mood-incongruent psychoses, schizoaffective disorders, schizophreniform disorders, and schizophrenias. None had received depot neuroleptics within 6 weeks of admission. Each patient underwent a systematic trial with lithium carbonate alone, with plasma levels in the range of 1.0 to 1.2 mEq. Excellent responses with remission were seen in 29% of patients. Lithium responders fared well, without the introduction of neuroleptics at any time during the course of hospitalization and could be discharged on lithium alone, essentially symptom free. Of the lithium-responsive patients who were readmitted, about half showed a concordant lithium response on readmission. Unlike the generally reproducible response to lithium in typical affective disorders, in only half of these atypical patients could the response be replicated. Using the terminology of recent years, we could say that the initially well-proved response “was lost” in one-half of the patients.

This “antipsychotic” effect of lithium superficially resembles both the prophylactic and antimanic effects, although closer observation exposes a different profile. First, patients benefiting from the antipsychotic effect of lithium experience a reduction of manias but no reduction in their depressive episodes (Grof 1994). Second, when these patients are readmitted for mania, the antimanic effect is reproducible in only about half of the patients (Garver et al. 1988; Garver and Hutchinson 1988), as if there had been a loss of efficacy over time or a loss of efficacy on discontinuation. It would seem that, for a satisfactory long-term effect, in about half of these initial responders, lithium treatment must eventually be combined with, or replaced by, other psychotropic drugs. Third, lithium toxicity may develop, even with therapeutic lithium levels. Fourth, when lithium is discontinued, patients with atypical affective or mood-incongruent disorders frequently present with early relapses (Lenz et al. 1988, Grof 1994).

These observations strongly suggest that the prophylactic, normal mood-stabilizing effect in typical affective disorders and the “antipsychotic” effect in atypical disorders are two different benefits, with possibly connected, but different, underlying mechanisms. It may be prudent to consider these two lithium benefits separately, both at the clinical and the basic science level

@eduvigis

But in general, four main symptoms are associated with a psychotic episode:

hallucinations (very occasional pseudohallucinations)
delusions( according to psychiatric notes)
confused and disturbed thoughts(mention of confused and paranoid thinking in notes)
lack of insight and self-awareness ( Opinions on this have varied. Some saying there’s a lack of insight others not)

I accept I don’t experience psychosis as severely as many here and that it’s probably seen as more transient in nature…

I was really unaware lithium had any antipsychotic effect. That really changes this equation then doesn’t it?

Bear in mind it is hard for me to put myself in your place as my psychosis is not transient in nature.

Your effective dose of Risperdal Consta could also be much lower than someone else since there are poor and extensive metabolizers. Or maybe that only impacts the half life of the medication? Yes, I think it is 25mg regardless of this.

You get your medication every two weeks so you are on a little less than 2mg everyday, I was on 3mg Risperidone and I think that is a high dose. Maybe an medium dosage for schizophrenia. Risperdal Consta the initial dose is 25mg, and I suppose many people are stable on that. It also says some can benefit from 12.5mg but it has not been proven by clinical trials.

From what I’ve read in some people the psychotic symptoms tend to quiet down over time. Since you are in late-middle age isn’t it possible that your symptoms have become less of an urgent thing? I don’t know what year these psychiatry notes you have posted are from, but sz tends to be chronic with flare ups and so on.

So I suppose you are on the equivalent of 3mg. That is not a low dose for most people (for me 3mg wasn’t nearly enough). Are you sure it is helping balance you out? As in have you ever felt symptom coming through?

I guess we are all a little different when it comes to our treatment response, I still get symptoms at a high dose of medication, so I suppose I lost the genetic lottery when it comes to that. I can’t even imagine a month without symptoms.

You must have a stellar mental health health care system wherever you live, my doctors never took notes on me. They just gave us meds and made sure we weren’t mutilating ourselves or others. I suppose it is a little different everywhere you go.