Bipolar blogger Natasha Tracy offers exclusive insight into the world of bipolar disorder.See all posts »
Things I Wish I Had Known Before Taking Antipsychotics
I’ve been in treatment for bipolar disorder for about 15 years. In that time bipolar treatment has changed immensely and one of the changes has been the major emergence of antipsychotics.
True, even 15 years ago a psychiatrist might try an adjunctive antipsychotic in very treatment-resistant cases, but now we’re seeing them used more frequently and earlier in the treatment cycle.
And I can tell you, the notion of taking an antipsychotic scared me to death back then. There are so many reasons for this, many of them purely psychological. But I would have felt more comfortable trying my first antipsychotic had I known certain tips about taking them. I’m going to share a bit of this hard-fought wisdom below.
Side Effects of Antipsychotics
One of my big fears when taking antipsychotics was about getting all their side effects. While no one would suggest that antidepressants are side effect-free, antipsychotics have a particularly frightening side effect profile (in my opinion).
Metabolic and Blood Sugar Side Effects
The first concerns, and the most likely problems for many, surround metabolic and blood sugar effects. These side effects can increase your risk for diabetes, obesity, heart disease, and other illnesses. They can even shorten your life. But there is good news here and the good news is that we have tests and scales that measure these sorts of problems; so if they develop, you can find out as soon as possible and not let the problems get out of control.
My major advice here is to get regular blood work done and watch your weight. If either of those change, then discuss with your doctor the ramifications. (And, if, for some reason, your doctor isn’t ordering regular blood work then ask him why. You don’t have to go along with your psychiatrist, especially when his care is sub-standard.) Keep in mind that some antipsychotics (many atypicals) are more prone to these side effects than others.
Antipsychotics and Movement Disorders
The other major side effect concern is movement disorders. These disorders include things like tardive dyskinesia (involuntary, repetitive body movements, sometimes of the face and jaw). Movement disorders are more common in older (typical) antipsychotics but do also occur in the newer (atypical) antipsychotics. I mention tardive dyskinesia specifically because this side effect can be permanent even after the drug is discontinued. It’s important to note that as this isn’t the case with most side effects.
My advice regarding these types of side effect is to address any involuntary movement with your physician as soon as it occurs—do not wait. Not every involuntary muscle spasm is something to sound alarm bells over and certainly many of us can live with small, occasional muscle movements of the arms and legs, but if you’re at all concerned, it’s definitely something worth a conversation.
And while I am loathed to present such an option, there are, in fact medications that can address movement disorder side effects. Yes, a medication to address medication side effects is suboptimal, but sometimes it’s the best option if the antipsychotic is working well in other respects.
Overall Antipsychotic Side Effect Advice
In all, it’s important to keep in mind that your chances of getting these serious side effects go up with increased dosage and prolonged medication use. The general, medical, recommendation then, is to use the smallest effective dose for the shortest amount of time possible.
And keep in mind that not everyone experiences these side effects. While some do experience large weight gain or blood sugar abnormalities, some people experience nothing at all. While it’s absolutely worth close monitoring and caution, it’s not something to stay awake at night over. Catching the side effects early and dealing with them openly can save you from a lot of needless suffering.
It goes without saying that I am not a doctor and you should discuss any and all concerns and medication changes with your doctor before changing anything.
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