First things first: I'm making this post primarily out of respect for a dear friend's opinion and concern. If it hadn't been for his/her input, I probably wouldn't have thought of making this thread.
Second, this is going to be a long post, so if you don't feel like reading all of it, I don't blame you. I would appreciate thoughts on this, however.
With that out of the way, let's get to the thread topic: for a few months, I have been taking a class of medications known as atypical antipsychotics to treat bipolar disorder. The first one I was on, Risperdal, made me unable to think clearly. I could handle some of the relatively minor but annoying side effects like frequent urination. I had to have my then-therapist change it, however, because of the inability to think clearly. Consequently, he changed my prescription to Zyprexa, which I'm in the process of withdrawing from due to concerns about some of the more serious side effects.
Today I saw a new therapist for the fourth time in less than two years. She refused to give me directions to taper off Zyprexa, saying that she couldn't "take part in a wrong thing." She insisted that I needed to be on antipsychotic medications, the class that has serious potential side effects, for treatment of my bipolar disorder. I told her that I was extremely worried about the more serious potential side effects of Zyprexa, such as tardive dyskinesia and diabetes. Her response was to remove Zyprexa from my prescription and add not one but three other antipsychotic medications. They are known in most countries as Clozapine, Abilify, and Seroquel, if I'm not mistaken. (I looked up the main ingredients to make sure I got the names right.)
Now, the main problem I see with this prescription is that all three medications still carry the risk of causing tardive dyskinesia and/or diabetes. Diabetes runs in my family on both the maternal and paternal sides, so that is not a risk to underestimate at all. Furthermore, I don't think the risk of developing tardive dyskinesia or any other movement disorder should be treated as small either (all highlighting mine):
Abilify:
Clozapine:
I couldn't find an exact figure for Seroquel on the same website, but the same problem is listed as a potential side effect:
Additionally for Seroquel (from the same link):
If the above statistics and other resources available online are to be believed, just one med of these carries a serious risk of developing a movement disorder that can be life-changing in many cases, not to mention diabetes. But the therapist didn't prescribe just one of these meds; she prescribed three, and if I follow her prescription, I'm supposed to take all three of them together.
This is where the problem comes in: I don't want to follow her prescription. I just don't want to put myself at risk of developing a serious movement disorder or diabetes, especially not this early in my life. The therapist told me that I would only have to be on these meds for 4-6 months, but when I asked her what would happen after I stopped taking them, she said, "You will be given an injection every two weeks to ensure that your condition remains stable." So she basically told me that I would indefinitely have this stuff in my body, thereby putting me at an increasing risk of the more serious side effects.
I'm not sure what to do from here. It's not like I enjoy living with frequent suicidal thoughts, but I'm worried so much about the possible side effects of these meds that I'm refusing to follow the prescription. The worry has literally kept me up at night on some days, and that is just from being on a low dose of one med of this class. The thought of being on three at the same time is just unbearable to me.
Please note that I'm not looking for medical advice, since I know that can't be reliably provided on an Internet forum. Instead, I'm just looking for general thoughts on the situation.
Thank you.
Second, this is going to be a long post, so if you don't feel like reading all of it, I don't blame you. I would appreciate thoughts on this, however.
With that out of the way, let's get to the thread topic: for a few months, I have been taking a class of medications known as atypical antipsychotics to treat bipolar disorder. The first one I was on, Risperdal, made me unable to think clearly. I could handle some of the relatively minor but annoying side effects like frequent urination. I had to have my then-therapist change it, however, because of the inability to think clearly. Consequently, he changed my prescription to Zyprexa, which I'm in the process of withdrawing from due to concerns about some of the more serious side effects.
Today I saw a new therapist for the fourth time in less than two years. She refused to give me directions to taper off Zyprexa, saying that she couldn't "take part in a wrong thing." She insisted that I needed to be on antipsychotic medications, the class that has serious potential side effects, for treatment of my bipolar disorder. I told her that I was extremely worried about the more serious potential side effects of Zyprexa, such as tardive dyskinesia and diabetes. Her response was to remove Zyprexa from my prescription and add not one but three other antipsychotic medications. They are known in most countries as Clozapine, Abilify, and Seroquel, if I'm not mistaken. (I looked up the main ingredients to make sure I got the names right.)
Now, the main problem I see with this prescription is that all three medications still carry the risk of causing tardive dyskinesia and/or diabetes. Diabetes runs in my family on both the maternal and paternal sides, so that is not a risk to underestimate at all. Furthermore, I don't think the risk of developing tardive dyskinesia or any other movement disorder should be treated as small either (all highlighting mine):
Abilify:
Very common (10% or more): Headache (up to 27%), akathisia (up to 25%), somnolence (up to 23%), extrapyramidal disorder (up to 20%)
Clozapine:
Common (1% to 10%): Tremor, syncope, hypokinesia/akinesia, seizures, rigidity, akathisia, vertigo, dysarthria, extrapyramidal symptoms
I couldn't find an exact figure for Seroquel on the same website, but the same problem is listed as a potential side effect:
Nervous system side effects have included agitation (20%), somnolence (18%), dizziness (11%), tremor (8%), and anxiety (4%). Hypertonia, dysarthria, abnormal dreams, dyskinesia, abnormal thinking, tardive dyskinesia, [...]
Additionally for Seroquel (from the same link):
A study of U.S. military veterans with schizophrenia has reported that patients on quetiapine (the active ingredient contained in Seroquel) had 3.34 times as many cases of diabetes when compared to patients taking decades old drugs for psychosis including haloperidol, thioridazine, and others.
Additional studies have confirmed that patients receiving atypical antipsychotics (i.e., clozapine, risperidone, olanzapine, quetiapine, ziprasidone) are at an increased risk of developing hyperglycemia and/or diabetes mellitus.
If the above statistics and other resources available online are to be believed, just one med of these carries a serious risk of developing a movement disorder that can be life-changing in many cases, not to mention diabetes. But the therapist didn't prescribe just one of these meds; she prescribed three, and if I follow her prescription, I'm supposed to take all three of them together.
This is where the problem comes in: I don't want to follow her prescription. I just don't want to put myself at risk of developing a serious movement disorder or diabetes, especially not this early in my life. The therapist told me that I would only have to be on these meds for 4-6 months, but when I asked her what would happen after I stopped taking them, she said, "You will be given an injection every two weeks to ensure that your condition remains stable." So she basically told me that I would indefinitely have this stuff in my body, thereby putting me at an increasing risk of the more serious side effects.
I'm not sure what to do from here. It's not like I enjoy living with frequent suicidal thoughts, but I'm worried so much about the possible side effects of these meds that I'm refusing to follow the prescription. The worry has literally kept me up at night on some days, and that is just from being on a low dose of one med of this class. The thought of being on three at the same time is just unbearable to me.
Please note that I'm not looking for medical advice, since I know that can't be reliably provided on an Internet forum. Instead, I'm just looking for general thoughts on the situation.
Thank you.