Mental Health best /worst ap meds

apsucks

Ex-Bluelighter
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What do you think are the most benign or least worst of all the anti-psychotics ?
 
Worst is Invega/Risperidone stay away from that shit
Best are Quetiapine (Seroquel) and Abilify (Aripiprazole)
 
^Both of those are pretty well state of the art.

The safest bet, if you must bet, and we all do in this game, is to talk to your doctor. Let them know as specifically as possible what's going on with you. Then let them choose.

Not to trivialize, but it really does matter how you define that. Overall, clozapine is the best. The others vary in tolerability and may have additional effects on anxiety or depression. From the 1950's to the 1970's, the first antipsychotics were discovered and marketed. Thousands and thousands were able to be treated in their community. One of those, haldol, is still in use today as perhaps the best one to reduce agitation. But those first ones were somewhat crude in terms of tolerability. These "typical/1st-gen" antipsyhcotics are mainly known to prevent overactivation of dopamine in limbic system, largely in the striatum.

In the 1970's, clozpaine was discovered, which remains the most sophisticated one by the highest margin. It was the first "atypical/2nd gen" antipsychotic. There followed many more of this latter class, through the 1990's. They are distinguished by also preventing the overactivity of serotonin binding to the 5-HT2a receptor (5-HT being hydroxytryptamine, or, serotonin). That may sound bad, but this specific kind of serotonin receptor should not be as overactive as it is in the brain of people with psychotic disorders.

Then what some say is the 3rd gen, perhaps not much different from the 2nd, started with abilify in the early 2000's. They might be mostly distinguished by keeping the dopamine receptor activity within a ceiling and a floor, unlike the 1st and 2nd gen that work to just provide a ceiling. They also act as the 2nd-gen does in blocking 5-HT2a Perhaps this 3rd gen is not actually that different form the 2nd. The ceiling is pretty low. Especially at higher doses. But tolerability could be superior. These 3rd-gens can really help depression at lower doses, and tend to be more stimulating at this level, kind of counter-intuitive, compared to higher doses.

All of this is neurobiological theory, though, not hard fact. The real information comes into play by what they actually do for people.

I honestly think that getting the two-week to six-month injections is a good idea. It can take six months or longer for all of the effects to sink in. At first, it may seem like imprisonment. But later on, it can really do wonders for life. Ability to think more clearly, being sociable, not ruminating on complex philosophy, energy, as so on can take time.

So my honest preference is clozapine. But they really should have a four-week depot shot for it. Past that, olanzapine with a small dosage of rexulti could be next in line. Good thing to keep in mind is what the doctor is seeing, and how they understand your grievances. For example, antidepressants might not be the best medication class for you, even if you're feeling very depressed, because schizophrenia may be the main culprit behind your depression.
 
Clozapine in general is riddled with side effects you prefer it above anything else?
 
Abilify. I once had a girlfriend diagnosed with paranoid schizophrenia and when she was on Abilify she basically was a normal person.

However, I strongly suspect that she had a bad case of Borderline disorder and not schizophrenia, her mother had her diagnosed as schizophrenic to get benefits from the state. Also I smoked weed with her a couple of times and she had a very good reaction to it, AFAIK weed is highly contraindicated to people with schizoid personality as it can send them into psychosis, while she just felt high and then sleepy. :)

Her father was legitimately schizophrenic and he needed quite the cocktail of pills to keep paranoia and violent outbursts in check.
 
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It varies from person to person, but Seroquel seems to have the least side effects.

However, I have known numerous people who took Seroquel, Abilify, Olanzapine, etc, and would avoid all antipsychotics unless you have severe psychotic symptoms caused by schizophrenia or another disorder (e.g. Bipolar 1)
The side effects seem awful and even Seroquel can permanently cause memory issues, diabetes, and severe movement disorders.
 
One of my exes was on seroquel for a while. It was bad. Several years gone by and she's kept on a mix of ADs and benzos, yup, a long-term benzo prescription as sleep aid turned out to be better than an antipsychotic.

I also know someone who was accidentally overdosed in hospital and got a permanent heart condition because of it. Olanzapine (Zyprexa) is more benign ime, with the common side effect of weight gain but less dangers than seroquel.
 
What happened to make you change your mind?
All the bad side effects not a single good effect
Just sleep, Sleep sleep, eat repeat
once I stopped it I regained my productivity and managed to tackle and finish two projects
I'm off APs from now on, either Ritalin or I won't take anything other than an anti depressant + lamotrigine
 
I wouldn't say there are best antipsychotics. Just bad stuff, bad drug. Haldol is physically debilitating. Risperdone fucked with my wit. Then you get invega which is where you get led when it's ongoing.
 
Worst is Invega/Risperidone stay away from that shit
Best are Quetiapine (Seroquel) and Abilify (Aripiprazole)

Some wisdom here. Seroquel is useful for bipolar disorder on mania but also depression. Bonuses that it helps sleep at possibly attention. Can be useful for schizophrenia, but a less powerful treatment.

Abilify appears to also be good for bipolar disorder. They have month (or several) long shots for Abilify in schizophrenia. But usually as a main medication, it's more useful for less severe forms of schizophrenia or for bipolar disorder. Also can help sleep at these higher doses, with less weight gain and less exacerbation of negative symptoms. Seems to induce less weight gain.

It's important here to understand that mental illnesses are different. But there are effective medications. They just don't always work the same way, or in the same time-frame. Antipyschotics often make people feel blah (or the equivalent) at first. It takes a good six months for them to work fully. It's not like taking Ritalin for ADHD, or Xanax for panic attacks, which tend to be fast acting, but in time the effect may diminish to an extent. With antipsychotics, it can seem that they diminish life in the immediate, but in time start to round one's life out well.

All the bad side effects not a single good effect
Just sleep, Sleep sleep, eat repeat
once I stopped it I regained my productivity and managed to tackle and finish two projects
I'm off APs from now on, either Ritalin or I won't take anything other than an anti depressant + lamotrigine

I say the following with advisement. Please understand the nuances of what I say. Also, I am not a doctor. What I'm laying down is a general idea from a layman. I'm not a doctor, and this is not medical advise, nor is it justification for taking dangerous drugs of abuse.

At the start, people need to be stabilized. This can take years. It also means that no cannabis be used, absolutely. Best to also avoid all drugs of abuse. They will screw you over in the end.

After that time period, one's brain might be strong enough to gain a net benefit from something that acts more quickly. I'm no expert, but I have a running hypothesis that ADHD meds mostly just exacerbate problems that are already present. So, by analogy, not sleeping/eating/resting for days is something that stimulants can latch onto and make you much more of a mess than otherwise. If you smoke weed and use a stimulant, the stimulant will take that mind-fuckery to another level. Same if you take a stimulant before the antipsychotic has a chance to set a solid bedrock of "sanity" in your brain. The only way to make sure that the psychotic effects of the illness have dissipated, is for a qualified doctor to not get a whiff of it under the lid there, which takes years. If they sense it, and they will if it's there, then don't even consider it.

If you've been 100% clean for years, stabilized on an appropriate dose of an antipsychotic for that long, and have an actual specific worldly reason to take a stimulant (school, work), then someone might learn to trust you, and judge that you'll be better off taking a medication while staying on your antipsychotic, than not taking your antipsychotics and self-medicating with weed or whatever. But if you have had addiction in the past, that's another reason not to give you something that can be abused. I get the frustration. But the vast majority of the rules, and the prescribers, serves to protect you, not harm you. It's really about discipline.

Again: not medical advice. This was meant as possibly shedding insight on a lot of the frustration here. I also want to be clear that I am sanctioning use of abusable drugs. I am just guessing on what might be theory behind some of these questions. The main, main thing I want to communicate, is that you must be entirely clean and take antipsychotic medication exactly as prescribed, totally stabilized, for years, before this actually becomes something possibly feasible to look at.
 
Agree with AMP: APs are good for stabilizing and then at some point you can move on to other things, but sometimes you just need APs.

Replying to @WhitePlaster: I also had a pretty bad case of borderline and started having schizo symptoms. Started taking olanzapine, was on it for 2 years. Couldn't finish uni and dropped out cause I was so sleepy all the time, but it kept me safe and eventually I stabilized.

I eventually stopped taking. The WD was awful -- felt like I was going to pass out and die for 2 weeks straight, and I also had brain zaps -- my partner had to take care of me for a big part of it.

But nowadays I don't need to take any psych meds, only stuff to help with insomnia. I recommend olanzapine. I also took Risperidone for any manic episodes, as I also have bipolar.

Hope that helps!

💜
 
Abilify. I once had a girlfriend diagnosed with paranoid schizophrenia and when she was on Abilify she basically was a normal person.

However, I strongly suspect that she had a bad case of Borderline disorder and not schizophrenia, her mother had her diagnosed as schizophrenic to get benefits from the state. Also I smoked weed with her a couple of times and she had a very good reaction to it, AFAIK weed is highly contraindicated to people with schizoid personality as it can send them into psychosis, while she just felt high and then sleepy. :)

Her father was legitimately schizophrenic and he needed quite the cocktail of pills to keep paranoia and violent outbursts in check.
I'm a schizophrenic and weed has no adverse effects neither do hallucinogens
 
I'm a schizophrenic and weed has no adverse effects neither do hallucinogens

At this point in the research, psychedelic hallucinogens may not be entirely contraindicated with schizophrenia in a few circumstances.

As for weed, things get more complicated. There are so many substances in weed so that two given strains can feel very different, even if they have the same delta-9-THC levels. Also, phytocannabinoids and the endocannabinoid system have not been well-researched, probably partly by refusal to allow people to use it (S-I status), but also because it's just much more complicated than looking at monoamine, or GABA, or endomorphin activity.

I think a good substantiated example would be that there can be very therapeutic effects and very detrimental effects at the same time, when using the product. It can be easy to kind of push out the view of the negative effects by citing the positive ones. Another idea would be that marijuana can help with a variety of mental illnesses like PTSD, depression, and insomnia, but is possibly as far off as can be when looking at helping psychotic symptoms. Something that can be used to help sleep isn't something that would logically fit in place with regard to also increasing psychotic tendencies.

Another idea would be that people are discriminated against if they have schizophrenia, so that weed could allay that trauma, but again, can make organic symptoms worse. Weed may also help some autistic symptoms in concert with a healthy CBD dose, which can appear similar to some symptoms of schizophrenia, but not the same. People can rationalize use that way, however.

I've known lots of people with schizophrenia who say it helps them. The truth is, it probably helps them and hurts them. But the hurt is of quite greater magnitude than the help, especially with most weed of today. That's what psychiatry agrees upon. Every weed user with schizophrenia whom I know, said it helped them when they were on it, then said it didn't help them at all when they were able to be clean. Also by observation, these people looked considerably more sick when they were smoking weed.

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Lol vote me for prime minister.

I don't think that doctors do a great job of detailing out one's prognosis. But then again it can't be easy to tell where someone's mind is, especially if that someone is supposed to be exceptional in not thinking like the masses. At that point it's like an "when you grow up, you'll understand" thing, which can feel positively condescending, and made worse because of how harsh we can be to people, including ourselves. I think that most mental health patients have some mood instability already. Pair that with feeling condescended to, habit, social issues, and usually some kind of drug use, and you get a volatile mixture such that most people won't want to trust mental health authorities.
 
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