antipsychotics

Question

Hi, doing some research about antipsychotics, i am very scared of what i have found. It seems that there is substantial proof that it shrink the brain at a rate of 1% by year. Studies with healthy monkeys show the same thing. There is also risk for cardiovascular system, weight gain, diabete risks and very problematic nervous system risks. My doctor wants to prescribe me an antipsychotic for my sleeping problems and anxiety problems (I do have a probable diagnosis of bipolar disorder). I have found that the comity of the FDA think that seroquel as too much health risks to be prescribe for anxiety. That doesnt seems to prevent psychiatrist to prescribe it whatsoever...

I would like to understand how we do prescribe a medication that was design for squizophrenia, which is probably a brain degenerative illness in the first place, that may shrink non-squizophrenic patient brain around the mesolimbic pathway without knowing the exact outcome in the long term? I am very afraid to loose mental capacities or to develop other mental problems in the long run. Is there any information about this issue ?

lindahand · Accepted Answer

I won't say don't take the antipsychotic, but I will say that you need to have a more complete discussion with your pdoc. Make sure you do some research going in. Crazymeds (google it) is a good site. They tend to lean towards the medication side of things but are very honest about side effects.

There is a lot of information through google but none of it very useful. It is either fear mongering (if you take this you'll be stupid as a two year old in 20 years) to the sunshine and roses (don't worry nothing bad will happen to you. You will spin in happy circles on a beach next to the ocean taking this medication). I talked to my pdoc about it and he said that they don't know the clinical significance of the brain shrinkage such as if it is in critical structures. He also said that for people like me there is a greater risk not taking the medication. Death by suicide is a very real side-effect of a life without medication for me.

If I had anxiety with the possibility of bipolar 2, and was functioning fairly normally. Able to hold a job, had a few friends, mostly decent life, wouldn't touch the stuff. It simply has too many side effects to use it as a sleep aid. There is medication like buspar which is designed for anxiety and is off patent so won't cost you thousands of dollars a year. Lamotrigine, although not an anxiety drug, has a much lower side-effect profile in terms of bipolar medication. Trazodone with is an older antidepressant can also be used for sleep. Again at a much reduced cost compared to antipsychotics.

Every time a new drug comes out doctors tend to forget about the old drugs that work just as well. 

Note of caution. Make sure you don't come across as 'I know best'. I have heard way too many people who go into pdocs armed with their new found knowledge to be shot down. And the pdoc is the only one with the prescription pad. They are human and you don't want to bruise their egos. I find it works best when I bring up the issue, say what I want to happen, let them talk about what they think is best, and together we come up with a compromise. I may not always agree with my pdoc but I respect him. If you can't respect your pdoc - get a new one. Your brain is too important to be messed with.

Good luck. Navigating the medication waters is tough.

looloo141 · Answer

I am on Seroquel XR and I cannot find anything wrong with it to be honest, as far as side effects are concerned I haven't had any in comparison to other anti psychotics that I have been on.. Sulpiride, Risperdal and Olanzapine..being on the extended release Seroquel is a lot different to the instant release one where people have described quite strong side effects.
After the first few weeks of being on Seroquel ( the first few weeks on any med can be hard, side effects are stronger at this time ) I did not notice any changes to my cognition, some mornings I feel a little drowsy but it is well worth it, as without the Seroquel i do not sleep and life is pretty tense.
Everyone is different and I think we all have a journey to go on with the meds, my Pdoc sometimes gives me a choice between different meds that do the same thing, but he always makes me aware of the side effects, he knows I am a control freak and it's better to give me a little control rather than me not taking the meds.
I hope you find the right pathway for you ...

lilymoon · Answer

I have no info but I can tell you this;I am on anti psychotics and I rather live a little shorter maybe but have quality of life then suffer and live longer.

ILADVOCATE · Answer

The issue with the brain shrinking is unproven and is controversial and may not exist. The concerns about weight gain and diabetes are realistic, cardiovascular concerns depends on the specific medication and short term and long term movement disorders are another standard concern. All of this information is on the medication website and you could discuss it with your psychiatrist. The risk/benefit ratio is worthwhile when an antipsychotic is prescribed to treat psychosis or associated concerns. If they are prescribing it only for anxiety and sleep concerns there are other options and if you have concerns you could speak to them about this.

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