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Antipsychotics: to Take or to Leave?

Debater Slayer

Vipassana
Staff member
Premium Member
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:

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.
 

savagewind

Veteran Member
Premium Member
Have you tried natural remedies?
  • Omega-3 fatty acids. These oils may help improve depression associated with bipolar disorder. ...
  • Magnesium. Several small studies have suggested that magnesium supplements may lessen mania and the rapid cycling of bipolar symptoms. ...
  • St. John's wort. ...
  • S-adenosyl-L-methionine (SAMe). ...
  • Herbal combinations. ...
  • Acupuncture.
Can you learn yoga? I stretch every morning and I think it keeps my body and my mind aligned.
 

FTNZ

Agnostic Atheist Ex-Christian
Have you tried natural remedies?
  • Omega-3 fatty acids. These oils may help improve depression associated with bipolar disorder. ...
  • Magnesium. Several small studies have suggested that magnesium supplements may lessen mania and the rapid cycling of bipolar symptoms. ...
  • St. John's wort. ...
  • S-adenosyl-L-methionine (SAMe). ...
  • Herbal combinations. ...
  • Acupuncture.
Can you learn yoga? I stretch every morning and I think it keeps my body and my mind aligned.
Do you have links to any studies demonstrating effectiveness and safety of these substances in treating bipolar disorder, especially in combination with pharmaceutical drugs?
 

psychoslice

Veteran Member
I myself take anti-psychotics, without them my life would bve hell, you have to weigh it all up, is it worth going through psychosis all the time, or is it worth taking the resk of having other problems that you don't have at the moment. Quality of life is more important than quantity, well that's how I see it, schizophrenia isn't pleasant at times and anti-psychotics makes my life worth living, so it was an easy dissision for me to make.
 

Thana

Lady
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.

Easy. Get a second opinion.
Let the second doctor know your concerns and ask their medical opinion. If nothing else, they might be able to assuage your fears or just flat out tell you they don't think you should do it.
 

Debater Slayer

Vipassana
Staff member
Premium Member
Have you tried natural remedies?
  • Omega-3 fatty acids. These oils may help improve depression associated with bipolar disorder. ...
  • Magnesium. Several small studies have suggested that magnesium supplements may lessen mania and the rapid cycling of bipolar symptoms. ...
  • St. John's wort. ...
  • S-adenosyl-L-methionine (SAMe). ...
  • Herbal combinations. ...
  • Acupuncture.
Can you learn yoga? I stretch every morning and I think it keeps my body and my mind aligned.

I haven't tried any of these except St. John's Wort, and it was ineffective.

I think I could use more exercise. I walk a lot almost daily, though.
 

Debater Slayer

Vipassana
Staff member
Premium Member
I myself take anti-psychotics, without them my life would bve hell, you have to weigh it all up, is it worth going through psychosis all the time, or is it worth taking the resk of having other problems that you don't have at the moment. Quality of life is more important than quantity, well that's how I see it, schizophrenia isn't pleasant at times and anti-psychotics makes my life worth living, so it was an easy dissision for me to make.

She prescribed them for bipolar disorder, not psychosis; I only have the former.
 

Debater Slayer

Vipassana
Staff member
Premium Member
Easy. Get a second opinion.
Let the second doctor know your concerns and ask their medical opinion. If nothing else, they might be able to assuage your fears or just flat out tell you they don't think you should do it.

Correction: Fifth opinion. :D

The last three therapists (including her) prescribed antipsychotics. I'm thinking about seeking more opinions, but it is honestly a very tiresome and frustrating process to go through so many therapists and not see any improvement every time.
 

savagewind

Veteran Member
Premium Member
Do you have links to any studies demonstrating effectiveness and safety of these substances in treating bipolar disorder, especially in combination with pharmaceutical drugs?
I HATE pharmaceuticals. I have a theory that they might be useful for a while but that they might be able to train the physiology of the body.

I took that list off the internet. Anyone can do that. :)

They once called me psysophrenic. How can I be that when I can't even spell it? God damn even google can't spell it. They put me on meds and for many, many years I have been on nothing. I am OK imho. I recently enlisted in aroma therapy but I have not studied it yet. It is because I am the queen of procrastination, I have lessons in Chakras that I haven't opened yet. But I think Chakra might work. Haha
 

savagewind

Veteran Member
Premium Member
I haven't tried any of these except St. John's Wort, and it was ineffective.

I think I could use more exercise. I walk a lot almost daily, though.
Are you sleeping ok? Do you sleep restfully the whole night?
Good food, exercise and rest are a good start.
Make sure there isn't something in your environment that is making you weak.
 

FTNZ

Agnostic Atheist Ex-Christian
I HATE pharmaceuticals. I have a theory that they might be useful for a while but that they might be able to train the physiology of the body.

I took that list off the internet. Anyone can do that. :)

They once called me psysophrenic. How can I be that when I can't even spell it? God damn even google can't spell it. They put me on meds and for many, many years I have been on nothing. I am OK imho. I recently enlisted in aroma therapy but I have not studied it yet. It is because I am the queen of procrastination, I have lessons in Chakras that I haven't opened yet. But I think Chakra might work. Haha
The substances and treatments you suggested may have severe side effects and/or are ineffective for bipolar, therefore wasting money and potentially preventing a person from getting effective treatment. I think it's better to stick to recommending treatments that have been demonstrated effective and safe.
 

FTNZ

Agnostic Atheist Ex-Christian
Are you sleeping ok? Do you sleep restfully the whole night?
Good food, exercise and rest are a good start.
Make sure there isn't something in your environment that is making you weak.
Bipolar disorder is a serious medical condition and is more than just being "weak".
 

savagewind

Veteran Member
Premium Member
The substances and treatments you suggested may have severe side effects and/or are ineffective for bipolar, therefore wasting money and potentially preventing a person from getting effective treatment. I think it's better to stick to recommending treatments that have been demonstrated effective and safe.
Yes. That is practical. I think herbs have to be safe in the right amounts. They are FOOD.
 

savagewind

Veteran Member
Premium Member
The substances and treatments you suggested may have severe side effects and/or are ineffective for bipolar, therefore wasting money and potentially preventing a person from getting effective treatment. I think it's better to stick to recommending treatments that have been demonstrated effective and safe.
I googled "natural remedies" and I assumed they were natural. I can be wrong. Can't we all?
 

savagewind

Veteran Member
Premium Member
Bipolar disorder is a serious medical condition and is more than just being "weak".
I know. Disease is a reaction to something sometimes. It is like sad happens when we see something sad. I know it is more complicated than that
and sometimes it is strictly genetic but maybe it isn't.
 

Thana

Lady
Correction: Fifth opinion. :D

The last three therapists (including her) prescribed antipsychotics. I'm thinking about seeking more opinions, but it is honestly a very tiresome and frustrating process to go through so many therapists and not see any improvement every time.

Welp, It's up to you then.

Personally, I'd go with the Doc's recommendation. Pretty much most meds come with side effects, so you're probably not going to find alternatives that will be much better. Even the pill, a commonplace prescription, has side effects that can ultimately kill you.
 

Covellite

Active Member
I am not a doctor, but I know what are you talking about. I've been thorough that.
If you want to be better, you will have to take medications. Unfortunately, most people do feel better, but never feel really good.
All medications have side effects. The worst one is heavy addiction to medications. Clozapine is so addictive, that after 3 or 4 weeks you will have to take it for the rest of your life.
My advice: avoid any advice, especially from the Internet.
 

Debater Slayer

Vipassana
Staff member
Premium Member
Are you sleeping ok? Do you sleep restfully the whole night?

I was oversleeping on most nights while taking the antipsychotics. I tend to sleep well most of the time.

Good food, exercise and rest are a good start.
Make sure there isn't something in your environment that is making you weak.

As has been pointed out, bipolar disorder has nothing to do with being "weak."
 
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