confirmedcrazy:

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.

holy shit.

thank you. i didn’t even notice this until reading this. i’ve been on my meds a year now, and i didn’t notice, didn’t connect it with the way i was suddenly terrible at homework, didn’t notice the way i was only able to do abstract discussion after i switched to a different med (although still an antipsychotic, it’s definitely less severe for me on the side-effect side of things). how did i not notice?

…thank you for writing this. why was i never told about this?

Wow, I am so glad my post could have this effect on someone!  (This wasn’t even something I had imagined might happen when I wrote the post; I was mainly intending to warn people who had never taken antipsychotics.)

Hearing that I helped you with this has made my day.  I can’t imagine how things might have been different if someone had told me the same while I was on Risperdal.

As for why no one ever told you about it: I honestly don’t know, and it confuses me too.  Some speculation:

I’m not sure even clinicians themselves are aware of this, necessarily, because they only see the patient for brief periods of time and have trouble noticing something if the patient can’t see it themselves.  (Or some may know but not tell the patient for reasons, possibly/probably bad ones.)

The drug companies themselves are of course going to want to play down the downsides of their meds except in cases where that could cause trouble for them.  For instance, the Risperdal prescribing information hilariously warns about “cognitive impairment” solely in the context of “operating hazardous machinery” (what if someone gets in a car crash? think of the lawsuits!):

Inform patients and caregivers that ­RISPERDAL® has the potential to impair judgment, thinking, or motor skills. Advise caution about operating hazardous machinery, including automobiles, until patients are reasonably certain that RISPERDAL® therapy does not affect them adversely [see Warnings and Precautions (5.9)].

“until patients are reasonably certain that RISPERDAL® therapy does not affect them adversely” hmmmmm what possibly could go wrong here

Finally, I think there’s a relative lack of public discussion/knowledge of antipsychotics.  Maybe because people aren’t as likely to admit they’re taking them as with, say, antidepressants?  And the public perception of some of the things they are prescribed for (e.g. psychotic symptoms) is roughly “that is so bad that anything that reduces it is probably worth it.”  Even if that’s not true.  (I’ve read testimonials online from schizophrenic people who prefer their unmedicated symptoms to being on Risperdal.)

I hope your cognitive situation continues to improve!

(via creepycrawlycrazies)