Tag Archive: Psychiatric Medications


 

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Oh man, nothing makes me so angry as when people peddle misinformation as being fact, especially when it comes to psychiatric medications. While I acknowledge that not all people are helped by them and that some have bad reactions to them, the anti-medication movement is often riddled with ridiculous statements such as “Antidepressants damage the brain and cause people to become sociopaths.”  My conscience is very much intact, thank you very much. And that goes for others I know who take antidepressants as well.

I am focusing in this post on antidepressant medications, although the same principles apply to many other psychiatric medications as well. But I hear antidepressants being brought up more often than others, and I have studied them more than others as well.  I want to say upfront that I am not a medical professional. I am a mental health consumer who believes knowledge is power, so I have done my own research on this.

There are more subtle charges about antidepressants than what I posted above, that are more believable to people who don’t know the facts.

“Antidepressants work no better than a placebo”

Partly true. The end should say “For mild to moderate depression.”  But for major clinical depression and bipolar depression they do work. The logical conclusion is that many if not most of mild to moderate cases of depression are situational, rather than biological. Antidepressants are not designed to treat non-biological depression.  Unfortunately the overprescribing of antidepressants to those who don’t need them has resulted in a backlash from the public and the media is not always reporting the entire story.

Another charge is this:

“It says right in the antidepressant drug information that they don’t know how it works so the hypothesis that it corrects a chemical imbalance must be wrong.”

Again, partly true. It does say that it is “thought to work” by correcting a chemical imbalance in the brain. But there are many non-psychiatric medications that have the same type of caveat. Just because they don’t always know exactly how a medication works does not mean that it is a useless medication. It is results that matter. Some research has shown that perhaps it causes an increase in neurons which might account for why it may take up to a few weeks to become effective. It may also be a case of multiple effects that are in play as well. Perhaps the medication affects both the levels of neurotransmitters in the brain AND increases neurons. It has to be pointed out that until recently it was thought that the brain could not regenerate and produce new cells. That has been proven wrong with the new science of neuroplasticity or neurogenesis.  My next post is going to go into how the hypothesis of the chemical imbalance came about. It was not an unreasonable idea in light of the knowledge of the brain they had at the time, in the 1950’s. But I want to point out that the “chemical imbalance” hypothesis, while it is being challenged, has not been disproven either. It is up in the air at the moment.

One thing that many people don’t understand is that science progresses in stages and it is self-correcting as well. No scientist will ever claim that they understand everything perfectly. When  I debate people on scientific research, I point out this as an example of how science works. While Isaac Newton was a brilliant man, he never actually understood what gravity is. He was the one who discovered the principle or the theory of gravity and described its mathematical qualities but he didn’t know what it was or the cause of it. Others built upon his discovery so that we have a more complete view now.  But even now there are mysteries because Newtonian physics and Quantum physics should not be able to exist side by side as they contradict each other. Yet they do, not because either one of them is wrong, but because our understanding is incomplete.

And gravity works, whether you understand it or not. The same principle applies with medications.

This is just something to keep in mind when people claim that “such and such research” has been “disproven”, many times based on only one study. Studies have to be replicated in order to have any validity at all. And the human brain is a rather difficult organ to do research on. Lab animals can be subjected to medications and also be controlled for variables. Then they are killed and their brains dissected. You can’t do that with people. So studies have to be based on effectiveness, not on a complete understanding of the pathology of the mentally ill brain.

But the one that really “Grinds my gears” is when people compare psychiatric medications to addictive illegal drugs.

“Antidepressants change the levels of neurotransmitters and alter receptors. Cocaine also changes the levels of both dopamine and serotonin, as well as noradrenaline, and alters receptors.”

This is one of the most insidious charges around. The fact is that many medications affect the levels of neurotransmitters and possibly receptors as well.  That does not automatically mean that they are bad for you or are addictive. Many migraine medications, and drugs for Parkinson’s disease for example. In fact any medication that can cross the blood-brain barrier is likely to affect the brain in some manner, such as with older antihistamine medications that cause drowsiness and are still a popular ingredient in over-the-counter sleep medications.

The difference between a horrendously addictive and destructive drug  and an antidepressant is HOW it works in the brain. Cocaine does raise the “feel-good” chemicals in the brain, temporarily, by causing them all to be released at once. That is what causes people to feel high. When you come down though, those chemicals are depleted and then you become depressed and your body craves another high.

On the other hand, antidepressant medication does not cause a high and is thought to work by conserving the levels of neurotransmitters by inhibiting the re-uptake into the cells. It essentially is recycling the chemicals that would otherwise be broken down by the body, meaning more of it is available for use in the brain.

Those are two completely different processes and in fact antidepressants do exactly the opposite of what cocaine does! Cocaine depletes, antidepressants conserve!

If anyone challenges you on taking “happy pills” ask them what the street value for these things are. The answer is zero.

The only psychiatric medications that you need to watch out for are tranquilizers and sleeping pills. Some people do end up abusing them. You and your doctor need to watch out for signs of tolerance, needing more to have the same effect. If you are uncomfortable taking these medications, ask your doctor for non-addictive medications or other ways to manage your symptoms. And please do not get the term ‘major tranquilizers” confused with the term “tranquilizers” as the former is an old-fashioned term for antipsychotics, which are not addictive.

The answer to all this insanity is to educate yourself and others (if they are open to that). Learn what your medications are and how they work. All the information I have supplied here is readily available online and you can also ask your doctor. Read the drug information from the pharmacy too and ask the pharmacist questions as well. Knowledge is power!  😉

 

 

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Explaining medication usage to the patient

Explaining medication usage to the patient (Photo credit: Wikipedia)

Getting the Best Care You Can

Choosing a good psychiatrist can be a tricky job, especially when you are in the midst of a crisis. But it is important to find a doctor that you are comfortable with and that you can work with, otherwise you may not get the care you deserve.

Do you suffer from depression, bipolar disorder or other mental disorders? If so you are not alone. Many people suffer along with you. But how do you know if you need professional help? Feeling overwhelmed and unable to function in your daily life is a good sign that you may need help. Reducing stress and getting counseling may help, but if your symptoms are severe then you may want to see a psychiatrist.

Note: If you are in crisis, such as feeling suicidal get help from a psychiatrist right away. You may need to check yourself into a hospital to get the proper care.

How to Know if You Have a Good Doctor

Unfortunately not all doctors are created equal. Here are the characteristics of a true professional:

A good doctor will listen to you. If he rushes you or spends more time filling out your prescription slips than talking with you, you need to find someone else.

He should be willing to discuss options and address your concerns about medications. If you are worried about side-effects or the potential for addiction, then you should feel comfortable about bringing these issues up.

The doctor-patient relationship should be one of partnership. He may be an expert in his field, but you are the expert on yourself. If your symptoms don’t match his treatment plan then you may have to find someone else (it helps if you do some research on your own to find out what the proper treatment is for your condition).

If a particular medication is not helping you, you should be able to talk to your doctor about making changes. (Bear in mind though that some medications, such as antidepressants, can take up to several weeks to be effective).

Note: There are a lot of GP ‘s who are willing to dispense psychiatric drugs. My personal feeling is that this is unwise. Only a professional psychiatrist is qualified to diagnose and to treat mental disorders. Also not everyone who is mildly depressed needs medication.

Getting the Most out of Your Visit

Bring a list of all your current medications and dosages, including non-psychiatric drugs. Include past medications, and if you have had any allergic reactions or side-effects with them.Also bring a list of past medical history, including hospitalizations.

Tell your doctor about all of your symptoms even if you think that they are not important or you think you can handle them on your own. Many people are misdiagnosed because the doctor is not given the proper information.

Ask questions such as “What is my diagnosis? What are the side-effects of my medications? Are they addictive?”

Note: There are some medications that can cause withdrawal symptoms, such as certain antidepressants. However the clinical definition of addiction means having to take more and more to get the same effect, in other words abusing your medications. There is no abuse potential with antidepressants, even though you may experience withdrawal symptoms when you go off of it. However tranquilizers and sleeping pills can be abused so it is a good idea to be cautious with them.

If you are uncomfortable with taking a particular medication, ask for alternatives. For instance if you are concerned about addiction to sleeping pills or tranquilizers, there are non-addictive medications available that have the side effect of sedation.

Note: If you are in a crisis you may not be able to apply all these steps. If this is so, it would be a good idea to bring in a trusted friend or family member to advocate for you.

After Your Visit

Educate yourself about your medications and side-effects. The doctor may not have time to discuss every side-effect that could happen. Read the information sheets that comes with your prescriptions. You may also want to talk with your pharmacist, who may be more familiar with side-effects than your doctor.

Learn more about your illness. Again your doctor may not have time to explain it in detail. Remember that educating yourself about your illness makes it easier to to get the proper care. You can make a note of your symptoms and take that information to your doctor.

Remember that the quality of health care that you receive is up to you. Following these suggestions can help you get the best care possible.

If you are interested in some of my personal experiences with Psychiatrists then click on these three links: The Good, The Bad and The Ugly.

Symptoms + Cures

Symptoms + Cures (Photo credit: Wikipedia)

 

While I am eternally grateful for psychiatrists and the medications that treats my bipolar disorder, I have run into problems with certain doctors who think they know what is best for me.  So I have come up with a personal mantra to remind myself who is in charge here:

Doctor, you are the expert on medications.

However, I am the expert on me.

I have yet to say this but I am keeping that in mind. I get my mental health care through the state right now and they often switch doctors on me.  For the most part, despite frequent changes, I have gotten better service through them than I have in the private sector. Where I live I have little choice because there are only three doctors who take Medicare plans and they are all terrible.

Now of course I advocate co-operating with your doctor, especially when you are first diagnosed. At that point it is likely that he does know more than you do about your symptoms and how to treat them. You may be at a point where you are so sick that you can’t think clearly anyway.

I do believe however, that it is unhealthy to develop a long-term dependence on the psychiatrist’s opinions because he is only human. He makes mistakes too. From my work as a peer mentor in the mental health field and from my own experience it seems to me that the people who have developed co-operative partnerships with their psychiatrists actually do better in the long-term than those who are more passive.

It is important to learn as much as you can about your illness and how it is treated, otherwise you may get the wrong treatment altogether. Keep in mind also that in many ways the doctor is making an educated guess as to what is wrong with you and what your treatment options are. This is because many symptoms of a particular mental illness can actually overlap with another diagnosis. For instance a person with major depression could actually have undiagnosed bipolar disorder.  Someone with a mood disorder can also have some periodic schizophrenic symptoms (breaks with reality). Someone with schizophrenia can have mood symptoms also (schizo-affective disorder). Quite a few people have co-current issues with anxiety. Doctors base their diagnosis on what the patient tells them, so it is important to be as open as possible.

So I believe it is paramount for me to understand my symptoms, how they are treated, and how these treatments affect both my body and my mind.

Most doctors I have seen respond positively to my input. However there are some old-school psychiatrists out there who actually have the audacity to tell me that I can’t possibly know myself, my own symptoms, and my own reactions to my medications. They treat me, well, like I’m crazy.

The worst example I have is a doctor who told me that I couldn’t possibly be feeling what I was feeling because it wasn’t in the textbook. Not only was he wrong, but you can find those symptoms on any reputable website on the internet. I was having a mixed-episode, rapid-cycling between feeling high and euphoric and feeling depressed. When I came in to see him I was crying. So in his mind I must have been confusing being anxious with hypo-mania.

Granted I haven’t experienced mania that often, but I have experienced anxiety.  Both anxiety and mania have racing thoughts and hyperactive behavior as symptoms, but the feeling is quite different. I don’t experience euphoria and hypersexuality when I am anxious.

His solution was to prescribe a tranquilizer. I declined, because I am a recovering addict.

I left, completely frustrated and crying. Because I knew exactly what I needed. I wasn’t a newbie or an idiot. I had years of experience dealing with my illness, listening to other people’s accounts when I worked as a mental health peer mentor, and doing a lot of research on my own. I needed a mood stabilizer medication. That is the standard treatment. I don’t care what his outdated textbook says.

This is why it is so important to know your symptoms and what your treatment options are. Because you are the expert on yourself, not the doctor.