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  • BDD Moderators: Keif’ Richards | negrogesic

Why's there so much hate towards antipsychotics?

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M

Mude

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Jun 6, 2016
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Central Europe
Hey Bluelighters!
(Please skip the first paragraph if you just want to see the actual topic discussed)

I couldn't find what I was looking for using the search engine, so decided to open up a thread. Apologies if a thread like this does exist after all. I also have a bit of a bad conscience for not really contributing much to Bluelight/being inactive for long, and then signing in again when I have a question...

So, basically in the past I've sometimes seen threads that discussed antipsychotics (usually threads that weren't actually about antipsychotics... Antipsychotics were just mentioned on the side). And every single time, people strongly advised against taking antipsychotics. I wish I had an example for you, but it's been a while since I saw those posts, and I'm a bit lazy at the moment. It was like they were literally "hated", which I find a bit weird on a forum where a lot of users take impure street drugs or research chemicals.

I understand that things such as neuroleptic malignant syndrome are a possible side effect of using antipsychotics, but the way I understand it, one only really has to worry about that if the medication is taken in relatively high doses for prolonged periods of time, or if two or more antipsychotics are used in conjunction.

I'm not talking about abusing antipsychotics btw (not sure if that's even possible lol, abusing a Dopamine antagonist =D). I use them for sleep, sometimes for anxiety (though I don't find them very effective for that). By now, everyone who's reading this is probably screaming inside their head "WHICH ANTIPSYCHOTIC? THERE ARE MANY DIFFERENT ONES WITH DIFFERENT RECEPTOR BINDING PROFILES."
In my case, I'm specifically talking about Chlorprothixene and Prothipendyl. I have no idea how common these are in the USA or the UK, but in Germany they're very common. I'm currently on a Buprenorphine taper (now on 0.8mg), and use Prothipendyl for sleep. I try not to take it daily, but sleep's gotten pretty bad, so recently I've been using it more regularly. Occasionally I'll switch and use stuff like Doxylamine or Promethazine instead. Pregabalin also helps somewhat. My Sub doctor seemed "happy" to prescribe Prothipendyl. He said pretty much everyone in the clinic he works in gets it if they suffer from insomnia.
I've never gotten any side effects from them (as far as I can tell), and never understood why people hate antipsychotics, or even antihistamines like Diphenhydramine or Doxylamine so much (people keep talking about how horrible the side effects are, and I just don't get what they're talking about, but then everyone's different). The only side effect that I get is a dry mouth. I can live with that.

Please enlighten me. I'd be really happy to hear/read your thoughts! Is there any danger in me using Prothipendyl (or Chlorprothixene) for sleep regularly? Apart from a possible upregulation of D2 receptors (which doesn't really sound too bad to me, but I'm a massive novice when it comes to pharmacology)...

Kind regards,
Mµde
 
Hey Mude and welcome to Bluelight. I see you're only at 19 posts, so if you should have any questions regarding how we try to operate here in Basic Drug Discussion or Bluelight as a whole, feel free to message me or any of the other moderators and we would be happy to help.

I'm not really sure if you can say that people "hate" Antipsychotics here on Bluelight. As you've mentioned, the term Antipsychotic refers to a plethora of different medications with different effects profiles, so it's hard to have this discussion with such an open-ended starting point. I think people definitely shy away from antipsychotics as recreational substances, because they typically are not found to have qualities that people are really wanting to pursue.

Also, depending on the AP in question, the effects can be fairly subtle, like say, Quetiapine (Seroquel) or very pronounced like Chlorpromazine (Thorazine). Even between these two drugs, there is a very wide gap in terms of differing effects. But, just like in your country, AP's are frequently prescribed "off-label" for similar indications. One quality that a lot of these drugs possess is the ability to sedate or induce sleep (somnolence/hypnosis). Also, newer AP's like the above stated Quetiapine, possess fewer side-effects than some of the older drugs of the class like Chlorpromazine.

Some of the older AP drugs produced a pretty wide range of side-effects. Chlorpromazine is well-known for producing severe Akathisia. This is where the term "Thorazine Shuffle" comes from, in which you might see a heavily medicated schizoid patient just kind of "shuffling" around all day, wiggling his body and his feet and such just like you might if you were in Opioid withdrawal. Some of these older drugs get a bad rap (perhaps rightfully so), because they do have such potentially severe side-effects.

I guess when we're examining this question, it might be important to separate the older AP's from the newer ones. I would use Quetiapine for sleep if I were suffering from insomnia without any fear, but I wouldn't touch Chlorpromazine. I think we can maybe hypothesize that this "hatred" that you've seen for antipsychotic drugs might be related to the older drugs which possess more side-effects than the newer ones with fewer side-effects. What do you think?
 
I think antihistamine with anticholinergic effects have so much hate is because of how severely uncomfortable and distressing they are when you take too many. For example today I took 50 mg of diphenhydramine (2 benadyrl) and only had slight dry mouth. But if I took diphenhydramine 1000 mg ( 40 benadyrl) I might start seeing bugs crawl out of peoples eyes, thousands of spiders crawl out from behind my bed, the devil laughing at me on a poster on my wall, uncontrollable sweating, pounding abnormal heart rate, ect.
 
Hey!
Thank you both for you contributions to the thread, and please excuse the late reply :)
And @ Keif' Richards: Thanks for the offer. I'll get back to you if I have any questions.

I think that makes sense. I suppose I always misunderstood people, thinking they were disliking (older) AP's even when taking them in lower doses. I personally have (luckily) never had to experience AP induced Akathisia.

Prothipendyl (the AP my doc prescribed me) is actually really old. So you're thinking I should be careful taking it (regularly)? I don't know how it compares to Chlorpromazine, I think Chlorprothixene, the other AP I mentioned is pretty similar to Chlorpromazine, but even with that I haven't had any trouble. I guess that some people are just more susceptible to the side effects.

Looking forward to any other input or experiences from people. I think I'll continue taking the Prothipendyl for sleep, mainly because I don't want to take Benzos or Z-drugs for sleep, as I'm sure the possibly resulting addiction to those substances is way worse than any mild side effects I've had from AP's.

Thank you both for the heads up. Just realising that I must have been completely misunderstanding the people who say they hate taking antihistamines or AP's. In low doses they seem to be okay. Saying that though, last night I took half a Doxylamine (25mg, I think), and I still slept terribly. It's almost like Doxylamine has lost it's effects, maybe due to cross tolerance with the antihistaminergic activity of the Prothipendyl.

Kind regards,
Mµde
 
I found Seroquel already to be kind of a hard drug to deal with, also with nasty side effects like weight gain, I now get Nozinan (Levomepromazine) prescribed, not because I'm psychotic, but because I'm a heavy insomniac, this one does not give weight gain or the compulsive need to eat once the effects kick in - luckily I did not take the Seroquel for a long time and I lost the extra weight very fast (since I use Coke and Heroin all day every day as well as oxynorm I don't eat that much normally, yet when the Seroquel started to kick in I had the compulsive urge to eat a huge lot all of a sudden).

At first I found this AP to be very strong, but without much side-effects. Now I don't even feel it's that strong anymore. I started off with 100 mg. but currently I'm on 200 mg., although they told me this AP should not create tolerance, it seems like it does... Does anyone know something more about AP's or this specific AP and building up tolerance or not? (my web searches stayed inconclusive...)

ps: it does help me sleep very well by the way, much better than Seroquel which seemed to turn my mind into a zombie-like state but not able to get me fully to sleep, which was a very creepy feeling to me; with my current AP the only side-effect that seemed disturbing but which was gone quickly, was that when I woke up I was so sedated I could not speak and definitely not properly the first hour or so I was awake somewhere not long before noon...

Thx.
 
Any doc who hands out shite like APs to nonpsychotic patients instead of a proper sleep aid just because of potential abuse capacity deserves to have a beer bong inserted down his neck and lead-saturated car battery acid poured down it, with caustic soda rammed up his fucking arse through another one. Or failing any caustic to hand, perhaps a wasp nest inserted several feet deep into his anal passageway.

Fucking cheapskatery of the worst kind.
 
I think culture has a big role. A lot of older anti-psychotics are known, justifiably or not, for being just a form of chemical restraint on unruly patients.

It's hard for a lot of people to get past overweight zombies drooling on themselves in a psych ward--I've seen this personally, including the psychotic patient pinned to the ground for a shot in his ass cheek.

That's not to say there aren't newer ones that do great things for people, and unfortunately, psychotic patients can be better off sedated sometimes than experiencing active psychosis around other psychotic patients.


(That was an interesting two nights I had back in the day)
 
Mude said:
Hey Bluelighters!
(Please skip the first paragraph if you just want to see the actual topic discussed)

I couldn't find what I was looking for using the search engine, so decided to open up a thread. Apologies if a thread like this does exist after all. I also have a bit of a bad conscience for not really contributing much to Bluelight/being inactive for long, and then signing in again when I have a question...

So, basically in the past I've sometimes seen threads that discussed antipsychotics (usually threads that weren't actually about antipsychotics... Antipsychotics were just mentioned on the side). And every single time, people strongly advised against taking antipsychotics. I wish I had an example for you, but it's been a while since I saw those posts, and I'm a bit lazy at the moment. It was like they were literally "hated", which I find a bit weird on a forum where a lot of users take impure street drugs or research chemicals.

I understand that things such as neuroleptic malignant syndrome are a possible side effect of using antipsychotics, but the way I understand it, one only really has to worry about that if the medication is taken in relatively high doses for prolonged periods of time, or if two or more antipsychotics are used in conjunction.

I'm not talking about abusing antipsychotics btw (not sure if that's even possible lol, abusing a Dopamine antagonist =D). I use them for sleep, sometimes for anxiety (though I don't find them very effective for that). By now, everyone who's reading this is probably screaming inside their head "WHICH ANTIPSYCHOTIC? THERE ARE MANY DIFFERENT ONES WITH DIFFERENT RECEPTOR BINDING PROFILES."
In my case, I'm specifically talking about Chlorprothixene and Prothipendyl. I have no idea how common these are in the USA or the UK, but in Germany they're very common. I'm currently on a Buprenorphine taper (now on 0.8mg), and use Prothipendyl for sleep. I try not to take it daily, but sleep's gotten pretty bad, so recently I've been using it more regularly. Occasionally I'll switch and use stuff like Doxylamine or Promethazine instead. Pregabalin also helps somewhat. My Sub doctor seemed "happy" to prescribe Prothipendyl. He said pretty much everyone in the clinic he works in gets it if they suffer from insomnia.
I've never gotten any side effects from them (as far as I can tell), and never understood why people hate antipsychotics, or even antihistamines like Diphenhydramine or Doxylamine so much (people keep talking about how horrible the side effects are, and I just don't get what they're talking about, but then everyone's different). The only side effect that I get is a dry mouth. I can live with that.

Please enlighten me. I'd be really happy to hear/read your thoughts! Is there any danger in me using Prothipendyl (or Chlorprothixene) for sleep regularly? Apart from a possible upregulation of D2 receptors (which doesn't really sound too bad to me, but I'm a massive novice when it comes to pharmacology)...

Kind regards,
Mµde
Click to expand...

To me the hate arises from the sometimes permanent antipyramidal and akinesia side effects. My brother has been on them since the early 70's and abruptly stopped a few months ago because (my opinion) of the overworked public mental health centers psychiatrists inability to correct the situation exacerbated by ever more restrictive health insurance prescription coverage. I was temporarily incapable of helping much because I was going thru hellish bupe withdrawal. He had absolutely no problem stopping cold turkey, is sleeping fine and seems to be as happy as ever. I can't explain it. My wife thinks the lack of testosterone due to his age has something to do with it which I think John Nash portrayed in A Beautiful Mind alluded to.
 
I can tell you one thing. Before I began my quest for ultimate drug knowledge, I had a couple of PsyD's offer to put me on drugs like Quetiapine (Seroquel) for sleep issues and I totally recoiled at the suggestion purely because of the nomenclature. In my mind, taking an antipsychotic must mean that I am actually insane. Just the name "antipsychotic" stirs up a ton of negative emotion in myself and I'm sure a lot of other folks to.

Honestly, I think a name change for some of these medications would definitely put an end to some of the controversy and conjecture surrounding their use. I mean, at this point, I think that there are far more "non-psychotic" people using these medications outside of medical indications like schizoid/paranoid disorders. Interesting topic, for sure. I'm at a point where I'm trying to find a Harm Reduction principle in what we're discussing, but I feel that we could do some good in terms of education by leaving this thread open. If I recoiled at the mention of "antipsychotic", I can only imagine that a large cluster of the general population probably would be scared away from taking these medications, which might indeed be appropriate for their conditions.
 
Knowing from experience that marketing runs pharma companies, I checked the websites for aripiprazole/Abilify and quetiapine/Seroquel, which are both antipsychotics now being prescribed for a larger, non-inpatient population.

The word "antipsychotic" is used only once on the Abilify website, and not at all for Seroquel. Instead they both may help "when antidepressants alone aren't enough" or are "bipolar medicines". The last might be worse if you don't capitalize Bipolar or include "disorder".

The thing they have in common, and why they get labelled as anti-psychotics, is antagonism of the Dopamine 2 receptor (or inverse agonism). Why they haven't been renamed "Dopey 2's" or "anti-dopes", well, there are seriously lucrative jobs out there if anyone can figure out a good one. It really is the opposite action of how methamphetamine makes you delusional, so anti-dope is somewhat accurate.

A lot of them also seriously antagonize histamine receptors, which makes them very sedating. Sometimes that's more clinically relevant than the psychiatric effects. I thought it funny that while thousands of people take cetirizine/Zyrtec for allergies, it's just a metabolite of hydroxyzine, an anti-pyschotic (if I thought it was a sinister conspiracy, well, it would mean I'm back on meth).

At the same time, bipolar and schizoid illness are things that should be immune to fuckin marketing. Like, you don't have to give your chemo drugs pretty names--I'll be just as happy with IV "Letsalldryheave" or "Learntocrochethats" if it killed my tumor.
 
Somewhat nit picky but I believe seroquel and abilify are different then a standard typical d2 dopamine receptor antagonist.

I think some antipsychotics increase the effects of ssris when a remission isnt achieved is by blocking seritonin 5 ht2a and 5ht2c receptors.

Certizine may be the metabolite of hydroxyzine but rather than conspiracy id suggest perhaps hydroxyzine like atypical antipsychotic antagonize 5 ht2 receptors which may cause a antianxiety effect.
 
Scrofula said:
Knowing from experience that marketing runs pharma companies, I checked the websites for aripiprazole/Abilify and quetiapine/Seroquel, which are both antipsychotics now being prescribed for a larger, non-inpatient population.

The word "antipsychotic" is used only once on the Abilify website, and not at all for Seroquel. Instead they both may help "when antidepressants alone aren't enough" or are "bipolar medicines". The last might be worse if you don't capitalize Bipolar or include "disorder".

The thing they have in common, and why they get labelled as anti-psychotics, is antagonism of the Dopamine 2 receptor (or inverse agonism). Why they haven't been renamed "Dopey 2's" or "anti-dopes", well, there are seriously lucrative jobs out there if anyone can figure out a good one. It really is the opposite action of how methamphetamine makes you delusional, so anti-dope is somewhat accurate.

A lot of them also seriously antagonize histamine receptors, which makes them very sedating. Sometimes that's more clinically relevant than the psychiatric effects. I thought it funny that while thousands of people take cetirizine/Zyrtec for allergies, it's just a metabolite of hydroxyzine, an anti-pyschotic (if I thought it was a sinister conspiracy, well, it would mean I'm back on meth).

At the same time, bipolar and schizoid illness are things that should be immune to fuckin marketing. Like, you don't have to give your chemo drugs pretty names--I'll be just as happy with IV "Letsalldryheave" or "Learntocrochethats" if it killed my tumor.
Click to expand...

Hahaha "letsaldriheevizine hydrochloride" for rectal administration only.
 
No nits to pick--those two drugs (and a bunch of others) are called "atypical" and their effectiveness is thought to require their effects on serotonin. What they do to serotonin gets pretty hard to put in ad copy, which may be another reason they haven't been renamed yet.

For instance, quetiapine/Seroquel is an HT1a agonist, yet antagonist at HT2A and 2C. It's also strongly anti-adrenergic. That and HT-2C role in modulating dopamine, makes it hard to unravel.

The thing the drugs called "antipsychotics" have in common is antagonism or inverse agonism at D2. If you over-stimulate the D2 receptor (like with methamphetamine) you are almost guaranteed to get some psychotic effects. That's not to say it's the sole cause of psychoses, and certainly HT2a receptor stimulation can do similar things, but that's where the terminology comes from.

They also have lots of other targets, and which one you emphasize depends on what you're trying to treat--most of them could be called anti-histamines, if you were just using them to sleep.

(My conspiracy ref. was just a joke in poor taste)
 
I could, but the picture is more than a little complicated and a long way from understood. For this forum, it's enough to say HT2c activation is directly involved in dopamine and norepinephrine release, at least in some parts of the brain. SSRIs will thus have effects on DA and NE, but there are exceptions, like fluoxetine/Prozac, which antagonizes that receptor.

I can follow you over to the pharma forum if you want to start a thread there; I'll be in between turkey bastings for the next five hours (I don't watch football or dog shows or shop and already baked three pies, so really, it's just another Thursday).
 
The number one prescribed drug is an anti psychotic to "use along when your SSRI
isnt working as good as it should" (abilify)

"Just ask your DR. for it" fucking scumbag big pharma (& alot of Dr's also)
 
Well, I don't know about hating antipsychotics as there's one I really like: Largactil, also known as chlorpromazine. It stops vomiting, every time. Possibly the best antinauseant known to man up until Zofran came on the scene. Again, it arrests vomiting. For the college kid who used to vomit BEFORE HE HAD HIS BREAKFAST with his cigarette every morning, Largactil was a blessing.

About its use on balls-to-the-wall insane patients I have no idea - but it sure works wonders for travel sickness!
 
A lot of antipsychotics are strong anti-histamines, including chlorpromazine, aka Thorazine. Anti-histamines help prevent nausea, in a way different from ondansetron/Zofran (which works on serotonin 3 receptors). Dopamine is also involved in the chemoreceptor trigger zone, so a lot of anti-psychotics have double-action against nausea.

They have awful side effects, but at least nausea isn't one of them.
 
As a rabid insomniac, I would rather stay up for 3 days straight + than take quetiapine (Seroquel).

I was prescribed quetiapine during oxycdone withdrawals and I took it once. The sleep was "dirty" and I felt worse the next day than I had with less than six hours of sleep in 84 hours. Never again with the quetiapine.

Promethazine is great for preventing nausea with a weak antihistamine effect, ime.
 
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