 | |
 |
|
|
|
Medications
In brief, the medications that have been prescribed for me (those that I am aware of) were: 1. 1981 (15 years old): imipramine 2. 1990 (24 years old): amitriptyline, chlorpromazine, and an anxiolytic All quotes on this page are Wikipedia, except those related to side effects. Imipramine Imipramine was, in the late 1950s, the first tricyclic antidepressant to be developed (by Ciba-Geigy). It was first tried against psychotic disorders, such as schizophrenia, but proved insufficient. During the clinical studies, its antidepressant qualities were unsurpassed by other antidepressants. To this day, Imipramine is often considered the "gold standard" antidepressant, as its ability to lift the most severe depressive episodes is unsurpassed[2]. It is not surprising, therefore, that Imipramine is also known to cause a high rate of manic and hypomanic reactions, especially in patients with preexisting bipolar disease. It is estimated that up to 25% of such patients maintained on Imipramine will switch into mania or hypomania.[3] Such powerful antidepressant properties have made it favorable in the treatment of treatment-resistant depression. Common Side Effects: Dizziness; drowsiness; dry mouth; excitement; headache; impotence; nausea; nightmares; pupil dilation; sensitivity to sunlight; sweating; tiredness; upset stomach; vomiting; weakness; weight loss or gain. It is less rare to experience constipation and increased depression, but apparently nowadays if this occurs you are supposed to contact your doctor right away. Amitriptyline Amitriptyline is approved for the treatment of major depression, as well as clinical/endogenous depression and also involutional melancholia or "depression of late life", which is no longer seen as a disease in its own right. Common Side Effects: Dizziness; drowsiness; dryness of mouth; headache; increased appetite (may include craving for sweets); nausea; tiredness or weakness (mild); unpleasant taste; weight gain Chlorpromazine The original antipsychotic drugs were happened upon largely by chance and were tested empirically for their effectiveness. The first antipsychotic was chlorpromazine, which was developed as a surgical anesthetic. It was first used on psychiatric patients because of its powerful calming effect; at the time it was regarded as a "chemical lobotomy". Lobotomy was used to treat many behavioral disorders, including psychosis, although its "effectiveness" was (from a modern viewpoint) due to its tendency to markedly reduce behavior of all types. However, chlorpromazine quickly proved to reduce the effects of psychosis in a more effective and specific manner than the extreme lobotomy-like sedation it was known for. The underlying neurochemistry involved has since been studied in detail, and subsequent anti-psychotic drugs have been discovered by an approach that incorporates this sort of information. Chlorpromazine is known to cause tardive dyskinesia, which can be irreversible.[2] Chlorpromazine impairs the metabolism of tricyclic antidepressants which can thus increase the risk of toxicity. Can increase appetite, resulting in weight gain. Impaired sexual response. Common Side Effects: Blurred vision; constipation; dizziness; drowsiness; dry mouth; light sensitivity; nasal congestion. Anxiolytics (antianxiety medication) Benzodiazepines Benzodiazepine Benzodiazepines are prescribed for short-term relief of severe and disabling anxiety. Benzodiazepines may also be indicated to cover the latent periods associated with the medications prescribed to treat an underlying anxiety disorder. They are used to treat a wide variety of conditions and symptoms and are usually a first choice when short-term CNS sedation is needed. Longer-term uses include treatment for severe anxiety. There is a risk of a benzodiazepine withdrawal and rebound syndrome after continuous usage for longer than two weeks. There is also the added problem of the accumulation of drug metabolites and adverse effects.[3] Benzodiazepines include: Alprazolam (Xanax) Chlordiazepoxide (Librium) Clonazepam (Klonopin) Diazepam (Valium) Lorazepam (Ativan) Benzodiazepines exert their anxiolytic properties at moderate dosage. At higher dosage hypnotic properties occur I am not sure which Benzodiazepine I was prescribed. Some of these can impair sexual functioning or result in slight incontinence, as well as decrease ability to concentrate. Imipramine was the first antidepressant prescribed for me. It was prescribed in autumn 1981, when I was 15, after a binge drinking episode resulted in suspected alcohol poisoning. At the hospital, I was asked some questions, and a history was taken. I took the pills for a few months, but did not feel less depressed. If anything, I felt more hopeless. I also had an extremely dry mouth, which never let up. After giving the pills some time to work, I began to save them up, and they were eventually used in a suicide attempt in late March 1982. There had been other side effects in addition to the dry mouth: a kind of fuzzy weird thing in my head sometimes, and constipation. However, it was the way the 'professionals' talked about chemical imbalances and made false statements about my blood tests (i.e., that they could tell from my blood tests that the 'imbalance' had been corrected) that changed my attitude about meds to a less open, more skeptical one. I would never again be as willing to trust that the professionals really knew what they were doing. In 1989, I was prescribed one drug by an admitting doctor when I had been taken by the police to the hospital (I had trouble talking to him at all because I was crying uncontrollably), which was immediately changed to something else when the doctor on the psych ward interviewed me. I don't know what either of these drugs were. When I asked the psych ward doctor for an explanation, he would not give it, and so I began to refuse meds. I remember only that the side effects seemed 'strange' or 'scary' to me - I don't remember the details. It was actually the side effects which prompted me to ask about the medication. I was prescribed amitriptyline at age 24 (1990), during a hospitalization of two months. At the same time I was also prescribed an antianxiety medication and the antipsychotic chlorpromazine. I did not take any of these medications. In talking to one of the staff, she had vaguely stated that the antipsychotic would 'clear up my thinking' - when I couldn't clearly see that my thinking was any less clear than hers. I didn't think I actually needed the other meds - what I thought was necessary for me was to talk for a long time to someone, but considering the approach and lack of depth of the conversation I encountered in the various hospital therapies, I didn't think I was likely to find what would help me personally. Also, psychologically-based therapies were not covered by my provincial health insurance. Is it true that some disorders or conditions might actually be 'created' so that a new drug can be marketed? Do doctors get monetary rewards for recommending or prescribing certain drugs? Drug companies and medicalization It has also been alleged that the way the categories of the DSM are structured, as well as the substantial expansion of the number of categories, are representative of an increasing medicalization of human nature, which may be attributed to disease mongering by pharmaceutical companies and psychiatrists, whose influence has dramatically grown in recent decades.[49] Of the authors who selected and defined the DSM-IV psychiatric disorders, roughly half had had financial relationships with the pharmaceutical industry at one time, raising the prospect of a direct conflict of interest.[50] In 2008, then American Psychiatric Association President Steven Sharfstein released a statement in which he conceded that psychiatrists had "allowed the biopsychosocial model to become the bio-bio-bio model".[51] However, although the number of identified diagnoses has increased by more than 300% (from 106 in DSM-I to 365 in DSM-IV-TR), psychiatrists such as Zimmerman and Spitzer argue it almost entirely represents greater specification of the forms of pathology, thereby allowing better grouping of more similar patients.[4] The meds can only do so much, and for some people, there might be a psychological placebo effect - through trusting the hospital, accepting or relying on meds, you relax your own sense of control and might feel less anxious. However, I couldn't help being aware of my motives for taking the drug or trying it, and I couldn't help being aware that in a practical sense, it didn't really solve important issues for me. I needed help focused in a different area. When motivated, I could handle anxiety myself. Psychiatric drugs carry their own risks, and sometimes the side effects involved merely add to your problems or make it more difficult to tackle the original problem. They also cost money, and require that a person be monitored by a professional, which requires more money. Some of the drugs prescribed for me could potentially have caused weight gain or impaired sexual response - two side effects that would have contributed to my problems, and which I would definitely not have found acceptable. Also, the idea that I had been prescribed a drug which could have resulted in permanent tardive dyskinesia, and I had not been warned about this beforehand, infuriates me. Alcohol I think that alcohol is a valid medication, for me. With alcohol and other non-prescription drugs, there may be different side effects, different levels of risk, and different long-term side effects. But, as with prescription drugs, some non-prescription drugs will help some and not others. Speaking for myself, a suicide pill would be a valuable medication. |
|
