A few questions about Schizo-Affective/Bipolar Disorder.

Question

Do atypical antipsychotics address the disorganization in these disorders?

Would a light dosage be recommended for those who are sensitive to everything?

Can these disorders lead to full blown Schizophrenia to someone whose already 23-24? How about Dementia at an older age?

Are the side effects of the medications really that bad?

Thank you kindly for your answers... :)

Answer 1

"Do atypical antipsychotics address the disorganization in these disorders?"

- Yes, if you are referring to disorganized thoughts.

"Would a light dosage be recommended for those who are sensitive to everything?"

-Not sure what you mean 'sensitive to everything'. If you mean that you typically have side effects to medications, then yes a slightly lower dose may help work fine for you.

"Can these disorders lead to full blown Schizophrenia to someone whose already 23-24? How about Dementia at an older age?"

- Schizoaffective disorder is considered a form of schizophrenia, you have to meet criteria for Schizophrenia and also have severe mood problems like recurrent episodes of depression or mania. As for dementia, I am not sure about the exact numbers, but from clinical experience it does seem like patients with Bipolar disorder and Schizoaffective disorder have a high rate of cognitive impairments in older age similar to dementia. Of course, I see people mainly who do not take their medications. It is entirely possible that patients with well treated schizoaffective disorder do not have a higher rate of dementia.

"Are the side effects of the medications really that bad?"

Atypical antipsychotics are associated with a number of bad side effects including weight gain, diabetes, high cholesterol, and tardive dyskinesia. Lithium is associated with thyroid and kidney problems. Of course you have to keep things in perspective, severe cases of schizoaffective and bipolar disorder are completely debilitating. The rate of suicide is much higher in both disorders and many people end up on disabilty. Compared to that, the side effects can be worth the benefits.

Best wishes!  

Answer 2

Disorganization? Not particularly well.

Depends on which atypical. Seroquel around 100mg/day. Risperdal might be a better choice, probably under 5mg/day. Depends on what you can tolerate. An antiepileptic drug/mood stabilizer is generally a better choice for bipolar, with schizoaffective you're probably a bit better off in the antipsychotic domain. Your psychiatrist will know best.

No full blown schizophrenia, no increased risk of dementia. Though unmedicated bipolar folk tend to do things that increase their risk of dementia, such as large quantities of illicit drugs, risky behavior etc.

The side effects of atypicals can be pretty miserable. I don't like Zyprexa at all due to Eli Lily's deceptive practices, off label marketing and data manipulation. Also the fact that the vast majority of people have major weight problems on it. Seroquel seems to be a bit better than Zyprexa, but is almost as sedating. Abilify and Risperdal tend to be better tolerated than the first two. Geodon is a strange drug, and bipolar folks should probably stay away from it due to anti-depressant like qualities it produces.

I'd recommend www.crazymeds.us if you have specific questions about medications, they have very good data sheets and forums with some very good drug info.