Seroquel wins, by a lot.
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Dinah, ClinkShrink, & Roy produce Shrink Rap: a blog by Psychiatrists for Psychiatrists, interested bystanders are also welcome. A place to talk; no one has to listen.
Monday, December 17, 2007
Poll Results: What's Your Favorite Anti-Psychotic Medication
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17 comments:
I'm not surprised to see Seroquel at the top, for the reasons listed in this post over at Furious Seasons. For trade, snorting or injection, it's quite popular inside the walls. Then again, so is any sedating medication.
So how does a shrink choose???
I couldn't vote in this one. I think you'd have a better chance getting me on the dreaded Lithium than an antipsychotic...
I think I voted for zyprexa, but it was so long ago that I don't really remember! I probably said before, but the favorites for headache are zyprexa, thorazine, compazine, abilify (apparently, though I've never tried this one...), haldol, geodon. Out of all those that I've tried, I liked zyprexa and thorazine the best - although thorazine makes me completely non functional, and I've received it via slow IV push and IV piggyback many times in addition to the oral doses I have for backups to my usual abortive meds. Haldol caused me to have anaphylaxis 3 times, so I can't say I'm very fond of that one, but a lot of headache sufferers who go inpatient love haldol and thorazine - they're even begging to get those meds, if you can imagine. Geodon was so sedating to me that I couldn't even stay awake. I tried the pill form every day for 2 weeks, and it didn't get better - I received the IM injections in the hospital and I used to dread them because within 20-30 minutes, I'd be so sedated I could no longer visit with my family when they came at night.
At any rate, my vote was not for my favorite antipsychotic really, since I wasn't voting on them for their antipsychotic uses but rather for their use in headache. The times I actually was psychotic (anticholinergic), I wasn't given meds - thank goodness! I personally think it was more delirium than psychosis, but the psychiatrist for the headache center added a diagnosis of psychosis, NOS to my chart - which I wasn't entirely happy about, but what can you do.
Interesting "other" choices...!
Take care,
Carrie :)
dear Dinah, i am a nut case who loves reading you blogs when i can think straight! i have had paranoid schizophrenia since my early teens. i have secretly gone off my clozapine since two and a half years ago. my psychiatrist does not know it. i really want to tell him but i dont know how to even start this conversation with him. i have really gone through hell for this. do you have any ideas? coz he just keeps prescribing them and i dont know what to do with the lot and they are really getting piled up. can i please also ask at least what to expect? i just thought may be the shrinks think the same... thank you. sorry for carrying on and on and on and....
wondering bird,
Just because you have a mental illness, it does not mean you forfeit your right to decide whether or not you want to take psychiatric drugs. If your shrink disagrees with your right to choose, get another shrink. It's your body, not his. Congratulations on getting off the drugs! It's hard to get support for this, I agree.
It's true that Seroquel is used for snorting (I could have sworn I wrote that in a comment a long while back--it was the This Post is a Lie--(made me laugh). On the other hand, I would be inclined to think that most people who chose it on this poll didn't have that in mind. When you strip aside the weight gain etc, you get a drug that, when it works, works very well, tends to cause less weight gain than Zyprexa, is appoved for both ends of the bipolar spectrum, and is being prescribed off label for insomnia and so many other conditions (for which it also works very well). There is so much of it out there that more people will have had experience with it than with some other drugs. Younger patients and younger doctors may not have had much experience with some of the older drugs at all.
I know people who are taking this drug for anxiety who do not realize that they are taking an anti-pyschotic. "The doctor said these would help".
Naturally, if you voted for your favorite AP and chose Seroquel then you realized it is an AP, or perhaps when you saw it listed that was when you realized that it was.
If they could ever come up with a Seroquel minus the weight gain and metabolic side effects, what a wondeful world this would be.
For acute psychotic episodes in the ER I love Geodon, but it takes so darn long to mix. I wish they would come out with a premix that we can just draw up and give. I think that's one of the reasons that Haldol is still given in acute episodes.
Does anyone have any experience using Abilify to treat the rigidity,anxiety and social ackwardness associated with Aspergers? My 15 y/o son is going to start Ability over winter break. I am nervious about starting him on this med but want to try it to see if it will help him cope at school and in social situations. Any comments or advice?
I think it's all relative when it comes to Anti-psychotics (at least for me). They aren't front line medications for managing Bipolar Disorder - they seem to be reserved for when my illness rages out of control. So from that point of view, they are a godsend. Side effects aside, Seroquel has brought me down quicker than anything else, and despite it's sedating effect, it's enabling me to function as we speak. So really, I can't complain.
The "future" of antipsychotic selection appears to be genetic. The American Society of Human Genetics met here this past summer and the current research is fascinating:
"Using gene variants to guide antipsychotic selection for patients with schizophrenia has potential to decrease time to clinical improvement, decrease overall healthcare costs, and improve patients' quality of life. Additional research is needed to identify more markers, for which whole-genome association studies in the context of comparison trials hold promise, and to document improvements in clinical outcome resulting from the use of this technology."
Docs with a Medscape account can look here .
Clink - In the CA prisons where Seroquel is prescribed, it is always "crushed and stirred in water." Why am I thinking it's a bitter affair...
wondering bird: your psychiatrist cannot help you if you are not honest with him. remember that you get a say in your treatment, too. he can't just TELL you what to take and have that be law. there is almost always room for compromise. but he needs to know you are not taking your meds in order to be as helpful to you as possible.
Thank you one4thread. sometimes I really do stare into his eyes and I just wish soooo much that he knew.
Gin. Heh.
Not sure about my favourite (complete lack of experience really). I've seen a few side effects of clozapine though. It obviously takes a lot of judgement to prescribe antipsychotics". *One day I may get there*.
I voted for Haldol, only because there was nothing else good on the list. I didn't notice the write in your own, or I likely would have had some scribbly random ass answer like the ones there. ;)
Annonymous,
I have NLD, which is similar to AS. While I definitely understand the desperation of wanting to make life better for your son, I can tell you from personal experience that psych meds, in the long run, considerably make things worse.
I never took an antipsychotic, thank goodness, but a psych med coctail for 3 antidepressants and a stimulant considerably worsened my NLD problems over a period of 10 plus years. When you neurologically can't read non verbal language (you can compensate), psych meds aren't going to make things better in the long run.
What I fear is that the Seroquel will cause side effects that will make any of your son's current problems look mild in comparson.
You may have done this already but personally, I would look for a good therapist with an understanding of autistic spectrum disorders who can teach your so the social skils that he needs to be successful.
I don't know how you feel about having your son take supplements but you might want to look into magnesium for the anxiety. A medical professional advised me to take it and it has really done wonders for my anxiety on just a very small amount. Of course, run it by your doctor.
I know this isn't going to be the most popular post on this blog because of what I just said. Obviously, you have to do what you feel is right. But I can't begin to tell you how much better things would have been for me if I had gotten the right help in dealing with my NLD instead of being medicated into obvlivian and suffering numerous side effects Hey, it was my choice so I can't blame anyone. But now that I have woken up, I am trying to prevent other people from making the same mistakes that I made.
AA
Wondering Bird,
Congratulations on being med free. I am currently tapering off my meds and greatly look forward to the day I am med free.
I found it very hard to tell my psychiatrist but it wasn't as bad as I thought it would be.
You can do it and Jayme said, you have the right to make the choice to be med free.
AA
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