The problem is the stigma that comes with all these diagnoses, who will ever listen to someone who's labelled as schizophrenic, even more when it has been a drug induced psychosis etc ... and even if someone does listen to them, if you are in anticholinergic delirium, things don't make sense any more and you're not able to come up with solid arguments. You'll just get the dosage adjusted or another toxic agent on top of all. With luck, one will eventually oppose the adverse effects of the other and maybe one's able to get himself out of the psychiatry and live as a 'recovered' schizophrenic. Usually they will take the neuroleptics at a low dosage for years, in fear of slipping into psychosis again, and experiencing constant dysphoria, asexuality, obesity, whatever.
Then we have all this flawed theory and practice of giving a bunch of widely used drugs against next to every minor or major mental ailment which is like pouring kerosine into a fire for some, once I thought of it being just a problem of a particular subgroup - genetically or whatever - but the more I read, the more I think, about my own experiences, about people I've saw, met, talked with about etc. and the more scientific evidence becomes available, it seems to be a problem that is much more common and affects the majority of people in psychiatry.
The downward spiral is real, once you have the schizophrenia diagnosis, you won't get it away again.
We have serious problems out there, yeah, psychopaths mainly, people with unipolar mania to some extent ... but they won't search therapy, just that they are more often found in the upper classes of society or politics and are doing some harm to others.
I suppose if there was a subgroup of schizophrenia that had an acetylcholine deficit responsible for some of the symptoms, any amount of anticholinergic activity would be going in the completely opposite direction.
Think this is really true and might not just be a problem of a small subgroup, but many people experiencing delusions will be more sensitive to anticholinergics. Would make sense, not?
Just read
all these
reports, we have this Invega Sustenna guy here, and so on ... I think just with those here on bluelight we could fill books!
And this are only the people who are still rational enough to question about their experiences, find the right words despite being halfway in delirium and/or have people around them who care!
If you look at the Ki values for e.g. olanzapine, it's not exactly weak at antagonising the muscarinic acetylcholine receptors.
And we have all this exciting new research & evidence about inflammation (genetically and/or immune-related), glutamatergic / cholinergic / adenosinergic imbalances ...
N-acetylcysteine makes a really interesting supplement for treatment resistant schizophrenia(!!). NADPH oxidase might be another target - over e.g.
apocynin.
Because apocynin is structurally closely related to homovanillic acid, one of the major dopamine breakdown products,
this could well explain why antidopaminergics actually work, by antagonising dopamine auto receptors, more dopamine gets released & metabolised into homovanillic acid, in the end increased
oxoloacetate, less oxidative stress, less glutamatergic overexcitation etc.. Some indeed get 'antipsychotic' / anxiety / paranoia alleviating effects from
low dosages of psychostimulants, and the opposite when they wear off (rebound).
This could make a nice link to stimulant psychosis - when the dopamine gets depleted (and there's already much stress and oxidation going on from sleep deprivation), this escalates --> voila.
But then we could avoid all the dopamine related adverse effects by using a directly acting medicine!
I think we're really into something with the link of choline disruption and psychosis / schizophrenia. These posted findings about Coluracetam etc. are very very remarkable and we should look further into this for sure. Also
sarcosine is somewhat interesting.
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I've lived for around a year and a half in Southern France with a novel project where they tried to help people recovering from mental illnesses, and so countless many have all reported the same. Their problems got worse when they entered psychiatry, nobody cared, there is no time, no empathy, just labelling and medication, adverse effects and stigma.
Oh, and they had to finally close this lovely little project at the end of 2014, after years of exhausting fundraising etc. because the authorities said no (okay, and the leaders were estranged, because the funder was only psychologist and the neurologist they acquired was .. well, he was an idiot. Everybody felt the same. He didn't take the time to get to know me personally, but wanted to write me off as a 'drug addict' because I've talked a bit too much with people about medications and such..)
Just six months or so ago I watched a chief psych doc in Germany saying "You have psychosis. This won't go away, it lasts your whole life, you'll have to live with it." And he rushed away, leaving a prescription of olanzapine.
This is so crazy!
I don't say we should let them untreated at all. But the current treatment strategy is completely flawed and is certainly hurting more than it helps. It has and does destroy countless lives, so few people who experience 'schizophrenia' or 'psychosis' are ever able to live completely normal, sober, happy again without the constant fear of relapsing, hellish side effects, lasting damage, and all this shit.
If it was just about blocking dopamine, we indeed have some good agents available: Sulpride,
amisulpride (Solian),
reserpine. The sulprides actually help some psychotics much better than the traditional antipsychotics, they don't worsen psychosis for sure, but still have the akathisia and dyskinesia problems.
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I've been through all this shit. Look, I know I'm very lucky to be here right now in this sobriety, to be able to think about these things rationally and without hearing voices or seeing pink elephants outside ... or experiencing the hell of akathisia and dysphoria from dopamine blockade, etc. and so on. I've done a shitload of drugs in my life out of curiosity and self-medication attempts, and
nothing, really nothing brought me closer to schizophrenia than antipsychotics (together with all the psychiatric 'care').
Repeatedly!! I might be an extreme case, but it is the reality. I just had real luck and somehow my brain recovers very quickly. But if I hadn't managed to get the hell out of psychiatry, I'd be a babbling psychotic moron now. Granted, it's a bit weird to take a cough medicine and one for Alzheimer's daily when I don't have either ailment, but this is backed by solid robust scientific evidence and not just implications and theories that aren't proven but can't be disproven because nobody cares to look straight enough at them with common sense and see the obvious problems.
It would certainly feel much more wrong to give potentially delirium inducing medicine to people suffering from delusions. And when I'd gradually discontinue these meds, I wouldn't rush into psychosis either. I'd just be depressed, anxious, maybe a bit paranoid again.. and I've never lost hope, unless under strong dopamine blockade. This is hell on earth.
You absolutely need dopamine to feel alive and happy (and for motor skills too). And I'm not exactly proud to have achieved this state by myself, to be honest, it scares the hell out of me to see the reality so clear and the implications that come with when all say i'm such a weak person mentally, also that I have to be very, very cautious because if I'll ever get into acute psychiatry again, it will continue ... but it's okay, I won't be able to stop at last, I just happen to have this energy and hope in me that's driving me to get up every day again and be happy about the nature and the sun outside.. and that I'm free to do what I want, able to feel all these feelings..
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Really, as I've said,
many people would very probably be much better off with anti-excitatory agents like the anticonvulsants (especially gabapentin, pregabalin, tiagabin, valproate, GABOB, maybe lithium), memantine, riluzole, clonidine, sometimes even dextromethorphan or
just straight sedatives - mirtazapine, hydroxyzine, tripelennamine, trazodone, benzodiazepines, whatever.
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And look at the
Soteria project.
This is the right way to go!!
Soteria is a community service that provides a space for people experiencing mental distress or crisis. Based on a recovery model, common elements of the Soteria approach include primarily non-medical staffing; preserving resident's personal power, social networks, and communal responsibilities; finding meaning in the subjective experience of psychosis by "being with" clients; and no or minimal use of antipsychotic medication (with any medication taken from a position of choice and without coercion).[1]
Soterias were open — they had no restraint facilities for young psychotic patients, mostly at their onset. Loren Mosher, who founded the Soteria experience, showed that treating psychosis also in the acute phase is possible without using restraint methods.[2]
Soteria houses are often seen as gentler alternatives to a psychiatric hospital system perceived as authoritarian, hostile or violent and based on routine use of psychiatric (particularly antipsychotic) drugs. Soteria houses are sometimes used as "early intervention" or "crisis resolution" services.
