[Sometimes psychotic]

Psychiatrists' Judgments About Antipsychotic ... [Psychiatr Serv. 2014] - PubMed - NCBI

Apparently a few side effects never hurt anyone...EPS had little impact on psychiatrists picking a med or even a 15% weight gain.

What did matter? Hallucination and delusion remission were 10 times more important than either of those side effects...while improvement in negative symptoms which cannot even be treated with meds effectively were still 3 fold higher than considerations about weight gain. Funny how it works out when a doc doesn't have to adhere to these things him or herself. Even changes in social interactions were over double the importance of weight.

Keep this in mind next time you go to the doc. I think we've all experienced a lack of concern from the docs over weight gain but a lot of us have to deal with it. Even metabolic syndrome was half as important as a change in social interactions so diabetic but talking with people is apparently the goal. It's almost like they forgot they were actually MDs.

[newtus]

in august 2013 - before i started the injection i was 105. now im 137. im so mad how they forced 100mgs on me like that. makes me so mad.

[Sometimes psychotic]

Originally Posted by newtus

in august 2013 - before i started the injection i was 105. now im 137. im so mad

Yeah I don't know why they don't care about this...it pisses me off too

[TheatreKid]

My doc is relatively sensitive to weight gain. She knows I was anorexic in the past and I'll quit taking it if I gain a lot of weight. She's not always sensitive though - when I was on Zoloft I couldn't pee and she kept encouraging me to wait it out... yeah, no.

[Sometimes psychotic]

Originally Posted by TheatreKid

My doc is relatively sensitive to weight gain. She knows I was anorexic in the past and I'll quit taking it if I gain a lot of weight. She's not always sensitive though - when I was on Zoloft I couldn't pee and she kept encouraging me to wait it out... yeah, no.

Yeah I didn't poop for 5 days on risperidone and my doc was like I don't think it's the meds....um yeah let's see I have pooped every day from birth now not so much...wonder what it could be. I had to tell him I wasn't having a period and he switched me right away....apparently me not have a sex drive due to no period was an issue but basic biological functions not so much....

I have endured so many side effects on psych meds, and yet what P'd me off the most is when ex-pdoc made out like I was moaning on about nothing and wouldn't put up with the slightest little side effect. I had several meds that interfered with me peeing. On one it would take me an hour sitting on the toilet before the sphincter would relax enough to start peeing!!! And yet I persevered, so I don't exactly quit at the tiniest little thing! Yet, when I stopped reboxetine because I was having these 'attacks' of sweating, dizziness, darkening of vision, muscle weakness, and felt like I was going to pass out and kept vomiting FOR TWO WEEKS!!!!! She made out like I didn't give the drug a fair chance!

I really don't think that they have a clue what these drugs can do to people. If it was happening to them, they'd probably sing a very different tune!! :/

*Willow*

[nbritton]

I tell my doctor that weight inducing drugs are a deal breaker, it's up to you to tell them what's important to you. If they, repeatedly, don't listen then you should find someone else who will. You are paying them to help you, so be assertive with your wants and needs.

[Sometimes psychotic]

Originally Posted by nbritton

I tell my doctor that weight gain inducing drugs are a deal breaker, it's up to you to tell them what's important to you. If they, repeatedly, don't listen then you should find someone else who will. Be assertive with your wants and needs.

I think for me the key problem was not realizing that the meds would cause major weight gain etc sure there are like 100 symptoms on the package insert but how do you know which ones are likely to happen to you and I have to say that initially I was willing to put up with whatever the side effects just to stop the voices...I didn't get picky until later...

I think it's also difficult if you're looking at a two month wait for another pdoc who might not be any more responsive to your needs in order to get that med switch...I was tempted to just go off the meds right away when he finally switched me to abilify. I'm glad that didn't happen because I had no idea it could induce psychosis at the time...

[newtus]

with some insurances like mine - you dont have many options. unless youre willing to pay out of pocket which i cant afford

[Sometimes psychotic]

Originally Posted by newtus

with some insurances like mine - you dont have many options. unless youre willing to pay out of pocket which i cant afford

Medicaid and Medicare I thought covered all the antipsychotics by law?

[newtus]

Originally Posted by Sometimes psychotic

Medicaid and Medicare I thought covered all the antipsychotics by law?

but they dont cover all doctors or even some. im limited to maybe a couple of pdocs in this area and then the CMHC. the community services. thats the main one where they want people to goto with medicare/aid.

[Sometimes psychotic]

Originally Posted by newtus

but they dont cover all doctors or even some. im limited to maybe a couple of pdocs in this area and then the CMHC. the community services. thats the main one where they want people to goto with medicare/aid.

Oh I see I thought you were talking about the meds and not the docs....my mistake...

[The_little_didgee]

I have often wondered about haphazard prescribing of anti-psychotics, especially ones that promote the accumulation of fat in the midsection. It is well known that abdominal fat increases the risk of heart disease and type II diabetes.

Medications are not something, I take lightly. I only take them if I am in pain or my "illness" is impairing my ability to function. When I was on olanzepine, I gained about 10 to 15 pounds. I'm a small lady (5, 3"; 115 lb). People noticed the weight in my chest and rear. The drug really worked but it made me so damn hungry. No matter what I eat and how much, I never felt satiated. Fortunately, the drug induced hyperphagia never caused any health problems.

I knew two people who died prematurely, while taking olanzepine for schizophrenia. Both gained an enormous amount of weight shortly after they commenced treatment. One of these individuals was reluctant to get checked out, even though he complained about terrible indigestion shortly before he died. This was a sign that a heart attack was imminent. Both these individuals were men who smoked. One of them used a lot of drugs and drank. Obviously the olanzepine wasn't the sole reason for their premature deaths.

This makes me wonder about the off label use of anti-psychotics. People are often prescribed these drugs for problems, such as insomnia q.h.s. (when they don't have a psychotic illness).

People taking anti-psychotics should be monitored by a medical doctor, especially if they have a family history of type II diabetes and cardiovascular disease, drink, use drugs, and smoke. This should be mandatory.

[Sometimes psychotic]

Originally Posted by The_little_didgee

People taking anti-psychotics should be monitored by a medical doctor, especially if they have a family history of type II diabetes and cardiovascular disease, drink, use drugs, and smoke. This should be mandatory.

Yeah I mean for me it seems obvious that pdocs should order labs when they start people on this kind of med---they are MDs and they can order blood draws/testing etc but my pdoc was more worried about my prolactin levels than fat/sugar issues....lame

Also when I was in the hospital I got dizzy taking my meds and had low blood pressure---sure they took me off that med but given that it can cause Qt prolongation, arrhythmia etc why didn't they just give me one of those little pulse monitors that clips on your finger----I mean I was in the freakin hosptial---why the substandard care?

It's almost like they don't consider the things that are induced by the meds to be their responsibility---like they forgot they are actually doctors....

[junkDNA]

is it bad to have a high prolactin level? like is that bad for ur health?

[Sometimes psychotic]

Originally Posted by junkDNA

is it bad to have a high prolactin level? like is that bad for ur health?

No he was worried because I had no period...that's what I'm saying---he was actually worried because I had no sex drive now fat and diabetic that's OK but hey something involving social interaction well he sees that as his job but not the rest....its like pdocs just stopped thinking about peoples actual global functioning medically instead of the GAF...

[ickydog2006]

I was actually really surprised with my pdocs concern about weight gain as a side effect, he specifically avoided putting me on certain meds because he didn't want me to gain weight, he felt like that would just worsen the depression for me.

[faerie_moon_x]

My MIL always says: You tell the doctor you're depressed, so they give you a med that makes you fat, which causes you to feel depressed. It's like a snake eating it's own tail.

[venusss]

Well, they will try to pull the "fat and happy versus skinny and unhappy card" and some patients will sadly put up with it.

[Sometimes psychotic]

Originally Posted by ickydog2006

I was actually really surprised with my pdocs concern about weight gain as a side effect, he specifically avoided putting me on certain meds because he didn't want me to gain weight, he felt like that would just worsen the depression for me.

That's fantastic sounds like you have a good one

Originally Posted by nbritton

I tell my doctor that weight inducing drugs are a deal breaker, it's up to you to tell them what's important to you. If they, repeatedly, don't listen then you should find someone else who will. You are paying them to help you, so be assertive with your wants and needs.

You can't always shop around for a better pdoc though. In the UK there is the NHS (unless you are fortunate to be able to afford private treatment) and there's only a limited number of pdocs who cover your area. In Uni there were 2 pdocs working outpatient in my area. The first one I refused to see after a few appts, but luckily the second was much better. At home though there is only ex-pdoc who is a ***** and locums who change every couple of months and who go along with everything ex-pdoc says. Theoretically you can get a second opinion on the NHS, but the reality is very different :/

Originally Posted by The_little_didgee

People taking anti-psychotics should be monitored by a medical doctor, especially if they have a family history of type II diabetes and cardiovascular disease, drink, use drugs, and smoke. This should be mandatory.

In the UK, GPs are supposed to do annual physicals for people on APs, but bloods are only recommended for over 40s, which is stupid IMO.

Originally Posted by Sometimes psychotic

Yeah I mean for me it seems obvious that pdocs should order labs when they start people on this kind of med---they are MDs and they can order blood draws/testing etc but my pdoc was more worried about my prolactin levels than fat/sugar issues....lame

Also when I was in the hospital I got dizzy taking my meds and had low blood pressure---sure they took me off that med but given that it can cause Qt prolongation, arrhythmia etc why didn't they just give me one of those little pulse monitors that clips on your finger----I mean I was in the freakin hosptial---why the substandard care?

It's almost like they don't consider the things that are induced by the meds to be their responsibility---like they forgot they are actually doctors....

Yeah they just don't care about physical health :/

Originally Posted by junkDNA

is it bad to have a high prolactin level? like is that bad for ur health?

I don't think it's bad for your health per se, but it's bad for your fertility. High prolactin inhibits your periods because your body thinks you're breastfeeding a young baby and not in a good position to get pregnant yet. Thinking about it though, not regularly having a period *may* have an impact on risk of female cancers, but I'm not certain about that. (ETA: the research is mixed regarding the role of prolactin in cancers such as breast, ovarian, uterine, colorectal and prostate). It's best to switch a med that raises your prolactin IMO, but then future fertility is important to me.

Originally Posted by faerie_moon_x

My MIL always says: You tell the doctor you're depressed, so they give you a med that makes you fat, which causes you to feel depressed. It's like a snake eating it's own tail.

True!

Originally Posted by VenusHalley

Well, they will try to pull the "fat and happy versus skinny and unhappy card" and some patients will sadly put up with it.

Some people put up with it because they feel like they cannot be assertive about their care, or they don't realise that there are alternative meds that might not cause weight gain. Some people genuinely believe that fat and happy is better than skinny and unhappy.

*Willow*

[newtus]

i always vote for the skinny and unhappy card. (i know people here will think im crazy for saying that)

[faerie_moon_x]

They did a study on women once where they asked them if they'd rather be really smart and ugly, or really beautiful and dumb. As I remember it, a very large percentage chose the really beautiful and dumb card...

It's like. would you rather have these symptoms and thin or these side effects and no symptoms. But the problem is that obesity causes a lot of other problems too. It's like a no win situation. With the epidemic of obesity and diabetes you'd think they would be concerned. We have a poster in our office showing that if diabete was a nation, it would be the 3rd largest in the world, bigger than the population of the US.

In my experience, the choice is fat and unhappy or skinny and unhappy. Meds have never worked for me, but different ones have made me both fat and skinny. In the last 7 years my weight has fluctuated from -1 stone to +2½ stones on my baseline, which I had maintained for years without effort. I was very upset about the weight gain at +2½ stone because I was officially overweight and I felt out of control and worried about my health e.g. diabetes. I've lost 1stone from stopping meds, but now I'm not considered overweight it doesn't bother me as much.

In an ideal world I'd like to lose another stone, maybe the other half stone as well, but not enough to actually diet properly and exercise more. Dieting is hard and I have yet to find an easy/accessible form of exercise I like, and I struggle with motivation. Maybe I'm not so bothered about the weight because of my apathy, idk?? If I could wave a magic wand and be happy but have to stay at this weight, or go back to my base weight but have to stay feeling this way, then I would choose happiness, but maybe not if I had to go back up to my fattest...IDK?!

*Willow*

[junkDNA]

well my prolactin is really high and i dont get my period anymore. im pretty sure its the risperdal or now the invega. i told pdoc and T about this but idk how much they thought it was an issue. i am worried its messing me up. i dont know how i would feel if i became infertile. i dont like kids (dont hate me) and have always thought i would be a bad mother. idk why am i rambling about having kids.