Mental Health Antipsychotics Vs Diabetics Routine

Yes they can help in the short term to stabalize a patient and help them get needed rest- but thats where it should end. I dont believe in being prodded to take a pill that may or may not prevent relapse compared to those who arent taking medications. Theres no way to say the drugs are preventing relapse or the person. But i dont want to be the one thats commanded by some higher authority who thinks there working in my best interest to choose which way I go.

Indeed, I agree with you. The problem, which you yourself acknowledged, is that stopping these drugs (or practically any sedative) suddenly will often cause severe withdrawal symptoms. Doctors unfortunately also frequently see these drugs, much in the same way as they do with benzos and antidepressants, as some kind of cure rather than what actually are in most cases, which is a crutch to help people get back on their feet after a major breakdown, and which should be gradually tapered down and discontinued as the patient metaphorically re-learns how to walk.

The reason I suggested asking for a lower maintenance dose is that it's a tactic that's more likely to convince your doctor to concede than if you immediately discussed a discontinuation. Further down the line, once you're stabilized on your new "maintenance" dose (presuming you have no problems), you can, whenever you're comfortable, once again request a reduction in dose to a level below that, eventually reaching the point where your dose is small enough that you can reasonably suggest a complete discontinuation of the drug from your actual dose. You'd effectively be conducting your own slow taper off your medication without ever actually affirming so or saying anything else that could raise any red flags with your doctor.
 
To be honest it doesn't matter what the root cause is: it's the symptoms experienced that are neurological/biological in nature. Plently of research has found specific areas of the brain responsible for different symptoms, for example, frontal lobes, hippocampus and temporal lobes. The dopamine hypothesis is really interesting albeit further research shows it's by no means the be all and end all but certainly plays a big role in symptom production - hence why antipsychotics are prescribed; they work on the dopamine pathways to reduce and hopefully eliminate symptoms experienced in the same way that insulin/metformin reduce symptoms from diabetes.
 
To be honest it doesn't matter what the root cause is: it's the symptoms experienced that are neurological/biological in nature. Plently of research has found specific areas of the brain responsible for different symptoms, for example, frontal lobes, hippocampus and temporal lobes. The dopamine hypothesis is really interesting albeit further research shows it's by no means the be all and end all but certainly plays a big role in symptom production - hence why antipsychotics are prescribed; they work on the dopamine pathways to reduce and hopefully eliminate symptoms experienced in the same way that insulin/metformin reduce symptoms from diabetes.

The symptoms dont prove its biological. Even brain scans shown that London taxi cab drivers brains change in specific regions due to their experience driving. Brain changes can occur but they shouldnt be right away correlated with a biological cause, rather a developed trait be it from coping with trauma or learning the streets of London blindfolded.
 
Invega is a very strong sedative (and according to some reports I've read, not particularly effective as an antipsychotic, although I guess that really depends on your definition of psychosis) and seems an unusual choice for a first-line treatment. What led to you being put on it?

Actually Paliperidone is hardly a sedative at all as it lacks any anti-cholinergic or any anti-histamine effects that make Olanzapine and especially Quetiapine such strong sedatives to most people. Like Risperidone which Paliperidone is the main and only active metabolite of it's a potent D2 Antagonist and 5-HT2A Antagonist that lacks any real sedative effects though it can cause a zombie type effect which is common with the high potency D2 antagonists. Risperidone and Paliperidone are basically like the Haloperidol of Atypicals in that way though they are not neurotoxic to the best of my knowledge like Haldol and some other Typical high potency D2 antagonist anti-psychotics are. Quetiapine would be more like Chlorpromazine or Methotrimeprazine in the fact that although Quetiapine is a potent H1 antagonist and it's main metabolite Norquetiapine is a fairly strong anti-cholinergic and thus is very sedating it's not a potent Atypical anti-psychotic as you have to hit a certain dose (usually 200mg's or more) before it even starts acting as a 5-HT2A receptor antagonist and only at higher doses still does it start acting as a D2 antagonist at all. This is one reason why with Quetiapine alone EPS side effects are rare and Tardive Dyskinesia with Quetiapine alone with no previous use of anti-psychotics is almost unheard of. So while Paliperidone is a potent anti-psychotic it is not a strong sedative.

I have taken Risperidone for a good year everyday at doses of 2-4mg's depending on how bad my mania or mixed state Mania was. I find it somewhat unpredictable in treating mania as it has sometimes turned it into dysphoiric mania. I find Quetiapine and especially Olanzapine to work much better for Bipolar but that's just me. But i know lot's of people with Schizophrenia who have taken Risperidone and Paliperidone who found it worked well.
 
That's odd; I found Risperdal rather good at putting me to sleep, although I too prefer Seroquel as my nightly mood stabiliser (or mood annihilator, as I personally consider it :) ). I disagree with you that a potent D2 antagonist == a potent antipsychotic, however, much as a strong SERT inhibitor doesn't necessarily imply an effective antidepressant.
 
That's odd; I found Risperdal rather good at putting me to sleep, although I too prefer Seroquel as my nightly mood stabiliser (or mood annihilator, as I personally consider it :) ). I disagree with you that a potent D2 antagonist == a potent antipsychotic, however, much as a strong SERT inhibitor doesn't necessarily imply an effective antidepressant.

Well that just shows how everyone is different because Risperidone can actually give me insomnia. I find it zombifying unlike Quetiapine and Olanzapine but not sedating. The Typical anti-psychotics are ranked in potency by how strong of a Dopamine antagonist they are. For example Pimozide (brand name Orap) is a even higher potency anti-psychotic then Haldol. But D2 antagonism does not directly correlate with how well they work in Schizophrenia or Bipolar disorder as Clozapine the first atypical anti-psychotic tends to work when nothing else does and it works completely different then most Typical or Atypical anti-psychotics. Also Serotonin antagonism and other receptors play a part as well.
 
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