Should I stick with the Saphris I'm taking even though it gains appetite?
I would not be allowed to tell you to discontinue your medication, but if I was I surely wouldn't do so.
You say it hasn't worked
AT ALL in treating your intrusive thoughts, right? Then go discuss this with your doctor and see what he says. If he believes it will take some more time, you will have to be patient or get a second opinion. My guess is he will try to switch you to something else (e.g. clozapine might be promising, but this is never a first-line treatment, due to the potential side effects).
Regarding the side effects... It is a very difficult process, but you will have to start accepting the fact that you are suffering of mental illness. It is one thing hearing that or repeating it, but it is another to appreciate the implications of such illness.
You might become better over time or you might become worse. It depends a lot on the course of the illness itself, your lifestyle and the changes you have made (abstinence from recreational drugs is an excellent measure and you have my respect for that) and of course how well your medication is working (and how compliant you are with the treatment).
If you find medication that successfully treats all your symptoms, then you will have to live with some side effects. The side effects of neuroleptics are harsh and they can become much worse in the long term.
When I went on neuroleptics, I gained 30kg in 10months. That's 100g per day. It plateaued there, but it still took me some energy to accept these things. I got mad at the crappy medication, but in all honesty it did what it was supposed to do.
I'm currently on lithium which hopefully won't kill my thyroid or cause kidney damage. Eventhough I have acquired some acne since I'm on Lithium, my skin is constantly so dry it gets white and scaly in places, my eyes are burning at times due to being so dry, I'm losing hair, I experience stomach aches and nausea a lot, I have to drink 3-4 liters of water per day or I'll start having tremors and headaches, I often don't know whether I should down that next glass of water because I feel so dehydrated or go take the next piss, sometimes urine leaks out into my pants which is something I gotta be on the lookout for every time I take a leak or things will get awkward.
I don't want to whine here, but just tell you that some side effects have to be accepted if you want to function. You will only be able to accept side effects if you acknowledge the seriousness of your symptoms and the illnesses functional impairment surpassing that of the side effects. I have a daughter and have paused my studying medicine due to going into full-blown mania. I am now 30 with a daughter of almost 5. A lot of things haven't gone the way I wished due to this illness. I just want to be a functional member of society without relying on illicit sources of money to support my child and her mother (from whom I am separated). If this means becoming somatically ill, so be it. It's a trade-off.
This is why I was asking you how impaired you are functionally due to your intrusive thoughts.
Best advice I could give is to try to eat healthy, even if it's still too much and do sports to burn through some energy (both of which I am currently failing at lol). For most people the weight gain will stop at a certain level.