Common Psych Meds. Chapter 1: Antipsychotic Medication
There is no right or wrong way to manage a mental illness. Many individuals with mental illness chose to take medication in order to help them manage symptoms. Each person with mental illness will have to decide about many different treatment options throughout their lives. Some people choose to take medication and many people will have to take medications for the rest of their lives. I am one of those people.
Often people associate taking medication with weakness or inability to independently cope. This is false, but a valid and common feeling. You wouldn’t expect an individual with hypertension to think their way out of high blood pressure, so what makes people believe that we could think our way out of depression or psychosis? One way to think of medication is as a coping skill and it may be many people’s main coping skill. There’s nothing wrong with that. Knowing more about medications you are prescribed may help you be better informed and in turn you will be better able to make a decision that you feel comfortable with.
Common classes of medications given for mental illness include antipsychotics, antidepressants, mood stabilizers, antianxiety, and stimulants.
Antipsychotic Medications
Antipsychotics medications treat (surprise, surprise!) psychosis. What is psychosis? Psychosis is a medical condition where an individual experiences a break from reality. People will have trouble determining what is real and what is not real. Symptoms of psychosis include hallucinations and delusions. Hallucinations are when someone hears, sees, smells, feels, tastes something that is not there. An example would be an individual who hears voices or music. A delusion is a fixed false belief despite significant evidence to the contrary. An example of a delusion would be an individual believing that their food is being poisoned or that they are being followed by the Secret Service. Antipsychotic medications are used to treat psychosis in mental illnesses such as Schizophrenia, Schizoaffective Disorder, and Bipolar Disorder and have also been found to assist in what is known as treatment resistant depression.
No one knows for sure what causes psychosis (or mental illness in general), but there are definitely things that do NOT cause it including: the devil, sins, magic, lack of intelligence, curses, not praying or going to church/synagogue/mosque enough, planetary alignment or misalignment, Ms. Cleo, witchcraft, and much more. In addition, the word psychosis has been co-opted to the point where it has become synonymous with things like “psychotic killer clowns” or “chainsaw-wielding psychopaths.” I’m sure in the history of killer clowns, one or two may have experienced psychosis, but most have not. The vast majority of us (clowns and mental patients) are not dangerous. You are allowed to use any term you would like to describe psychosis, but we must stay conscious of other terms that people may use to describe themselves and honor that.
Antipsychotic medications are classified into two categories: typical and atypical. Older medications that treat psychosis are considered typical (or first generation) and the newer medications are considered atypical (or second generation). Scientists don’t know exactly how or why antipsychotic drugs work, but they influence the neurotransmitters in our brains. Neurotransmitters are our body’s chemical messengers that transmit messages from brain cell to brain cell and antipsychotic medications usually affect a neurotransmitter called dopamine.
The first antipsychotic medication was Thorazine and it was initially used for psychosis in the 1950s after being used in surgery and as an antihistamine for many years. Thorazine was considered a “major breakthrough” in psychiatry because individuals warehoused in institutions, who were formerly trapped in psychosis, were suddenly freed from the devastating effects of several mental illnesses. Other typical antipsychotics were introduced in the 1950s and atypical antipsychotics became available starting in the 1980s. These meds are often taken by mouth, but many of them also come in what is called a long acting injectable (LAI). An individual that takes a LAI will get a shot of the medication at specific intervals (monthly or bi-monthly) and the medication will work for that certain amount of time. Additionally, some of these meds can be taken as a PRN (pro re nata, Latin for “as needed”) when symptoms are acting up and more medication is needed.
The following are a list of some of the more common typical and atypical medications along with their generic names. The lists are in no way exhaustive and more medication are out there.
Examples of typical antipsychotics:
- Thorazine (chlorpromazine)
- Prolixin (fluphenazine)
- Haldol (haloperidol)
- Navane (thiothixene)
- Stelazine (trifluoperazine)
Example of atypical antipsychotics
- Abilify (aripiprazole)
- Clozaril (clozapine)
- Seroquel (quetiapine)
- Risperdal (risperidone)
- Geodon (ziprasidone)
Now while some of us can see the benefits of taking antipsychotic medications, there are definitely side effects that cannot be ignored. According to the National Institute of Mental Health (2016), the following are some common side effects of antipsychotic medications: “drowsiness, dizziness, restlessness, weight gain (the risk is higher with some atypical antipsychotic medicines), dry mouth, constipation, nausea, vomiting, blurred vision, low blood pressure, uncontrollable movements, such as tics and tremors (the risk is higher with typical antipsychotic medicines), and seizures.” One medication, Clozaril (generic name is clozapine) has a risk of causing a low white blood cell count and individuals who take this medication will have to have regular blood draws to monitor this possibility. Another concern with long term use of antipsychotics is a movement disorder called tardive dyskinesia. Individuals who believe they have developed/are developing tardive dyskinesia should contact their doctor.
So, that is a shit ton of potential things that could go wrong while also having to deal with symptoms that may not be under control quite yet. In some cases, medications may have to be discontinued because of side effects and sometimes people choose to endure certain side effects because the pros of taking the meds are going to outweigh the cons. That is going to have to be an individual’s personal decision. The most common side effect I have heard from my clients over the years is extreme tiredness sometimes to the point of sleeping most of the day. In this situation (or any situation where my day is overrun by side effects) I would speak with my doctor.
What’s it like to take an antipsychotic medication? I obviously cannot speak for everyone, but taking an antipsychotic medication can be rough. I have taken several atypical antipsychotic meds in my tenure as a mental patient and I have only been able to continue with one at this time. And even with that one I have had to contend with extreme drowsiness, weight gain, dry mouth, forgetfulness, and inability to focus. Trying to manage this can take chunks of time out of my day, but at this point I determined that the pros outweigh the cons. So if you see me with my gallon jug of ice water or if I tell you I am sleepy and I need another cup of coffee, please mind your business. I am out here trying to cope.
So, did we learn anything or did we get dumber?
- Antipsychotic medications are used to treat symptoms of mental illnesses which are medical conditions and not personal failures or weaknesses.
- There are many different antipsychotic medications available. These meds primarily affect the neurotransmitter dopamine, but no one really knows why, yet (fingers crossed).
- There are many potential side effects to these medications. A personal choice is going to have to be made in regards to determining the pros and the cons of taking a medication.
In conclusion… Are antipsychotic medications right for you? Idk. I am not a doctor and this is not medical advice. What I do know is that many people are getting bad advice from all sorts of sources. This post started because I was unable to find information for clients that wasn’t in some way absurd and offensive. Information will change as the years go by so my advice is to get your information from reputable sources and never stop questioning something when you get that little vibration in your body telling you that something about this feels a little suspicious. They’ll call you paranoid anyway, so do you and ask as many questions as you want.
Chapter Two coming soon.
U.S. Department of Health and Human Services. (2016). Mental health medications. National Institute of Mental Health. Retrieved March 18, 2022, from https://www.nimh.nih.gov/health/topics/mental-health-medications#part_2362
