Many antipsychotics are actually delirants - why on earth are they still used!?

[SteamboatBillJr]

Modern anti-psychotics keep the mentally ill complacent and compliant. On anti-psychotics externally the mentally ill behave less offensively. These medications aren't particularly effective at improving the quality of life of those with mental illness. They aren't effective at eliminating negative symptoms of the conditions.

Developing medications capable of reducing negative symptoms is politically unpopular. Forced acknowledgement of what was involved in how America historically handled mental illness is unpleasant. Perhaps the mentally ill could get well. It'd be a trip if we could create medications facilitating the mental ill getting well. On this day in America, our society prefers using the "chemical straight jackets" of anti-psychotics. If anti-psychotics won't make the mentally ill less offensive our government removes them from society, incarcerating them for committing petty crimes*.

I think our parents generation was mistaken. Now America incarcerates the most people on the planet. As younger Americans we realize the mentally ill could get well without back lash while the mentally healthy keep doing what they are doing. I expect how America treats the mentally ill could become the civil rights movement of our generation. We have learned and positive changes could be made.



*Over half of the 2.2 million individuals incarcerated in America during 2006 suffered from mental illness. (Source: United States Department of Justice)

 

[Kittycat5]

I am glad you mentioned the negative symptoms as they very often are the most crippling and treatment resistant. Antipsychotics all pretty much can stop positive symptoms and while newer one may slightly help negative symptoms in some, we havent developed anything close to adequate drugs for negative symptoms.

 

[Kdem]

'acetylcholine release promoting agent'
I'm not sure, would it work that way in the brain stem too ?

 

[dopamimetic]

Theory: If these promising new drugs didn't work in the trials, maybe the trials were flawed?

Dopamine antagonism actually causes much of the negative symptoms. And few have tried to use these anti-excitatory agent I've mentioned instead of antipsychotics in the treatment resistant cases probably.

 

[serotonin2A]

E

Theory: If these promising new drugs didn't work in the trials, maybe the trials were flawed?

Dopamine antagonism actually causes much of the negative symptoms..

There are usually multiple trials performed, and in some cases they use an active control drug, so it should be obvious if study flaws are the problem.

Negative symptoms are part of the natural course of the disease. In fact, patients start displaying negative symptoms faster, and with greater severity, if they are not treated with antipsychotics. That is why it is important to medicate patients as soon as they have the first psychotic break (and even before the break, it if possible), because their long term prognosis is much better.

http://www.nature.com/articles/npjschz20145

 

[dopamimetic]

Dopamine protects neurons against glutamate-induced excitotoxicity

Glutamate excitotoxicity is responsible for neuronal death in acute neurological disorders including stroke, trauma and neurodegenerative disease. Loss of calcium homeostasis is a key mediator of glutamate-induced cell death. The neurotransmitter dopamine (DA) is known to modulate calcium signalling, and here we show that it can do so in response to physiological concentrations of glutamate. Furthermore, DA is able to protect neurons from glutamate-induced cell death at pathological concentrations of glutamate. We demonstrate that DA has a novel role in preventing delayed calcium deregulation in cortical, hippocampal and midbrain neurons. The effect of DA in abolishing glutamate excitotoxicity can be induced by DA receptor agonists, and is abolished by DA receptor antagonists. Our data indicate that the modulation of glutamate excitotoxicity by DA is receptor-mediated. We postulate that DA has a major physiological function as a safety catch to restrict the glutamate-induced calcium signal, and thereby prevent glutamate-induced cell death in the brain.

Yeah! Antipsychotics might lead to cell death, if you want to interpret this as such.

 

[serotonin2A]

Yeah! Antipsychotics might lead to cell death, if you want to interpret this as such.

That's not the implication. Under normal circumstances, glutamate isn't excitotoxic, so this putative interaction wouldn't come into play. The only time this interaction MIGHT come into play is if a patient taking antipsychotics had a stroke or experienced severe hypoxia. But in that case the antipsychitic would be the least of their worries.

It is important to add, however, that there is no evidence that this actually happens in humans. Patients on antipsychotics have strokes and there has never been any obvious evidence that they have significantly worse outcomes...

 

[bingey]

I think the benefit of antipsychotics is you can vary the drugs and dosages. In this day and age there are more than a dozen antipsychotics, back in the 50s there were only a few with awful side effects. Straight jackets only come in one size: too tight.

In an ideal situation, modern drugs can and do control the symptoms of schizophrenia or bipolar to the point where they can function in society as individuals with minimal support. That's pretty close to Biblical for people who would have ended up in an asylum neglected only 100 years ago.

It's really a game of finding out what will be best for an individual. Right now it's just a guessing game, but maybe in the future we can use epigenetics or something to figure out which medicines will respond best.

I've had Haldol 5mg IM before when I ended up in the hopsital. That was not fun, let me tell you. Then again I am pretty mentally healthy, and that's a lot of haldol for anyone.

standard dose around for troblemakers across these parts


Any one have an idea on anti-psychotics and toxicity to small pets , my lovebird just ate an abilify 15 mg that's a monster dose for such a small bird but it seems to be coping fine , just some somnolence and hyperkinesia. (that a word?) , I'm sure it would have been dead with clozapine , also I can't mkae it throw p so I'm acidifying the water (frit juice) to speed up excretion.

Does abilify (aripiprazole) significantly lower/heighten seizure treshold?


It is important to keep this drug out of the reach of pets, as ingestion can result in profound lethargy, vomiting, hyperthermia, significant changes in heart rate and blood pressure, and seizures. If a pet ingests this drug, immediate veterinary attention is needed.

damn

 

[Kittycat5]

I really dont know about your poor bird but am aware that other species handle drugs in far different ways than humans. Well the proceses are similar but rates of metabolism and such vary greatly. But go see your vet if you care about your little buddy.

 

[Epsilon Alpha]

Anticholinergic drugs are often used to help prevent/treat the extrapyramidal side effects of anti-psychotic drugs. Its not a big stretch to think that back in the 1950's to 1970's when most of these drugs were developed that that moderate anticholinergic properties could have been seen as somewhat desirable from a standpoint of trying to prevent these serious and permanent side effects from happening. Keep in mind that back in those days dopamine was known as "prolactin inhibiting hormone" and the 1970 Nobel Prize in medicine went to the discovery of its role in motor function which was uncovered in 1958/59.

The first anti-psychotic chlorpromazine was stumbled upon in 1952, and in turn was based of of a series of antihistamines in an attempt to make an surgical sedative. The backbone it was based on tends to have high affinity for H1 histamine and M1 muscarinic acetylcholine receptors, and it was used as a lead compound for many other drugs.

https://en.wikipedia.org/wiki/Antipsychotic#History
https://en.wikipedia.org/wiki/Chlorpromazine#History
https://en.wikipedia.org/wiki/History_of_catecholamine_research#Dopamine
http://www.ncbi.nlm.nih.gov/pubmed/24102938

 

[Jiraiya]

Oh noes, shouldn't have read this haha.

I was using Quetiapine intermittently for about two weeks recently to help me sleep (25mg, apart from one day when I took it in the morning too - so 50mg that day). I quit taking it about two weeks ago because I hated the groggy/dreamlike state I was in the next morning. I probably took about 8 of these pills all up.

Fortunately I heard that low doses don't effect dopamine so much. But was this usage likely to cause me any harm?

 

[mb-909]

Nope, wouldn't worry at all about possible side effects. You literally took the lowest possible dose.

@topic:

After being 13 months off my prescribed antipsychotics, I am back to my usual self (even though there is no turning back, only "evolving"). My memory seems to be pretty medicore, but I suppose living years in depression takes its affects on the hippocampol formation. At least this seems to be no direct damage to the neurons, just the pathways. All in all I am kind of "sane" again and I don't spam threads about my possible brain damage anymore.

 

[Zilpe]

The reason we don't have effective anti-psychotic medicine is simple. We don't know how any of it works. Sure we can point to different areas of the brain or varying levels of neurotransmittors but ultimately mental illness takes place at a level of abstraction that we just don't have when it comes to describing how the brain works. Developing anti-psychotic medicine today is a lot like developing anti-biotics without a germ theory. It's mostly guess work. A medicine is effective usually if the symptoms improve, or if they don't improve at least they become tolerable those surrounding them. That's what most treatment for these conditions is about, not curing the disease but making sure they can be somewhat functional in society. This isn't malicious it's just the truth of where we are when it comes to understanding the brain.

 

[yodermstr]

I used to take quite a few different antipsychotics (not at the same time) and honestly a lot of them didn't even touch the hallucinations I was just to fucking zombed to realize I was hallucinating. the little bit I've read has really interested me but honestly is hard to understand but that was my first hand input on the topic