Comments: Atypicals: Short-term versus Long-term Use
I have three issues with what you posted:
1. "Take them for a day or two and you can knock that bad shit down." Day or two? Anyone who has taken any sort of psychiatric medication knows that meds don't simply start working in just a couple of days. They just doesn't. Psychiatric medication, especially atypicals takes at least a two or three weeks to work if not more. Unless you're talking about antianxiety meds such as Ativan which takes about 20 minutes to be theraputic, there is NO such way that such a short amount of time can do anything.
2. To paraphrase, you made the claim that we shoudln't be spending money on the more expensive atypicals becuase they supposedly don't work any better than the older medication. My friend, you are forgetting one MAJOR differnece between the two: tartadive dyskenthisia. For those who don't know what TD is, it's a disorder caused by older antipsychotic mediction that causes involuntary physical movements and trembling. And it's irreversible -- once you have it, even if you disontinue with the medication, you can't recover. Now, for you to make the statement that we should be giving patients the TD medicine, JUST becuase it's less expensive, you must be pretty heartless and cold.
3. You keep throwing around the phrases 'long term' and 'short term' without ever defining them. You keep saying antipsychotic meds work in the short term and not in the long term, yet I, and probably not a single other one of your readers, knows exactly what you mean. What the hell is short term? Is it a day? A week? A year? A decade? If you don't define this terminology of yours, your points become nebulous, and your whole argument falls apart.
Overall, you have to work harder at 1. Getting the facts straight; 2. Have more compassion for people's suffering; and 3. Going back to sixth grade to learn how to write an effective argument.
Posted by Gwen Davis at November 6, 2005 01:23 PM
Hm, Gwen, I think you misread some of my points. One, I was speaking of the use of atypicals in BIPOLAR DISORDER not in schizophrenia, and that's clear in the post. Two, I don't know where you are getting your information from that antipsychtoics aren't sometimes used here and there for a few days to knock down bad shit in bipolar disorder. They have been used that way by docs in bipolars for years. The advent of atypicals has made it easier for docs to use them over a longer period of time without the worry of inducing movement disorders. However, I wonder how you get that I don't have compassion for suffering of folks with SMI when it's clear that for bipolars taking atypicals, the meds themselves cause a fair amount of suffering beyond the suffering induced by the illness itself. If you don't recognize that that is the case in some bipolars, then i have to question your compassion for folks with bipolar disorder.
When it comes to schizophrenia, it is very clear that atypicals are a godsend, the best thing we've got, and so on. I strongly advocate their long-term use in treating schizophrenia and have said so in posts on this site.
When it comes to bipolar disorder, using atypicals long-term is a much more problematic matter. Please see the many posts on this site concerning that very issue.
I'll just let your 3rd point roll off me 'cuz it makes utterly zero sense to me.
Posted by Dawdy at November 6, 2005 02:10 PM
As for what's short-term and what's long-term, there really aren't any solid definitions that everyone in the psych world agrees upon so the terms end up being used rather loosely. For my purposes, I consider short-term to be up to 3 months, medium-term to be 4 to 6 months, and long-term to be over 6 months. How's that work for you?
Posted by Dawdy at November 6, 2005 02:13 PM
First of all, I have to say I'm sorry for flipantly suggesting that you don't have compassion for people with mental illness. OF COURSE YOU DO!!! I know that, and so does everyone who reads this post. I just love ratting you out sometimes. It's fun. I have a very aggressive and mean streak in me and at times it's hard to control. Especially against people whom I really like and admire. And I'm sorry, but you happen to be on that list.
Also, I really had no idea that taking a pill for a day can treat bipolar. That's news to me. When I was in the hospital, they had to wait weeks and months for the antipsychotic medication to start working. But I have schizophrenia, not bipolar, so I really don't have any idea what the hell I'm talking about (which is normally the case).
Also, about long term and short term, I guess one of the reasons why it was so unclear is becuase I've been on atypicals for five years and they've worked for me and my uncle has been on atypicals for three decades and they've worked for him. But again, I guess you where only speaking in terms of bipolar, not schizophrenia.
So, once again my profound ignorance has been revealed. I'll just shut up unless I'm absolutly sure. Or maybe I won't.
Posted by Gwen Davis at November 6, 2005 02:42 PM
cool. when i say that taking an antipsychotic for a day can help treat certain aspects of bipolar--especially, the raging anger stuff--i don't mean that it cures it, only that it fixes it for a time.
also, your uncle can't have been taking atypicals for 30 years...they only started using them around 1996! :P
and i am glad they work for both of you. as i mention in a more recent post than this one, atypicals are clearly a godsend for schizophrenics.
Posted by Dawdy at November 6, 2005 02:58 PM
Don't you consider Clozeril an atypical? I thought it was the first of those medications. It came out in the 80's. Oh, and maybe it was only two decades, not three (am I a brilliant mathmetician or what!)
Posted by Gwen Davis at November 6, 2005 03:22 PM
clozaril is indeed an atypical. it isn't used too much these days--and wasn't used too aggressively when it first came out around 1991--because, while it doesn't cause diskenisia like the older antipsychotics, it has toxic side effects, its use must be monitored very closely, and it does wacky shit to people's white cell counts which then leads to immunity problems. so i generally really count the advent of atypicals to about 1996 when zyprexa and risperdal first crashed ashore.
Posted by Dawdy at November 6, 2005 03:38 PM
To answer your question as to WHY...
$Cha Ching!$
Same with benzodiazepines. Short term only, please. Yet the docs prescribe them FOR LIFE on a regular basis. I got to choose between taking higher and higher doses, tolerance withdrawal, or the ordeal of withdrawal and protracted withdrawal. I chose the latter and I seriously doubt most people would travel this road. It's nearly impossible for most folks. Most go back on the benzos. For life.
SO it's for the money. "Take this pill, take that pill...we don't know what the long term effects are but hey, we'll spend your money anyway."
Cool blog, btw.
Posted by Laura Ogle at November 12, 2005 06:11 PM
Hello,
I was wondering if anyone thought to list the dangers of these newer drugs? I know what the old ones do because I am Bipolar myslef. Seroquel can cause diabetes. In order to deal with this disease, you half to be on your toes and educated about it, ALL THE TIME!
Posted by Jason at March 23, 2006 08:46 AM
www.drugdigest.org has a good med interaction tool. Also, look up the fine print on www.rxlist.com Most of these meds have warnings, some blackbox and severe, thus the art of medicine, where the risk vs. misery prevails. Sometimes the risk is becoming addicted to these medications. Neuroleptics are the antipsychotic medications. Some feel once on cant go off. No matter the med class, any medication we swallow can do something to our mind and body. It is very difficult.
Posted by Stephany at April 2, 2006 06:09 PM
Amother site www.crazymeds.org has links to just about every psych med with dry humor added.
Posted by Stephany at April 3, 2006 01:42 AM
Dear Sir,
Thank you for your very helpfull studies.
I have a question: What is the causes of schizophrenics ? and what to do to heale (cure)?
Jolin E.KERO
Accountant
Posted by KERO at January 2, 2007 01:47 AM