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Mental Health Psychiatric Treatments Debate vs trot out your medications bias and lemme at it

Hilary, the NIH article you linked to does not at all support the idea that antipsychotics damage one's brain. It merely suggests that medication is not always necessary long-term.

They describe the following pattern across these studies: (a) within the first 6-10 months after discontinuation, 25-55 percent of patients relapse; (b) for those who do not relapse during this period, subsequent relapses are much less frequent even after prolonged periods off medication.

This fits with what is already well-known about mental illness - that the severity of the illness is unique to each patient. Quite a few patients only experience one severe episode in their lifetime. Others will relapse consistently regardless of variables in one's life, and the article accounts for this. For some people, remaining on medication long-term might impede a full return to wellness. For others, discontinuing medication can be disastrous ... Neither first nor second generation antipsychotic medications do much to help with the so-called negative symptoms (lack of feeling, lack of motivation) or the problems with attention and judgment that may be major barriers to leading a productive, healthy life. Family education, supported employment, and cognitive behavioral therapy have all demonstrated efficacy in reducing the likelihood of relapse events, increasing the ability to function in daily life, and improving problem-solving and interpersonal skills. The article acknowledges that antipsychotics are quite useful in the short-term for most patients, and that they are not a cure-all for the other factors that can inhibit lasting recovery. And it also acknowledges that patients with severe cases need to stay on their medication long-term.

The "less is more" approach that this article suggests is also true for other areas of medicine as well - take chronic pain illnesses, for example. It's not wise to rely solely on script opioids to manage pain, because of both long-term side effects and essentially training the mind that the drug is the only method of getting relief. I've dealt with a number of pain management doctors over the last several years, and all of them follow this protocol. They want the illness to prove that strong opioids are necessary for the patient to find relief, and the want the patient to try other methods as well (acupuncture, dietary changes, exercise, physical therapy, etc.) But there are still numerous cases where the patient is doing all they can, and strong drugs are still necessary for them to have a decent quality of life. It's a trade-off between long-term risks and current relief, and the medications should periodically be re-evaluated to determine their necessity. This all applies to mental illness - medication should never be the only thing used, and nobody on this board argues for that. But there are plenty of us who have dealt with severe, recurring illness, who have done plenty of other therapy, and still need long-term medication to function well in their life. When you make such broad, blanket statements about medications, you're offering shit advice to a large percentage of the people who come here. The best person to evaluate the usefulness and necessity of medication is the patient's doctor, and I am consistently offended when you implicitly encourage people to distrust their doctors.

We realize that for too many people, today’s treatments are not good enough. New, better treatments are essential if we are to improve outcomes for all – that is the promise of research. But in the meantime, we need to be thoughtful about the treatments we have. Clearly, some individuals need to be on medication continually to avoid relapse. At the same time, we need to ask whether in the long-term, some individuals with a history of psychosis may do better off medication. This is a tough call, where known risks need to be balanced against potential benefits.
 
So silver wheel have you ever tried to stop the AP 's since you started? For a good length of time? I'd be interested to know. Have you heard of paws? And how it is with A P'S? And the reason for lapse. Hillarys a bit of a legend and talking the most sense here.
 
Interesting thought! Yeah it is possibly healthier to just get a simple job and use street drugs to medicate ones self. I:m addicted to goddamn seroquel, but I will admit it makes me feel better it seems. No more sleepless nights. Well mostly. I think the doses are too big for many on APs. True Bi Polar or Schiz is some hardcore shit, I think I am one of those people who could develop an illness if I kept fuckin wit speed or alcohol. Meds can stop the illness in its tracks iirc.
They do for a time but they deplete my dopamine and make me fat and lazy. Its either anti-psychotic and a lifetime of being a fat lazy fuck on disability or just dealing with my miserable bipolar life with drugs I earn by working. I choose the later. Its not the same for everyone some people totally turn their live around with the shit but ALOT of people are in my situation. Its easier for me to work and drink the monsters away than to just sit around in a fat lazy stupor.
 
So silver wheel have you ever tried to stop the AP 's since you started? For a good length of time? I'd be interested to know. Have you heard of paws? And how it is with A P'S? And the reason for lapse. Hillarys a bit of a legend and talking the most sense here.


No one can be a legend if they don't accurately represent the information they're posting.

Yes I have tried going off meds before. I was off AP's for almost ten years before I went back on them. In my case, I should have stayed on them the entire time. I would have spared myself a lot of suffering if I had done that. I've since decided to stay on them long-term because I don't want to end up like my uncle, who lost his life because he couldn't accept his diagnosis and his necessity for medication. So yes, I'm greatly offended by people who make sweeping statements about meds. Not everyone needs to stay on their meds long-term, but plenty of us do, and if their doctor wants them to stay on them, that's what they should do. It is wrong, and dangerous, for Hilary to act like she knows more than doctors, and to imply that people shouldn't trust their doctors.

deadendgame's doctor wants him to take his meds - that's the only opinion that matters.
 
Anti-psychotics make you feel numb, but whether that's "better" is debatable. They're not considered drugs with abuse potential so that says something. Although in jail there is a thriving underground trade in quetiapine. But people have problems sleeping in there so i suppose they are taking 'em not to get high but rather as a tool for sleep.
 
…you're offering shit advice to a large percentage of the people who come here. The best person to evaluate the usefulness and necessity of medication is the patient's doctor, and I am consistently offended when you implicitly encourage people to distrust their doctors.

I apologize that I didn’t initially read Desden’s post correctly. He’s been on medication for 19 years, starting at 19 years old. He may have trouble getting off his medication at this point. But that’s not to say it’s impossible. He would probably need a competent and sympathetic (meaning agreeable) professional and a trusted friend to help him. Few, if any, doctor’s will recommend CBD oil to help with symptoms. However the Mayo clinic has published recommended doses for CBD to treat schizophrenia. It says to take 40-1280mg for up to 4 weeks, but it’s perfectly safe to take 25mg a day for long term neuroprotective effect.

Mayo Clinic Dosing Guide
Hilary, the NIH article you linked to does not at all support the idea that antipsychotics damage one's brain. It merely suggests that medication is not always necessary long-term.

True – not in that NIH article. That’s in the U-tube video from mainstream psychiatric studies. I would suggest that shrinking brain tissue is a fairly significant indication of brain damage.
Antipsychotic drug effects on brain morphology…

“Along with brain shrinkage, antipsychotics also can cause obesity, high blood pressure, high cholesterol and diabetes”, pancreatitis, tremor and even death.
Honey, They Shrunk My Brain

If you don’t like that study link, there are plenty others. Everyone should do this type of research.

A dose reduction/discontinuation strategy improves long-term recovery in people with remitted first-episode psychosis compared to maintenance therapy.



One must be open minded enough to realize that there are probably better treatments than neuroleptic drugs. Obviously a psychiatrist has a vested interest in ensuring that he has repeat customers. Like it or not, the psychiatric model is badly flawed and doesn’t bode well for the future of psychiatry, in general, unless they start looking to science instead of pharmaceuticals for answers.

With all due respect, I disagree with your response, with 2 exceptions.

  1. Some people who have been on anti-psychotics for a long time, may or may not be able to successfully get off of them. (So in Dresden’s case, he should proceed cautiously)
  2. A small number of people will continue to have psychotic symptoms, regardless of their treatment,for whatever reason. This is because medical science just doesn’t have the right answers yet. But I think it makes sense to try non-destructive treatments first.

Either way, I feel strongly that it should be the patient’s choice, as long as they are not a danger to anyone, to live with their psychosis, take meds, or not take meds. Compassionate care and support should be the primary focus. Doctors often give bad advice – especially in the psychiatric field.
 
Anti-psychotics make you feel numb, but whether that's "better" is debatable. They're not considered drugs with abuse potential so that says something. Although in jail there is a thriving underground trade in quetiapine. But people have problems sleeping in there so i suppose they are taking 'em not to get high but rather as a tool for sleep.
Who gets to decide that anti-psychotics make me numb? There were a few I tried that did and I told my doctor and so we tried others and I found a combination of meds I felt great on. A lot of you are making these generalizations that these drugs make us all feel the same way even though like anything else they have common side effects.
Tylenol PM keeps me up at night, but I'm not going to say "Tylenol PM doesn't work, it keeps you up at night." Because maybe it knocks you out.
I'm sorry if you've had negative experiences with AP's or if you can control your specific illness without meds, which is great by the way, but lots of us consider them life saving and might argue we felt more numb before them.
 
What's wrong with mania? Some of my most profound moments came from manic states... in combination with altered states of mind (shamanic states). I used to come up with some of the best jokes... like jokes that would blow your fucking mind how well-put-together they were.

I've experienced the elated "happy mania" and it remains one of the most positive experiences of my life, so I can understand why someone who "specialises" in that brand wouldn't be too keen to medicate it away. For those of us whose mania is more like high-energy paranoia, anger, anxiety and negativity, though, medications that stabilise us can be a god send. And, you know, bonus points if you'd actually like to live the kind of life that frequent mania can get in the way of, like having a steady job and getting an education and having relationships that don't border on emotionally abusive.

Psychiatrists say that it is important to use antipsychotics. However, antipsychotics lead to shrinkage of the brain, and this effect is directly related to the dose and duration of the treatment. Hundreds of thousands of people have suffered serious debilitating, often permanent side effects from their prescribed medication, have much shorter life expectancies, and are often permanently disabled.


Between 15 and 17% of people with bipolar take their own lives. Suicide is the leading cause of death for people in the youth bracket in Australia. Bipolar disorder is a ongoing degenerative disorder that has physical, measurable, permanent effects on the brain that get worse with each episode. I'll take the medication side effects, thanks.

Psychiatrists have no idea about which interplay of psychosocial conditions, biochemical processes, receptors and neural pathways that lead to
mental disorders. The theories that patients with depression lack serotonin and that patients with schizophrenia have too much dopamine have long been refuted. Yet they continue to quote the “chemical imbalance” argument to justify prescribing drugs. Dissenting psychiatrists must remain quiet in their objections for fear of hurting their careers.


This is a complete misrepresentation of the current psychiatric research and development environment. And you're the only one in this thread who has mentioned the outdated serotonin/dopamine deficiency hypotheses.

Good plan IMO! Yeah Haldol can help in a dire emergency. But when you look at the long term prognosis of people on anti-psychotics – it’s bad. Not just the side effects – but your original symptoms become treatment resistant. The longer you stay on anti-psychotics the more damage they do to your brain. But be sure to taper down, don't just quit.

This doesn't reflect my experience at all. I haven't had a single episode since I was stabilised on antipsychotic medication over four years ago.

Anti-psychotics make you feel numb, but whether that's "better" is debatable. They're not considered drugs with abuse potential so that says something. Although in jail there is a thriving underground trade in quetiapine. But people have problems sleeping in there so i suppose they are taking 'em not to get high but rather as a tool for sleep.

I really wish people would stop perpetuating this myth. SOME antipsychotics make SOME people feel numb. This is a side effect, not a function of the medication, and if it happens to you you should consider talking to your psychiatrist about trying a different medication. I don't feel "numb" at all on my current medication mix - it just makes me feel like a normal, functional human adult with normal, manageable emotions.
 
I think that no amount of scientific research on the dangers of prescribed neuroleptic drugs will ever get through to someone who thinks that their lives were saved by drugs.

If you are only able to refute the most current science with your personal experience, that's not a very good argument.

I think it's fine if medication helps you and you are convinced that nothing else will ever help. That's your choice. But I'm against telling everyone else to do what you're doing, when it's clearly predictive of a bad outcome. The most recent scientific studies show that for 90% of those who experience a psychotic episode, the best long term outcomes are for those who don't take any AP's, second best is for those who take a short term regiment of APs, and it's the worst for those who stay 'medication compliant'.
 
It's more like that the data shows them to be helpful more than not, if prescribed appropriately, in the long run.

What it largely comes down to is opinion, but the science cements their validity. Whatever works.

I don't think many people claim that. Medication is essential, but it is by no means the only way to improve one's mental health. Please stop spreading false information. If you're going to make an outlandish claim, back it up.
 
Who gets to decide that anti-psychotics make me numb? There were a few I tried that did and I told my doctor and so we tried others and I found a combination of meds I felt great on. A lot of you are making these generalizations that these drugs make us all feel the same way even though like anything else they have common side effects.
Tylenol PM keeps me up at night, but I'm not going to say "Tylenol PM doesn't work, it keeps you up at night." Because maybe it knocks you out.
I'm sorry if you've had negative experiences with AP's or if you can control your specific illness without meds, which is great by the way, but lots of us consider them life saving and might argue we felt more numb before them.

Ease up turbo. That was my opinion. Last time I checked, BL was made up primarily of opinions. I'll rephrase lest I hurt your feelings again: Antipsychotics can make SOME people, including me, feel a sensation akin to "numbness". Better?
 
I think that no amount of scientific research on the dangers of prescribed neuroleptic drugs will ever get through to someone who thinks that their lives were saved by drugs.

If you are only able to refute the most current science with your personal experience, that's not a very good argument.

I think it's fine if medication helps you and you are convinced that nothing else will ever help. That's your choice. But I'm against telling everyone else to do what you're doing, when it's clearly predictive of a bad outcome. The most recent scientific studies show that for 90% of those who experience a psychotic episode, the best long term outcomes are for those who don't take any AP's, second best is for those who take a short term regiment of APs, and it's the worst for those who stay 'medication compliant'.

Hilary, the science does not support what you claim - and articles you link to contradict your conclusions. This is no different than lying. The NIH article you linked to earlier acknowledged that AP's are an effective acute treatment, and that many patients need to stay on them long term for their health. But this conveniently was left out of your post. You also seem to have trouble understanding the difference between causality and correlation - nowhere did the NIH say that medication caused the negative outcomes, but you used that article to support your claim. Don't forget that this thread was started not as a general discussion, but as the thoughts of a person who's having trouble taking their meds. You haven't come out and said it explicitly, but you are trying to convince the OP to quit his meds with your repeated attempts to hijack this thread to your liking. You are violating the spirit of the first forum rule if not the letter, and you are doing more harm than good. Your general thoughts are welcome in the thread created for general discussion, but as specific advice to this OP, they are not.
 
I have been backing up my claims, repeatedly.

Long-term Antipsychotic Treatment and Brain Volumes

Effects of long-term prolactin-raising antipsychotic medication on bone mineral density in patients with schizophrenia with schizophrenia

The dementia antipsychotic withdrawal trial (DART-AD): long-term follow-up

A Call for Caution on Antipsychotic Drugs

Does Long Term Use of “Antipsychotic” Drugs Result in More Disability, and More Psychosis?

Long-term Antipsychotics – making sense of the evidence


Antipsychotic Drug Side Effects
[h=1]Abilify Is Top-Selling U.S. Drug -- But New Reports Question Long-Term Antipsychotic Use, Cite Need for Personalized Services[/h][h=1]A psychiatrist thinks some patients are better off without antipsychotic drugs[/h]Anatomy of an Epidemic (A Case of Investigative Journalism)

I could go on and on with more links to data implicating the dangers of the long-term use of Psychotropic drugs. It’s surprising really, considering most drug studies are funded by pharmaceutical companies with a vested interest in showing the long-term efficacy of psychotropic drugs. So far, they have not been able to do that.

Opposing viewpoints may be found with the Royal College of Psychiatrists, Psych Central, etc. One pro-drug blogger (i.e. Natasha Tracy, who is diagnosed with ‘bipolar disorder’) will even go as far as suggesting that brain shrinkage could be a good thing. Really?
 
I think that no amount of scientific research on the dangers of prescribed neuroleptic drugs will ever get through to someone who thinks that their lives were saved by drugs.

If you are only able to refute the most current science with your personal experience, that's not a very good argument.

Nah, dude, the current scientific literature supports antipsychotic medication as an effective treatment for psychotic disorders and bipolar I where psychotic features may be present. You're not presenting "the most current science", you're googling and linking to sites that include antipsychiatry propaganda and alarmist clickbait media. If you have access to a university database, I can provide you with the names of some actual clinical trials about medication efficacy and prevalence and severity of side effects in randomised control trials. I mentioned my personal experience because a) it's in line with the scientific consensus and b) you personalised the issue by talking about people's individual symptoms and how they respond to medication.

I think it's fine if medication helps you and you are convinced that nothing else will ever help. That's your choice. But I'm against telling everyone else to do what you're doing, when it's clearly predictive of a bad outcome.

There's literally nothing stopping you from reading through the past threads on this forum where I and other posters go to great lengths to support individual choice when it comes to medication and encourage people to make informed, individual decisions about their own management of their mental health. No one but you is attempting to universalise their experience into "one size fits all" advice.

The most recent scientific studies show that for 90% of those who experience a psychotic episode, the best long term outcomes are for those who don't take any AP's, second best is for those who take a short term regiment of APs, and it's the worst for those who stay 'medication compliant'.

Efficacy rates for antipsychotics vary wildly depending on diagnosis, age of onset, comorbitities and symptom and treatment history including compliance, so the data from models that assess all patients being treated with antipsychotics who have ever had a psychotic epsiode is not that useful for evaluating success or long term suitability of antipsychotics. However, the research that has been done on this model is generally reflected in systemic reviews as about a third of people experiencing ongoing relief of symptoms, about a third of people failing to achieve any kind of remission, and about a third of people falling somewhere in the middle. The role of the kindling effect in worsening symptoms of bipolar disorder strongly precludes spontaneous remission of symptoms without treatment or with poor treatment compliance - although some people with bipolar are perfectly content to manage their symptoms without medication.

Your sentence is essentially meaningless because you're being (deliberately?) unclear about whether the "best long term outcomes" you refer to are about symptoms or side effects.

Most research on long term efficacy of antipscyotics in treating schizophrenia has found statistically significant positive outcomes for positive symptoms (regardless of which approved antipsychotic is used) and less clear results on cognitive and negative symptoms, with side effects rather than lack of efficacy being the most common reason for discontinuation. The most common side effect cited as reason for discontinuation with almost all antipsychotics is weight gain, not whatever weird "symptoms getting worse rather than better" shit you've made up. It's well known in the mental health field (and in no way denied) that there are long term health outcomes and an increased mortality rate from side effects of antipsychotics, but that doesn't necessarily equate to people's survival rate or quality of life being worse than if they had experienced the same symptoms and taken no medication, whether on an individual or population level.
 
Hey, everyone, it's your long-lost moderator Herby here popping into the thread to remind everyone that THIS THREAD was created a while back for just such a situation as this. The OP asked a personal (if vague) question and it has veered off into a general debate about whether medications are helpful or harmful. As many of you have pointed out, this is subjective to people's unique experience(even people with the same diagnosis) so there really is no "answer" to the OP's question.

I welcome the debate and understand that passionate views come from the importance of the topic. I am now going to merge this thread into the ongoing debate. Let's try to treat each other with respect and even more, with kindness, remembering that people listen best to an opposing viewpoint when they do not feel attacked. We are not necessarily out to change each others point of view but to each expand our own; inevitably this leads to better treatment for all of us.
 
From the research I've done I'm pretty convinced that all Psychiatric drugs, with the possible exception of SSRI's, cause some permanent brain damage after long term use.

Antidepressants: While some of the older Tricyclic antidepressants were shown to be neurotoxic in some animal experiments, most of the newer antidepressant that are currently used do not cause neurotoxicity or significant brain damage.

Stimulants: In my opinion these drugs on the whole do far more harm than good. There is strong strong evidence in animals and humans that amphetamine causes brain damage. In animals this brain damage after low dose use is characterized by profound cognitive impairment, hallucinatory type behaviour, behavioural sensitization, impaired movement and dopaminergic neurotoxicity. In humans is has been shown that prescription stimulant use is associated with a higher risk of developing a psychotic or bipolar illness, and an earlier age of onset of first episode psychosis. In a very large study done, it was shown that people in the past who had used prescription benzedrine or dexedrine had a higher risk of developing parkinsons disease. Even if one were to pretend that long term amphetamine use at low therapeutic doses causes no permanent changes in the brain of people being treated for ADHD, there are still millions of young Americans getting brain damaged by using these amphetamines recreationally

Sedative hypnotics: I think for short term use these are some of the safer drugs in psychiatry. Long term use of benzos has been associated with an increased risk of dying from cancer,as well as overall mortatlitiy. They have also been associated with an increased risk of developing Dementia. There is still debate as to whether they cause structural brain abnormalities after long term use. They have also been shown to permanently lower cognitive performance in adults in taken for long periods. All of these risks can be avoided by only taking them as needed or for a short period of time.

Neuroleptics: These are without a doubt the most damaging drugs in psychiatry, and arguably the most damaging drugs known to man. The risks of these drugs outweight the benefits in almost all cases. They shrink the human brain by up to 10%, cause Diabetes, reduce life expectancy, cause permanent brain damage and obvious movement disorders. They strip away your personality. It has been repeatedly proven that people who take these drugs have a worse prognosis than those who don't. Some would argue that the newer agents cause less severe brain damage, yet this advantage is counteracted by the tendency they have to make people obese and grow breasts. If you claim these drugs don't cause any lasting damage, then I dare you to take haloperidol or risperidone for a year and see what happens to your body and brain.

Mood stabilizers: These drugs are far safer than neuroleptics, but some of them, such a Lithium, can cause brain damage with long term use. The anticonvulsants which are used as mood stabilizers can also cause cognitive impairment whicch tends to be reversible.

From the studies I have read, it seems that neuroleptics and antidepressants worsen prognosis in the long run. Stimulant amphetamines are neurotoxic and can cause serious brain damage and psychiatric illness. Benzodiazepines are generally safe for short term use but can have devastating consequences if physical dependence occurs. Mood stabilizers can likewise be safe in the short term but cognitive impairment and neurotoxicity is still an issue.

Like Peter Gøtzsche, leader of the Nordic Cochrane Foundation, I am of the opinion that all psychiatric drugs cause brain damage and do more harm than good. I think its time we start looking into treatments with an established safety profile, such as cannabinoids and classical hallucinogens. These substances lack the toxicity and side effects of pharmaceutical psychiatric drugs and have proven to be effective in a wide range of mental disorders.
 
I think it's fine if medication helps you and you are convinced that nothing else will ever help. That's your choice. But I'm against telling everyone else to do what you're doing, when it's clearly predictive of a bad outcome. The most recent scientific studies show that for 90% of those who experience a psychotic episode, the best long term outcomes are for those who don't take any AP's, second best is for those who take a short term regiment of APs, and it's the worst for those who stay 'medication compliant'.
Have you seen any of us in favor of medication telling everyone else here to take medication?
You're the one being all doom and gloom telling us that we're all going to die from our meds as opposed to you know, killing ourselves in a depressive state or partaking in risky or even deadly behavior when we're manic.
 
This isn't backed up by anything concrete (thought I may as well throw out how little I know), but please be careful before tapering off antipsychotics if they actually help you - my schizophrenic friend always has flare ups with psychosis when he tries to get off them, taper or no taper. He dislikes being on them, but he's found not having hallucinations and delusions preferable to having them, and says going to the gym frequently, eating healthily and maintaining a support network helps make his life a happy one.

Also, swisscurrie, could you link me to your sources about stimulant medication please? I have adult ADHD and if what you said is true, it's beyond depressing.
 
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