This is not an easy question to answer; and, like most difficult questions, and most arguments, the trouble lies in defining a word, the word in this case being "safe." Neuroleptics (antipsychotics) do indeed have quite dramatic and unpleasant side-effect profiles. Many of these do get better after being on the meds for a decent length of time, and, while one can make broad generalizations, e.g. "2nd generation antipsychotics" are less likely to cause tardive dyskenesia, movement disorders, stiffness, etc. and are less likely to need something like Benadryl or Cogentin to deal with these side effects, however, 2GAs tend to have worse long-term side effect profiles, most notoriously Zyprexa (olanzapine/OLZ) and it's metabolic effects like weight gain (which is an issue with most neuroleptics, and most psych meds in general, actually, which works in at least three ways; first, they affect energy level, as does the underlying mental illness, and people often will wind up getting less exercise, and I don't mean working out, even just walking around; second, they often increase appetite; and third, they alter metabolism; this is a significant issue also with valproate/Depakote, various other drugs; carbamazepine/Tegretol is one of the only psych meds that actually tends to
decrease weight) and diabetes (for which OLZ is particularly notorious and is a safety major issue in terms of long-term health.)
However, in terms of "safety," from another angle, most antipsychotics in acute overdose are not especially dangerous (Thorazine/chlorpromazine/CPZ is a bit of an exception as it can drop blood pressure, which other neuroleptics also can, but it is still fairly safe.) This is also true of benzodiazepines. Overdosage will usually mean just being very, very sedated perhaps for quite a long period of time. This is
when these drugs are taken alone; combining with alcohol, opiates, neuroleptics+benzos, etc. can be significantly more dangerous in acute overdosage; but, as far as the drugs alone, there's a slightly-exaggerated aphorism in psychiatry, "the easiest way to die from them is to choke on them." Haldol/haloperidol, for instance, in the U.S. is usually given in a total of no more than 40mg/day, but in some places in Europe it is not uncommon to go up to 100mg/day. Obviously, side effects will worsen, the person will probably have to be placed on something to ameliorate the side effects and might take longer to adjust,
but they adjust. Life on psych meds will include dealing with side effects but it gets much, much better than in the first few days or weeks.
Severe side effects like constriction of the airway, etc. and less life-threatening but distressing symptoms like oculogyric crisis (eyes rolling upwards, etc) are rare (on the order of the rarity of drug allergies, and they usually will wind up being listed as one of the patient's "allergies" even though in the technical sense of the term they are not allergic reactions.) And they almost always occur in the first few days or so of treatment which is hopefully in-hospital. Other non-life-threatening but obnoxious and distressing symptoms like excessive drooling, mild stiffness of the muscles or tremor, etc. often can be dealt with by adding on some medications like Cogentin/benztropine or Benadryl/diphenhydramine or Rubinol/glycopyrollate or a few other alternatives.
Once balanced out, one can live a normal and productive life on antipsychotics but this is not to say that the side effect burden will disappear.
This leads us to the next question of safety.
Is the cure worse than the disease?
Why do you find yourself so frequently in the hospital? Psychosis? (Is it drug-induced or -related?) Suicide? Violence or self-harm? Something else?) To be in the hospital again and again is a clear indicator that
something is wrong. Presumably you're put on antipsychotics because you had some sort of psychotic experience or symptoms. Antipsychotics are meant to counteract that, and they do in most cases, although finding the one that works, and has the best balance of therapeutic effects to side effects, is an exercise between patient and provider that can take some time and trials of more than one drug. Some people on antipsychotics stll, e.g., hear voies, but the antipsychotics help them not to act on them or to realize they aren't real or to diminish them, etc. They aren't a cure-all but they do help, and in the case of psychosis which is either (a) dangerous (violence/suicide) or (b) distressing internally, as psychosis usually is, or (c) much like (b), making one unable to live a happy life.
(Most of what I'm saying here would apply just the same to mental illnesses other than psychosis.)
So, it's a cost-benefit analysis about the meds. Being in and out of mental hospitals, though, is too much of a cost. Some kind of treatment is needed. Neuroleptics are, apparently, the treatment that you were prescribed presumably because you were psychotic. This is necessary, people can't walk around being psychotic and be happy, productive members of society in the vast majority of cases.
Which brings us to benzos. Benzos are not treatment for psychosis. Benzos will make you feel better. They will decrease your distress, anxiety, etc.; this is what they are supposed to do. They do not, however, treat psychosis as such, although there have been studies in Europe of giving people huge (and I mean
huge) doses of Valium, and then the patient will sleep for days, and then treatment is continued and psychosis is improved, but this is fringe stuff, not typical medical practice and NOT SAFE WHATSOEVER especially if you are getting your meds not from a doctor because the withdrawal from huge doses like that is awful.
Withdrawal from neuroleptics and antipsychotics is awful, too, and underrated and ill-understood. Withdrawal from benzos is better known and more obvious.
The thing is, benzos have diminishing returns. The relief you feel from taking benzos will evetually disappear if you take them every day. They will still help to a degree with anxiety, etc. but will do nothing for psychosis. The official standard medical practice is that benzos should only be used for short term anxiety, but many if not most psychiatrists use them for much longer. There is resistance out there to prescribing benzos particularly for people who are known to have substance abuse problems which is a shame because they can be helpful, but also, benzos are not a cure all, they are a crutch, and they are extremely, insidiously addictive, to the point where going on them sometimes is nearly a lifetime decision without long term nightmarish withdrawals and post-acute anxiety issues.
Oftentimes,
both are needed, and the benzo
will cut down on some of the unpleasant side effects of the neuroleptic, but also of course will add to the sedation, but you'll get used to that. Also, it's important to be in therapy, cognitive-behavioral therapy (CBT) in particular while it won't diminish psychosis is helpful for anxiety and for getting one's life together in general; it's impportant to have supportive people around you; and it's important to examine your use of recreational drugs: is that what is landing you in the hospital? Does it help or hurt? Usually, in the long term, it hurts. Some drugs will give the feelng of relief from neuroleptic side effects, like cocaine and marijuana (cocaine actually being similar in structure to Cogentin, which is a med prescribed for side effects but which obviously has no cocaine-like effects) but they both will make psychosis worse: cocaine in the short term, marijuana in the long term and in a more insidious manner.
The most important thing is, what is right for you? What are your problems? Why do you keep going to the hospital? How can you avoid it? What drugs will help, and what drugs will make things worse? (Here I mean medications as well as recreational drugs.) The only way to find out is really by experimentation and trying different things out, psychiatry is not an exact science, eventually, some combination will be helpful, but you may have to go through trying a number of things and also you have to give them time to work and for your body and mind to get accustomed to them, which will remove a lot of the mental fog and so forth. You need a good psychiatrist/provider to work with, which can be hard to find, but will be worth his (or her, there are many wonderful female psychiatrists in particular) weight in gold. You need to establish a relationship with them, and then with that comes trust and a back-and-forth dialogue about what's needed and what helps. Benzos may come into the equation.
But DO NOT start using benzos obtained otherwise than from a doctor on a regular basis, particularly the novelties floating around the Internet (besides being unknown, people tend to wind up on obscene doses and then have their supply cut off and then wind up in an ER with doctors who don't know what the fuck the patient is talking about, big fucking mess there), but even the Xanax or Klonipin or whatever you might easily be able to get on the local black market. Your supply won't be regular and there's nothing worse than, for any of these drugs, neuroleptics, benzos, antidepressants, all of them, than inconsistent on/off dosing.
TL;DR. All drugs have pro's and con's. These include how they make you feel, and behave, and whether there's a risk of someone, most often yourself, getting hurt. Clearly you are in a place where help is needed (multiple hospital visits.) Find help. Establish a relationship. Find what works. Stick with it.
This post or any of my communications do not constitute professional advice nor do they establish a professional relationship of any kind; I make no claim to any specific professional credentials; in person consultation is essential for any medical, psychological, substance-related or harm reduction decisions. While peer support an advice can be helpful, any content posted online, regardless of it's source, cannot, by it's very nature, substitute for an in-person relationship with a clinician who has had the opportunity to take your history in the larger context and provide professional advice with all these factors, and others, taken into account.
