Medicines For Mental Illnesses - Comments

[adamx]

Thank you, Sheryl!

[cmike1980]

'There is no disagreement from the majority of us that there are unpleasant side effects from certain medications, that close monitoring of medication and side effects is needed and that CBT/DBT and other support is needed to allow patients to maintain activities of daily living and fulfill their life.'

I would totally agree with that. As such, since such unpleasant side effects from the related medications are naturally undesirable to anyone, the necessary precautionary measures are hence essential for the sake of healthcare and well-beings of the ones taking such medications.

Anyway, prevention is always better than cure, especially when the cure for such undesirable side effects, especially the irreversibly permanent ones like Tardive Dyskinesia etc, from such medications are not formally and conclusively available.

[Tolley]

I would like to add that my I know from bitter personal experience the side effects of drugs prescribed for schizophrenia.

My brother was a diagnosed schizophrenic and often the cure is worse than the disease when it comes to treatment options for people with that condition.

He couldn't live with the medications and he couldn't live without them but in the end the medications i believe contributed to him committing suicide.

Many other people are in the same situation.

No one really knows how to treat people with schizophrenia and the drugs basically pacify people so they don't disrupt others in society.

They are not a cure and in many cases cause severe side effects especially when people forget or refuse to take them and then all hel_l breaks lose literally inside the persons head.

I don't have any answers but what i do know is that most of the strong drugs they use can cause major problems but if they don't take the drugs they cause other people lots of problems.

What do you do???

[Sheryl]

You opt for the lesser of the 2 evils, which in the case of schizophrenia is almost always the meds, stay under close medical supervision and hope for the best (and development of better treatments!).

However lest people get too negative an impression, it should be remembered that

1) as imperfect as the current range of treatments are, they are far better than anything previously available and are enablingmany people who in the past would have had to be confined to mental hospitals live relatively normal and productive lives on the outside.

2) many schizophrenics do well on the treatment, do not experience uinmanageable side effects and are able to lead normal lives thanks to it.

Tolley, I am sorry to hear of your loss, but I would somehwat disagree on 2 points:

(1) Adminsitered properly, anti-psychotic drugs do not merely pacify (for that you don't need an anti-pyschotic; simple heavy sedation would work). They restore the capacity for normal thought and function. People who have experienced schizophrenia describe it as a horrible experience, a nightmare of confusion and uncontrolled wild thoughts. For people successfully treated (and it takes a very skilled psychiatrist and a bit of trial and error to achieve that), the meds are a lifeline out of extreme suffering.

(2) the hel_l that breaks loose when someone stops taking the meds is not a side effect of the meds, it is the disease re-occurring.

The problem is that many people, once restored to sanity on meds, come to think they no longer need them and stop taking them against (or without obtaining) trained medical advise. Counseling and support groups can make a big difference here, since the person needs to not only be brought back to sanity but also to come to understand that they have a chronic illness and how to live with it.

[Shotime]

The treatment methods for a wide variety of mental illnesses, here in Thailand, is to prescribe medicines that address the symptoms and keep the person subdued. I'm talking about the majority of Thai people who use government hospitals. Lithium, valium, some related to muscle loss of control like Parkinson's, and other's. Sometimes xanax. There is no attempt to treat the person unless they have money. I'm not familiar with the side effects, but the intended effects aren't good. There's also the question of where the medications used in Thailand are manufactured.

Edited December 5, 2008 by Shotime

[Sheryl]

These drugs are not anti-pyschotics and if being used to treat psychotic patients, it is clear mismanagement.

I believe it is true that there is a scarcity of appropriate pyschiatric care in public hospitals in Thailand.

[mrtoad]

You opt for the lesser of the 2 evils, which in the case of schizophrenia is almost always the meds, stay under close medical supervision and hope for the best (and development of better treatments!).

However lest people get too negative an impression, it should be remembered that

1) as imperfect as the current range of treatments are, they are far better than anything previously available and are enablingmany people who in the past would have had to be confined to mental hospitals live relatively normal and productive lives on the outside.

2) many schizophrenics do well on the treatment, do not experience uinmanageable side effects and are able to lead normal lives thanks to it.

Tolley, I am sorry to hear of your loss, but I would somehwat disagree on 2 points:

(1) Adminsitered properly, anti-psychotic drugs do not merely pacify (for that you don't need an anti-pyschotic; simple heavy sedation would work). They restore the capacity for normal thought and function. People who have experienced schizophrenia describe it as a horrible experience, a nightmare of confusion and uncontrolled wild thoughts. For people successfully treated (and it takes a very skilled psychiatrist and a bit of trial and error to achieve that), the meds are a lifeline out of extreme suffering.

(2) the hel_l that breaks loose when someone stops taking the meds is not a side effect of the meds, it is the disease re-occurring.

The problem is that many people, once restored to sanity on meds, come to think they no longer need them and stop taking them against (or without obtaining) trained medical advise. Counseling and support groups can make a big difference here, since the person needs to not only be brought back to sanity but also to come to understand that they have a chronic illness and how to live with it.

Sheryl, I think there is little that I can ad to that from my experience.

Certainly a very pertinent point is in the final paragraph, in which you mention people ceasing medication as they no longer think that they need them. I have come across countless examples of this where patients have just ceased taking their edication, become very unwell and then end back on section in an inpatient unit.

In our team back in the UK we actively tried to reduce medications to the lowest level that was possible with out causing relapse, sadly again this is a hit and miss approach, although in general our patients where made aware of what we were trying to do, and received significant support and monitoring.

At times it was heartbreaking to see a previously well maintained patients relapse and end back in hospital and go through the tortures of the illness, and effectively put their life back on hold. Working in a community seting, the relatinship between the CPN and the service user is very different to the relationship that service users have with inpatient staff. Community workers often work long hours, in stressful and demanding and potentialy dangerous situations (often as a lone worker), but in general the support that service users receive is significant, if it is carried out in the proper manner, and with a person who is willing to engage.

As you said, it is only when the person accepts that they have a chronic illness that they can only truly understand how to live and cope with it.

To Tolley, I am sorry for your loss, but there are many, many people who have continued to enjoy a much higher quality of life through the use of Anti-Psychotic medication, and I think that all of us would agree that the developments in medication has reduced a number of the previous unpleasant side - effects, although often new side effects have become more prominet, weight gain being a particular issue with certain meds.

[Chivas]

Am amazed no one has suggested Amitriptylene for mental illness and depression.

I was seen by numerous so called specialists over the course of 2 years and in the end changed General Practioner.

Within 4 weeks using Amitriptylene (which you can buy over the counter here plus is totally non addictive) I was 50% better and after 2 months fully recovered.

I now take a maintenance dose of 50 Mg daily at bed time which has the added bonus of making you sleepy.

Chivas

[mrtoad]

Am amazed no one has suggested Amitriptylene for mental illness and depression.

I was seen by numerous so called specialists over the course of 2 years and in the end changed General Practioner.

Within 4 weeks using Amitriptylene (which you can buy over the counter here plus is totally non addictive) I was 50% better and after 2 months fully recovered.

I now take a maintenance dose of 50 Mg daily at bed time which has the added bonus of making you sleepy.

Chivas

Amitryptaline is an old fashioned tricyclic anti-depressant. It is still used, but many doctors are reluctant to prescribe it these days, partly because if overdosed it is particularly dangerous (not saying that other drugs are not), but tricyclic antidepressants have a higher morbidity and mortality due to the cardiovascular and neurological toxicity..

I agree though, for depression it has been found to be effective, but the crux of the discussion here is regarding Anti-Psychotic medication which is for Schizophrenia.

As a side note, Amitryptaline is often prescribed to people with back pain, fcarpal tunnel syndrome, fibromyalgia and a number of other pain related complaints, although it is not licensed for a number of the things that it is presrcibed for.

[cmike1980]

'I am giving you feedbacks from my 16 years of working in Mental Health, both in the community and in patient settings. I think that allows me to be able give an objective remark, without determinng things for them.'

Well, please just bear in mind that helping those suffering from mental illnesses and witnessing their afflicted way of life, especially when such undesirable medication side effects manifest upon them and sustaining the pains of those side effects personally are simply two entirely different experiences that are hardly identical to one another, and at least there are certain discrepancies in them.

'They are not a cure and in many cases cause severe side effects especially when people forget or refuse to take them and then all hel_l breaks lose literally inside the persons head.

I don't have any answers but what i do know is that most of the strong drugs they use can cause major problems but if they don't take the drugs they cause other people lots of problems.

What do you do???'

'(1) Adminsitered properly, anti-psychotic drugs do not merely pacify (for that you don't need an anti-pyschotic; simple heavy sedation would work). They restore the capacity for normal thought and function. People who have experienced schizophrenia describe it as a horrible experience, a nightmare of confusion and uncontrolled wild thoughts. For people successfully treated (and it takes a very skilled psychiatrist and a bit of trial and error to achieve that), the meds are a lifeline out of extreme suffering.

(2) the hel_l that breaks loose when someone stops taking the meds is not a side effect of the meds, it is the disease re-occurring. '

I'm not asking anyone troubled with mental illnesses to stop taking the related medications just because of their potentially disastrous side effects. The normal solution for such chronic cases is naturally to seek at least a second opinion from the related medical specialists and experts. Besides, in terms of medications for mental illnesses, newer and newer drugs possibly with ever-decreasing side effects would tend to be invented from time to time to deal with such a problem in a much more effective way.

Next, that's simply the reason why certain trained psychiatrists would take the necessary precautions to put their patients on certain types of medication for a certain therapeutical period, and after certain professional observations, just switch the combinations / compositions of the medications to the different ones according to their respective needs based on their healing progress instead of just invariably sticking to the similar medications indefinitely regardless of any changes in their conditions.

Edited December 5, 2008 by cmike1980

[mrtoad]

New generation Anti Psychotics due indeed have much less side effects that have been previously mentioned, however many also have different side effects, such as weight gain. I think that no one here is suggesting that the side effects can be unpleasant, but then again not all patients suffer from side effects, or the same ones.

Could you maybe try and be a little more clear in what we are actually talking about, Anti-depressant, Anti-psychotics or mood stabalisers, as you have somehow manged to bracket it all together, and tarred treatment plans all with the same brush.

Whilst I can understand what you are tryinG to allude to, I do think that I have enough experience to empathise with patients, and having also taken AntI-depressants some years back I am also aware of what side effects can occur on that front.

I think that unfortunatley this thread is now starting to go back and forth, with very little value to add to it.

[Sheryl]

Agree, thread closed.