Antipsychotic Medications Demystified: A Comprehensive Guide to Types, Clinical Use & Side Effects

[@patrickm1666]

I’m experiencing chronic side effects from antipsychotics. Chronic aches and pains, chronic fatigue, mental anguish, depression, insomnia, vomiting. Fully disabled from these medications struggling to shower, brush teeth, change clothes, cook, do housework. Help my psychiatrist won’t let me stop taking them. Beware!

[@PsychiatrySimplified]

Please speak to your doctor - side effects should be discussed with your doctor. Wish you well.

[@Hollyucinogen]

Anti-psychotics are only supposed to be taken for 3-6 months. They're for short-term stabilization only. There are so many bad side-effects of long-term anti-psychotic use. He either doesn't know that, in which case he's a bad doctor; or he does know that and he's trying to convince you to take them anyway, in which case he's a bad doctor. Either way, he's a bad doctor. Fire him and challenge him to bring you to court and get a court-order to force you to take them against your will. He won't, he'll just take you off them.

[@kevinherron6051]

I would fly around the world to be treated by doc Sanil

[@PsychiatrySimplified]

Thank you for the praise. It does put a high expectation which is scary- but hopefully that is something that spurs me to keep improving.

[@kevinherron6051]

@@PsychiatrySimplified definitely. I learn so much from this. I’m still looking for the right combo but this helps keep me educated in my decisions.

[@joierm8779]

Wish i could too❤️

[@iwonab5150]

How do you make you’re patients heal without meds?

[@UltimateEnd0]

Back in 2011, I got treated with very heavy risperidone and then ziprasidone (Geodon) and I experienced extremely bad restless leg syndrome like I was about to call 911 for an ambulance. However, I was able to play a game (Castlevania:Harmony of Despair) until my symptoms subsided. Risperidone was much worse for my restless leg syndrome.

[@PsychiatrySimplified]

What you are describing is likely akathisia. Very distressing. We have a video on akathisa

[@RajSharma-g3i]

These short videos will facilitate to de-stigmatize the views of mental health and patient suffering held by the public and the medical/psychiatric professionals.

[@subhashnc1758]

Amisulpride causing sexual dysfunction..i switched to aripiprasol its cause akathesia...how i get my sex drive back

[@shieldmetal782]

Is there a relationship between getting psychosis because of trying drugs. And if there is...are those people given antisychosis medicine

[@sorianasor9730]

why sometimes combination clozapin with fluvoxamin?

[@PsychiatrySimplified]

Fluvoxamine increases levels of clozapine and affects the ratio of clozapine : nor clozapine which can help balance efficacy and tolerability

[@sorianasor9730]

@@PsychiatrySimplified thanks alot

[@dv_vid]

My violent thoughts and actions are directed towards psychiatrists. I am paranoia that these drugs are going to cause TD.

[@katmahbub]

so well explained, integrating neurophysiology, clinical and pharmocology.

[@PsychiatrySimplified]

Thank you 🙏🏻

[@beverlyteh4676]

Well. I’m here for a positive comment Sanil! Such a succinct video which I will point my medical students and juniors towards. Bravo!

[@PsychiatrySimplified]

Thank you Beverly 🙏🏼. I appreciate it

[@am13134]

Amazing video. I have 2nd year exams in few days and ur vid is extremely helpful for neurobiology and pharmacology too!

[@PsychiatrySimplified]

Thanks so much for your feedback: it's good to hear it makes a difference 🙏🏼

[@hopelesslyhopeful4396]

Thank you very much for this video. I have a question: atypicals that are not partial agonists, but only have D2 e 5HT2A, do create a situation where the combined effect brings (in the pathways that are not the positive symptoms related ones) a level of dopamine that is the "normal" one you would have without the med, or do they create a higher level of dopamine in those "areas"? Asking because i am curious about the antidepressant proprierties. Are they caused by the fact that low dosage of atypical antypsychotics can cause a slightly higher level of dopaminen in the area related to affective symptoms?

[@PsychiatrySimplified]

Good question - Treatment is divided into two phases 1. Short term 2. Long term Aim over the long term is an optimal balance of D1 excitatory and D2 inhibitory pathways. So in the short term in the cute phase, the focus is on D2 blockade to reduce the dopaminergic activity in the salience network that mediates psychosis with the 5HT2 A antagonism ensuring that the dopaminergic activity in fronto-striatal circuits is not compromised too much as 5HT2A antagonism leads to increased DA in F-S circuits. Once the symptoms are in remission or partial remission the aim is to ensure D1 receptors in the PFC are not excessively inhibited as PFC plays an important role in reducing striatal hyperactivity ( which mediates psychotic sx) something known as top-down inhibition. Here the dose of the agent should be modulated over time so that the D2 receptors are not excessively blocked leading to compensatory DA supersensitivity which can lead to breakthrough psychotic symptoms and side effects. Here the reduction of dose ensures the D1-D2 balance as it prevents DA supersensitivity and allows for 5HT2A to indirectly target D1 receptors which are also crucial for learning and are stimulated by unexpected rewards. This an optimal balance of cognition, movement and emotion. Hope this helps

[@neetusharma198]

Is taking Aripiprazole 2.5 mg daily increases weight gain and diabetes. Plz reply.

[@PsychiatrySimplified]

Not necessarily. At that dose and in terms of its profile its low risk for weight gain in general. However for individuals it may be different as it depends on their genes, metabolic factors, pre existing dianetes or metabolic dysfunction etc - so monitoring is needed.

[@danielfaherty491]

Hi Doctor, I am taking Olanzapine mainly for negative symptoms of schizophrenia. I don't have any positive symptoms. I like Olanzapine but I sleep for 12 hours a day. That's hard for me to deal with. Can you recommend an antipsychotic that I would sleep 8 hours instead of 12.

[@PsychiatrySimplified]

We can't give personal advice. In general when side effects occur - there are 4 options 1. Rule out other contributors - other medications, sleep disorders etc 2. Reduce dose while ensuring remission from symptoms 3. Augmentation ( usually with reduction of sedative agent and adding non sedative agent 4. Switch. There are evidence based treatments for negative symptoms that are non sedating. Cariprazine and amisulpride. For a more detailed read here is a review psychscenehub.com/psychinsights/negative-symptoms-in-schizophrenia/

[@naseermushtaq4968]

Age 25 male Plz tell me? Currently on lexapro 10mg oleanz 5mg does olanzapine cause diabetes em taking this medicine from almost 7 months em confused whether to continue med or not plz help me out? Bcz of fear of diabetes

[@PsychiatrySimplified]

Please speak to your doctor about this - it depends on risk factors etc. olanzapine is associated with a higher rates of metabolic dysfunction but this can be managed. It is crucial you discuss this with your doctor - medication should mot be stopped without medical advice. Pls see your doctor. PS not medical advice

[@DanielSRosehill]

Thanks Sanil! Appreciated the video!

[@mobillegenuiya4586]

Sir does this drug cause vivid dream. Because i get vivid dream while on this med and i feel like im barely sleeping no matter how long i sleep please sir help me out my psychiatry have no idea. Im so tired of this.

[@PsychiatrySimplified]

There are many medications in this group. Please speak to your prescriber about this complaint to consider evaluation for insomnia. Also some agents can lead to akathsia which can present with restlessness. We have videos on insomnia and akatbisia. Ps not medical advice. Wish you well.

[@kavitavakil5794]

Can we get your online consultation?

[@mobillegenuiya4586]

Sir could i ask for the link of hyperbolic tapering of antipsychotic

[@PsychiatrySimplified]

psychscenehub.com/psychinsights/antipsychotic-withdrawal-syndrome-tapering/

[@Nick-iu7ks]

I saw a tinnitus specialist (Professor Dirk De Ridder) who prescribed 0.5mg flupentixol to block D1 and take focus off tinnitus + 2mg Aripiprazole. He said the flupentixol should be taken with 0.5mg of Clonazepam to reduce chances of tardive dyskinesia. Is the risk high at this dosage? Is the Aripiprazole added to counteract the flupentixol?

[@PsychiatrySimplified]

I can’t answer this as the use of the medications seems very individualised to your situation. Please discuss this with your doctor as general information may be misconstrued. Wish you well

[@Nick-iu7ks]

@@PsychiatrySimplified I understand. What a shame we cannot share information without risk of liability ey.

[@PsychiatrySimplified]

@@Nick-iu7ks it’s not just liability but your question requires a formulation which includes incorporating all the individual factors ( your history, course etc ) into the answer. Anything less than that is an uninformed opinion or answer that I would write and that’s not fair .

[@jogigeorge5319]

Is there any relationship between Primary aldosteronism and bipolar disorder

[@PsychiatrySimplified]

Medical conditions can be associated with bipolar disorder . This can be cause or effect via another confounder. There are case reports of the association & Hyperaldosteronism is a sensitive marker for depression. an altered renal mineralocorticoid sensitivity is found in patients with depression.

[@dawitisaak437]

Why don't this damage world exist for Amnesty Why is it ok to harm only because you call them stupid

[@Amalek666]

Hello. I didnt get the chart about amisulpride/ prolactin. It doesnt cause It or It cause It Beyond belief? Asking for a friend Who Is taking 50 mg amisulpride

[@PsychiatrySimplified]

It is a very low dose. Usually prolactin increase occurs at higher doses as DA antagonism increases. However other factors that increase prolactin should be ruled out.

[@Amalek666]

@@PsychiatrySimplified thank you very much For the answer. I have another questions: If Low Dose amisulpride Is a Dopamin agonist , It can be equiparable to Parkinson medicaments for example? What's the differences?

[@PsychiatrySimplified]

@@Amalek666 low dose amisulpride acts as a d3 presynpatic antagonist so this increases Dopamine in prefrontal cortex. D2 antagonism at high doses is responsible for the extra pyramidal side effects

[@RichardHead-sw6dm]

What can a person do if they are being given this type of drug sneakily in other medications PLEASE HELP

[@Prince-yk8cr]

Hy i am taking resperidone i am face delay ejaculation please tells solution

[@PsychiatrySimplified]

Please discuss this with your doctor as there are multiple factors to be ruled out

[@Prince-yk8cr]

@@PsychiatrySimplified please you tell me i say dr but dr say leave the medicine when i leave medicine symptoms come

[@DennisBolanos]

When I was 8 years old, I was prescribed Risperdal 1 mg/d for autism, along with Dexedrine Spansule 40 mg/d. To this day, I’m intrigued as to why my psychiatrist recommended this combination. 🤷

[@kareendeveraux1847]

Why? Because your psychiatrist was a quack, as many (not all) are. With autism, your parents should have been advised to adjust your environment to your needs and not throw neurotoxines at you, especially as a child... (I have autism, too.) As in the video, it should be used for psychosis, and only short term, if possible. As for the use of neuroleptics, they are the standard drugs to take people out, in foster care, hospitals, prisons, nursing homes. The guidelines recommended to use haloperidol for covid patients. So... I'd call it medical abuse of society. 🤷‍♀️ (But that's my personal opinion and I don't have a phd in talking bullcrap, so I guess it doesn't count.)

[@PsychiatrySimplified]

The dexedrine is prescribed in autism to treat possible symptoms of inattention, impulsivity, ADHD which is comorbid. The risperidone has been in literature for autism to manage the ‘ behavioural disturbances’ - aggression etc. Risperdione in ASD now is being reconsidered due to the SE profiles. This is in general. Individual combinations are best discussed with the doctor.

[@DennisBolanos]

@@PsychiatrySimplified OK, thank you!

[@kareendeveraux1847]

@@PsychiatrySimplified Actually, I do think that public discussions about certain drug combinations, that are prescribed to people, are necessary in order to avoid more harm. It's called quality assurance and looking at the bad outcomes of psychiatry in general, absolutely needed. It makes no sense to me to prescribe a drug (dexedrine), that activates dopamine, and a drug, that blocks dopamine, at the same time. Am I missing some information here? Regarding the drug ripseridone in general, the lawsuits are only targeting the visible damage (man boobs), but neglecting the invisible (brain damage). Psychiatrists have to assume, that the pharma companies downplay the side effects by far and that seems to be one reason why psychiatry fails all over the place. Additionally, the damages of those drugs made their way into the typical symptoms of certain "mental disorders". For example, problems with eye movement that are directly caused by the anticholineric toxidrome are taken as proof for being schizophrenic. Furthermore, many drugs can cause hallucinations. It really raises the question in many cases: is psychiatry treating or also causing "mental illnesses"? (I'm not saying that mental illnesses don't exist. I'm questioning the treatment approaches because they make no sense to my aspie brain. Am I missing information?)

[@PsychiatrySimplified]

Understand where you are coming from. It is the doses at which they are prescribed and the synergy combined with individual factors where the risks and benefits are obtained. So appropriate dosing of Dexedrine increases PFC and striatal DA without increasing mesolimbic DA significantly (mesolimbic where psychosis originates). Risperidone at appropriate doses reduces mesolimbic DA while maintaining PFC and striatal DA through 5HT2A antagonism. at high doses it moves towards a D2 antagonist leading to significant side effects. Having said that prolactin elevation occurs at lower doses and is a side effect one should aim to avoid.

[@BrookeCollister-bw5rj]

I need your help doctor. I'm in mental and physical trouble. Can we possibly email or something 😔

[@mobillegenuiya4586]

Same

[@sorianasor9730]

very nice vid

[@PsychiatrySimplified]

Thank you 🙏🏼

[@naseermushtaq4968]

Plz reply

[@mobillegenuiya4586]

Sir my psychiatry prescribe olanz instead giving exposure therapy for my social phobia , thats crazy. Why would i take medicine if simple exposure therapy Will do the trick . They are so easy to prescribe high potent and dangerous drug. To be honest with you , im blaming them for that

[@PsychiatrySimplified]

Have a discussion with your doctor as they will be able to justify the reasons. Wish you well.

[@hypebeastuchiha9229]

Aren’t Antipsychotics linked to decreased gray matter?

[@PsychiatrySimplified]

There is a link but this is not causal as the illness such as schizophrenia is ideals associated with grey matter decrease.

[@bevvallieres4139]

Psychotic medicine, depression, medicine terrible thing to be on was put on for years and years and years I knew know better so many bad side effects. Never my mind never got better. I just seem to get worse and I was stupid enough to keep staying on it until one day I had enoughgot on vitamins, herbs, healthy, eating and exercise and of course if you need someone to talk to that’s great medicine crap

[@mobillegenuiya4586]

I read somewhere on the internet that olanzapine can cause vivid dream. I take olanzapine everyday. Is it true

[@PsychiatrySimplified]

Not necessarily. Much lower probability of this happening.

[@mobillegenuiya4586]

@@PsychiatrySimplified so it does have the probability happening then?

[@mobillegenuiya4586]

@@PsychiatrySimplified how is it much lower probability of this happening , i know it sounds Rude but i don't mean to, i just want answer

[@PsychiatrySimplified]

@@mobillegenuiya4586 Olanzapine has antihistaminergic action so sedation is prominent - in the majority of cases vivid dreams is not an issue. Where this can be an issue is if the dose is higher nd is a reflection of possible akathisia (but akathisia is also present during the day ) - a subjective or objective compulsion to move - restlessness. This restlessness in sleep can manifest as dreams

[@mobillegenuiya4586]

@@PsychiatrySimplified thanks a lot!