do the benefits of antipsychotics really outweigh the costs?

by **adeo.45hds** » Mon Aug 09, 2010 8:59 am

Conventional antipsychotic drugs are just as effective as atypical antipsychotics. Some of the atypical drugs appear to have an efficacy advantage, but it is small and of marginal clinical significance. The apparent better tolerability of the atypical antipsychotics in terms of extrapyramidal symptoms is variable and dose-dependent. It needs to be balanced against the problems of weight gain and metabolic adverse effects that are likely to contribute to long-term morbidity and mortality. Atypical antipsychotics are far more expensive than conventional drugs. Whatever modest benefits some of them may appear to have are outweighed by their high costs.

adeo.45hds wrote:Conventional antipsychotic drugs are just as effective as atypical antipsychotics. Some of the atypical drugs appear to have an efficacy advantage, but it is small and of marginal clinical significance. The apparent better tolerability of the atypical antipsychotics in terms of extrapyramidal symptoms is variable and dose-dependent. It needs to be balanced against the problems of weight gain and metabolic adverse effects that are likely to contribute to long-term morbidity and mortality. Atypical antipsychotics are far more expensive than conventional drugs. Whatever modest benefits some of them may appear to have are outweighed by their high costs.

Maybe it's better to say 'prohibited by cost'. Since the price is not inherent in the function of the medication (i.e. it is arbitrarily set and not a factor in performance given that one can obtain the medication)

But good call other than that.

by **Goliath** » Mon Aug 09, 2010 9:00 pm

IMO, anti-psychotic medications should only be used in extreme situations where a person has lost all perception of reality. They certainly aren't, IMO, a real good long-term solution. Sure, a chemical imbalance may be a factor but bombarding the brain with God knows what isn't the best solution.

Delusions have some source in reality, something that triggered them to occur. I think that a good therapist is more likely to find a LONG-TERM and final solution to the problem of psychosis or delusional state. I take medications myself for ADHD and panic attacks and they are very helpful but I still see the best long-term solution as being off of these and not needing them.

Medications can be very valuable and useful but if a person can, it is best to try to live in the purest state possible. Our world has enough pollutants of the air and mind already. I do realize that some people will certainly need their medications long-term. This is just my opinion on the subject, however.

by **gwilly** » Tue Aug 10, 2010 3:10 am

A valid opinion, but keep in mind that it usually isn't as simple as "go to therapy and get better".

Psychotic symptoms can often be inhibitive of treatment, even when the person hasn't lost all sense of reality. Some disorders are simply not conductive to treatment because the symptoms can inhibit the person from doing the treatment consistently, if they show up for it at all.

In fact it isn't at all uncommon for people to trick themselves into thinking they are better, drop out of treatment, then end up in a crisis a while later because they over estimated their abilities (or were mildly delusional or in denial)

by **geckopaws** » Sat Sep 11, 2010 3:41 am

Yeah I was taking antipsychotics for almost six years before they found that I did not even have a psychotic disorder, but DID or dissociative disorder. This disorder requires no medication at all sometimes, maybe a little help with depression. They had me on every kind of antipsychotic you can possibly think of. It slowed me down for six years and took parts and pieces of my memory away. These kinds of meds did not help me at all. I want to start a lawsuit against misdiagnosing me with some kind of psychotic disorder when in fact I have a personality disorder. When I was on those buggers I gained an excess over 120lbs. And since I've been off of them I've lost 68 lbs. I'm able to regain physical activity such as cycling which I did so many years ago and keep up to speed.

Personally, I do not think they are helpful in anyway. And it makes me very upset now that they are starting to give them to children as early as five or six.

by **gwilly** » Sat Sep 11, 2010 8:29 am

A misdiagnosis says nothing about the efficacy of the medication. It of course will not work if it is not needed. They are not automatic happy pills.

Though they are probably way over prescribed, which can make them appear to be ineffective, that actually has no bearing on the times when they do actually work.

You need the proper tool for the job. If you have a hammer when you need a saw, that says nothing of the effectiveness of hammers, it only says that you have the wrong tool.

by **Parador** » Sat Sep 11, 2010 2:35 pm

Yep - shrinks LOVE to prescribe antipsychotics. The reason they do it is to cover their asses. If their patient hurts someone they will be able to say they had the patient drugged up. If the patient is NOT drugged then they could get sued. One of my shrinks at the hospital admitted that to me.

by **gwilly** » Sat Sep 11, 2010 10:26 pm

Parador wrote:Yep - shrinks LOVE to prescribe antipsychotics. The reason they do it is to cover their asses. If their patient hurts someone they will be able to say they had the patient drugged up. If the patient is NOT drugged then they could get sued. One of my shrinks at the hospital admitted that to me.

Yeah. There's that, and also the fact that modern medicine is much like a business, unfortunately. Pharmaceutical corporations want to sell their medications because it helps to pay for ongoing research to make the 'next best thing'... which they will then sell and the cycle continues.

It's not entirely bad, because this some times leads to very helpful advances in medicine in general, in areas that would otherwise be far too expensive to research... but it is unfortunate that it also has its negative side effects.

by **Onebravegirl** » Sat Sep 11, 2010 10:50 pm

I had several doctors when i was Ill. My regular Psychiatrist (I'' call her A) and several others for when I was hospitalized. They all knew each other. When ever I was in the Psych Hospital The Head Doc (B) would dump on the meds. High doses, rapidly. the second I was out My personal Psych Doc would lower them.
My Opinion is that doc A was helping me cope. Doc B was containing me.
I look at Psych Meds as Scaffolding. Good for holding a person up until they can learn to stand on their own feet. I was Very Very medicated for several years. Up to NINE meds together at one point. Sometimes I felt Stoned out of my gourd. But they helped slow me down enough to pay attention to the real issues I had. Therapy and more Therapy made it possible for me to no longer be on any.
Meds are a tool not a solution.
Gwilly, I used to pull the same kinda stuff you mentioned. Kept the staff on their toes! The nurses were Amazingly patient though.
My bed wasn't bolted down either. If a person wants to have a fit, they can be very creative can't they!
One

by **Aanga** » Mon Sep 13, 2010 12:02 am

Parador wrote:
gwilly wrote:"Medication helped me when I was in a bad state to where I could not help myself.

I tried to commit suicide some years ago and wound up in a mental help place for a month. I was also having delusions, was anti-social and avoidant, and bouncing between severely depressed and manic. I did not eat anything for the first week in the hospital, except for some of these chicken broth packets they had in the cafeteria which you could put in a cup of hot water. After a few days I barricaded myself in my room using the beds and broke everything which I could break in the place, even though it was designed to be tamper proof I managed to rip the wall sockets out and pull the shatter-proof mirror off the bathroom wall, and I got the plastic molding off the sides of it and broke a piece and started to cut myself up before they could get in the room, they did get in but not before I did what I could.

Anyway... they doped me up pretty good after that, I was on thorazine for a while but eventually got off of it once it seemed like I was improving. I've been on other things since then, Risperdal, Depakote, Zoloft, Lamictal, and probably some others. There were times I did feel like a zombie and couldn't think well, and didn't like the medications. I don't take them anymore because of that, but now I am more able to manage myself, and I think if nothing else that the medications slowed me down and balanced me enough so that I could have the ability to make my own recovery.

I don't think I would have recovered without the medication, I'd probably be dead.

This isn't to say that it is for everyone, it definitely isn't, but we cannot just make sweeping judgements about medications. So the answer to the question in this topic should be "it depends.

\You were in a bad hospital. They should have the beds bolted to the floor to stop the barricading. I used to work in a hospital like that. they didn't adress issues like that and some people died. The place got decertified almost a decade ago.

If you had been in a better hospital you might not even had needed the thorozine. That's really bad stuff - not many places use it anymore.

What's wrong with thorozine? o.O I'm on a low dose of that. And I'm still quite medicationally retarded

do the benefits of antipsychotics really outweigh the costs?

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