nostalgebraist:

I saw what I guess you’d call a “medication positivity” post and while I didn’t want to derail by reblogging it, my reaction was “yes, this, except for antipsychotics/neuroleptics”

Even those, of course, are truly helpful in some cases – the costs don’t always outweigh the benefits.  What’s worrying about antipsychotics isn’t so much the cost and benefit sizes as the way they can mess with cost-benefit analysis itself

(Everything that follows is just based on my own experience and that of a few people I’ve talked to who had very similar experiences.  Everything should probably be qualified with a “can” or “in some cases” or etc.)

Antipsychotics can make you dumber.  So can a lot of other medications.  But with antipsychotics it isn’t the normal sort of drug-induced dumbness – feeling tired, or distracted, or mentally sluggish, say.  It’s more qualitative than that.  It’s like your capacity for abstract thought is reduced.

And one of the consequences of this is that you may lose the ability to notice that you have lost anything.  You agree to give the new med a try, and you start taking it, and then when you see your prescriber again you don’t report any problems because you’ve lost the ability to form thoughts like “my cognition has changed a lot recently, and the change coincided with the introduction of this new med.”

This can go on for years.  It did for me and for several people I know.

When I finally went off Risperdal – encouraged by my parents, I don’t remember really caring – it suddenly seemed obvious that I’d been cognitively altered for the past five years.  I didn’t remember the time before that very well (I had started Risperdal when I was about 10 years old), but there were objective indicators – for instance, I loved reading before Risperdal, and while on Risperdal I don’t think I read a single book cover-to-cover.

You’d think I would have noticed that I couldn’t read anymore.  Somehow I didn’t, for five years.  What did it feel like?  It’s hard to remember and also hard to describe.  Sort of a passivity.  The world acted upon me for mysterious reasons.  I did not draw correlations between present and past events, didn’t formulate ideas about the workings of things.  The present was simply given; I wasn’t frustrated when it refused to honor my theories.  “Reading is hard” was a datum, and was unpleasant, but I was not really surprised by it, or frustrated in the “this wasn’t supposed to happen!” way of abstract-reasoning-creatures.  It was a given datum and all I did was hope that given data would be pleasant and not unpleasant.

I think people should know that antipsychotics can do this.  They still may be worth trying, in certain situations.  But taking an antipsychotic is a special sort of decision, one that interferes with decision-making itself, like choosing to listen to the Sirens.

Reblog to note some interesting responses:

@kerapace says “my experience going on antipsychotics was a lot like yours going off them” in reference to Seroquel, but also says they were on Risperdal for a few months and “it does indeed turn you into a zombie.”

Seems like it would be worthwhile to find out which antipsychotics are the best/worst for this stuff – maybe Risperdal is especially bad?  (It makes me wonder why I was given it; I’d taken one other thing beforehand which didn’t help my Tourette’s at all, so it’s possible that giving me Risperdal was an attempt to “get more heavy-duty.”)

Similarly, @devipotato says some antipsychotics have this effect on her and some don’t.  She also notes that this varies a lot from person to person.

@brazenautomaton asks whether this kind of effect can be permanent; @notingisnoral reports just such an experience.

@arjan-de-lumens says they haven’t experienced such an effect, but suspects that the Risperdal-induced state I described is just their normal state, so there might just have been no further to go in that direction.

@trueculprit and @closeonmarksnosedive added tags reporting similar experiences from others – #(i’ve never been on this type of med but my partner has and. yeah) and #I cannot count how many psychotic ppl I’ve talked to who have had this experience

@metagorgon notes that my Risperdal experience resembles certain stories in the horror genre.  This makes me smile – “my teenage years were like a work of horror fiction” sounds so cool, y’know?  If bad stuff is to happen to me, at least let it be interesting bad stuff.