Talk:Antipsychotic

3rd Generation Anti psychotics

What is the classification for 3rd generation anti-psychotics? I put bifeprunox under the list that already had abilify on it. I presume 3rd generation drugs are partial dopamine antagonist. —Preceding unsigned comment added by Sp0 (talk • contribs) 05:44, 24 September 2008 (UTC)

Asenapine

This article does not list Asenapine but it lists Bifeprunox

Efficacy

In Skeptic magazine vol. 13 no. 3, 2007, there is an article, "The Trouble with Psychiatry," by John Sorboro, M.D. He says the following on page 42:

Even what most psychiatrists assume would be an obvious and universal approach of drug therapy to treat the most "biologic" of psychiatric diseases, schizophrenia lacks the kind of clarity most people assume exists. Recent landmark trials over 12-18 month periods funded by the US and British government involving the treatment of schizophrenia, found that regardless of medication used, many patients stopped taking medication, the medications demostrated a relatively poor efficacy, and new expensive medications did not perform any better than the old inexpensive ones.

he cites:

Bola, J.R 2006 "Medication-Free Research in early epsisode schizophrenia: evidence of long -term harm?" schizophrenia bulletin

Lieberman J A 2005, "Effectiveness of antipsychotic drugs in patients with chronic schizophrenia" new england journal of medicine

Rosenheck, R.A 2006 "Outcomes, costs, and policy caution: A Commentary on the cost utility of the latest antipstchotic drugs in schizophrenia study" Archives of general psychiatry. Sp0 (talk) 00:46, 10 May 2008 (UTC)

There's not much new here - it's WELL understood that psychosis is very difficult to manage and poorly understood, and the drugs available (which ARE effective) are the best of a bad bunch rather than brilliant treatments. I think it's generally appreciated that any improvement of new drugs is not light years ahead of older drugs, and despite Sorboro and the research cited there is also a lot of medical opinion and research that suggests later generations are generally at least a bit better or a bit less harmful. Remember that what counts as a "better" drug in practice is based on a complicated balancing act that partly depends on your value system regarding different benefits and side-effects, and depends very much on the individual patient. Having said that, I think it's pretty reasonable to have a brief, not-too-strenuous disclaimer that there is good research that suggests there is less than full support for the wholesale movement of everybody onto later generation drugs. 131.172.99.15 (talk) 06:08, 13 June 2008 (UTC)snaxalotl

I think the second paragraph, detailing as it does the dangers of antipsychotics, is particularly important now that many psychiatrists are augmenting reasonably safe drugs, e.g. SSRI's, with atypicals. It is important to the reader to be acquainted with the considerable risks involved with being treated with these drugs-and use might reasonable be confined to psychosis and not add-ons for depression, anxiety, etc.. A well done and important section, even though that's a POV comment.

Dehughes (talk) 23:01, 20 October 2010 (UTC)

Classes

Added Haloperidol which is never shown under 1st generation antipsychotics. Madglee (talk) 00:03, 15 April 2008

LY2140023

now... i'm reading the article, and i've been wondering... "Dr.Sandeep Patil's team proved that LY2140023 appeared to work as an antipsychotic when tested upon rodents." - i cant help but wonder, how do you measure how psychotic a rodent is? are psychiatric drugs really supposed to show efficacy on animals during clinical trials? are drugs given to humans at random, just because they didn't manage to kill a rodent? i know this is what the source says, and its supposed to be a reliable one, but this sounds too unrealistic to me. Fdskjs (talk) 01:50, 12 April 2008 (UTC)

agree. you absolutely CANNOT say that some drug works as an antipsychotic on rodents. you can only say that some drug has some certain effect within some certain animal model of psychosis. anyone who doesn't understand how to do this has no business making an entry like the one you describe. this is the sort of article that attracts a lot of nutters, and I think it's generally a good idea to summarily weed out anything that is "not very good" or "not very clear", because if something really needs explaining to complete the article, someone who knows what they are talking about will eventually come along and do it. Honestly, large amounts of this article look like it's been mangled by someone with a psychology freshman understanding of psychosis. I have a copy from a couple of years back that read s like a real encyclopedia entry. 131.172.99.15 (talk) 06:20, 13 June 2008 (UTC)snaxalotl

Antipsychiatry opposition

Someone should mention anti-psychiatry's opposition to these drugs. --Daniel C. Boyer 17:33 Jan 13, 2003 (UTC)

I think the main objection has been to the use of forced or coercive medication rather than to any particular treatment per se. Certainly Szasz would aruge that people should have free access to antipsychotic drugs but would argue against their control or imposition against someone's will. - Vaughan 12:25, 1 Aug 2003 (UTC)

I agree that this article is conspicuous by the absence of the initial point raised above. Antipsychotics were a primary target of the original 60s/70s antipsychiatry movement, often referred to as chemical straightjackets. Avoiding them (entirely or relatively) was a key part of developments like soteria. The modern antipsychiatry or consumer/survivor movement is also associated with a lot of criticism of their potentially anti-recovery long-term use, and of the basis for the huge pharmaceutical industry promotion of atypicals now that the typicals are out of patent. I'm sure it could be covered in the context of good balanced sections on effectiveness claims and adverse effects, they're a bit random-seeming in their coverage at the moment. EverSince 02:50, 23 December 2006 (UTC) p.s. i've added a subheading that wasn't there before, to try to clarify the discussion, I hope this is OK

However much you don't like anti-psychotics, without them, labotomies would have taken longer to reduce to their current levels. Supposed 21:58, 28 August 2007 (UTC)

I don't agree that the main objection is coerced medication (but I definitely agree this should be a serious ongoing concern). There are enormous numbers of people who think psychosis drugs interfere with a perfectly normal mode of being (e.g. classic 60's anti-psychiatry movement), or that you can just buckle down and THINK your way out of schizophrenia (e.g. all scientologists). I absolutely don't think it's valid to express these views as established scientific fact in a general encyclopedia article, but I think it should be mentioned that these views exist and who holds them. This is a significant sociological fact. I can think of at least one household name who claims to be a widely read expert on psychiatry, despite having a complete misunderstanding of some of the most basic issues in the field. 131.172.99.15 (talk) 06:29, 13 June 2008 (UTC)snaxalotl

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This article is a bit chaotic but I've added a few things and hopefully cleared up the most obvious red herrings.

I'll try and spend some time to organise and reference it a little better in the near future. - Vaughan 12:25, 1 Aug 2003 (UTC)

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Minor change from 'The term antipsychotic is applied to any drug used to treat psychotic disorders...' to 'The term antipsychotic is applied to a group of drugs used to treat psychotic disorders...' as (for example) benzos and antidepressants can be used to treat psychotic episodes, however these are not considered to be antipsychotics.

- Vaughan 12:30, 1 Aug 2003 (UTC)

I think this is somewhat wrong. as you say, these drugs treat episodes, not the disorder per se. antipsychotics produce a generalized improvement in function (within the context that everyone understands they're more ok than great), so I don't think the examples conflict with the original. the new version is fine, though. —Preceding unsigned comment added by 131.172.99.15 (talk) 06:38, 13 June 2008 (UTC)

Amotivation

The article on dopamine mentions that some anti-psychotics that affect dopamine activity can act as amotivators. Is anyone able to elaborate on this?

Look below in "Making symptoms worse / side effects".

128.151.161.49 17:34, 6 March 2006 (UTC)Iain Marcuson

The part about off-label uses for antipsychotics is incorrect. Pimozide and Haloperidol are indeed used for Tourette's Syndrome, but those are FDA approved drugs for that condition. Off-label refers to treating a disorder with a drug that is not approved for such usage, such as using an anti-seizure medication to correct a mood disorder.

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One thing I notice isn’t mentioned clearly in the article is the disastrous effect some of these drugs can have on people. In 1997 I suffered a mental breakdown and had what was called a severe psychotic episode (basically due to extreme stress), I was sectioned and put in mental hospital and was put on Droperidol, paroxetine and a short course of high dose lorazepam. My symptoms from these 'anti-psychotics' became very severe. I became suicidal while in hospital and I never had been ever before. Worse, as the drugs ‘cured’ my bipolar 'depression' my reality began to slip and for a while after I was out of hospital I lost my core reality completely. I had gone from being psychotic and manic depressive to full blown schizophrenia. Eventually I began to regain reality, and have at least partly recovered but it has been a very difficult process and I don't even know if I would be alive now if it wasn’t for my families (especially my mothers) huge help.

I am probably the ultimate non-typical mental patient, until my breakdown I had been well rooted in reality for all my then 27 years. I was and am a computer scientist, I was specialising in AI and machine intelligence, I had a reasonably good knowledge of neurology and psychology, had been actively studying human consciousness for several years and was specialising in vision systems. What makes me even more untypical was that I had just made a breakthrough and was contemplating something not worth millions but many billions of dollars, and it was the stress of this this that I partly blame for the original breakdown.

The source of all my problems was that the doctors treated me like a sausage in a sausage factory, most of the people in that (uk) hospital got the same drugs as me and its obvious that its not so much the drugs fault so much as the way they were prescribed - the doctors and the system. Understandably I now have a deep fear and a certain hatred of psychiatrists because of this - just like seemingly most other mental patients. Another point not mentioned is the huge physical damage the drugs do to people, the line of emaciated half corpses that were most of the patients in that hospital reminded me unmistakably of Dachau.

I apologise for the length of this but its not easy to put things simply. Lucien86 05:58, 4 June 2006 (UTC)

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Sorry Lucien but it sounds like you were misdiagnosed, essentially malingering. A nervous breakdown and "acting out" often leads people to be misdiagnosed. The problem was lack of honest communication between you and the doctor. Not all mental patients hate psychiatrists. Even many who do do so irrationally or selfishly . . . many wouldn't function without psychiatric treatment. Your claim of a breakthrough in AI worth "billions of dollars" sounds pretty dubious . . . and your entire attitude sounds much like the TYPICAL immature, narcissistic mental patient. Magmagoblin2 (talk) 12:32, 15 October 2009 (UTC)

English please?

As this is an encylopedic article, could we break this down into something more understanable to the common person? I mean, the article isn't in a science magazine, nor is it being presented at a science convention of some sort. It's for the common persons and the researchers. Is it possible to make this more understandable? I read through it and I'm not an expert, but that's exactly my point. Colonel Marksman 06:31, 16 December 2006 (UTC)

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To be fair, this isn't the kind of topic generally looked up by anyone but a student or specialist, and as such, will find much more value in being indepth and technical the way it is, rather than simplified for your average user. More simplified explainations can be found in the various pages for specific antipsychotics, which is quite possibly where the information you're looking for or interested in is covered? ;-)

neodarkcell

Personally I agree that it could and should be more readable, which doesn't preclude depth EverSince 03:02, 23 December 2006 (UTC)

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Not looked up by anyone but med students or specialists? First, specialists are well versed in the knowledge presented in this wiki and likely to find it elementary. Second, what about PATIENTS?

Move?

It seems like this would be less awkward under the title "Antipsychotics," since the article is about the class of drug, not a single thing. Night Gyr (talk/Oy) 03:51, 11 January 2007 (UTC)

External link to objectionable website

There is a link under the subheading "Side Effects" (Tardive dyskinesia) that redirects to what appears to be a pseudoscience website www.yoism.org. Although there are indeed pictures there of what appear to be something like tardive dyskinesia, viewers must sift through alot of highly opinionated non-scientific garbage to get to anything of interest. Would it be ok to remove this link? Surely there must be other sources that would do better here? I will look for some.Neurophysik 05:25, 27 February 2007 (UTC)

Indications

Are antipsychotics indicated to prevent suicide? E.g. would they be given to someone who is suicidal because of depression?--137.205.76.219 16:38, 17 March 2007 (UTC)

Criticism

this section is more or less complete crap. good prognosis in developing countries is unrelated to occurrence rates or neuroleptics, but probably the superior management that arises from being better accepted and integrated into the community. Note that the /appearance/ of schizophrenia is highly dependent on management strategies, and also note that cross cultural studies have huge methodological difficulties, and aren't that common. the basic rule for schizophrenia is that there /is/ no good treatment, only the best of a bad bunch, and I'd hate to see the hippies, anti-psychiatrists and scientologists encouraging people to abandon neuroleptics because of crank science

I've tried making an efficacy/effectiveness section instead of a criticisms section, to include the views and evidence for, as well as against, antipsychotic efficacy. It probably needs to give a fuller account of the case for efficacy, but for now I've at least added coverage of the two major guidelines recommending them. I have tried to reliably describe and source the case against, which is a bit more disparate. There are more specifics on efficacy in the section comparing typicals and atypicals. EverSince 14:52, 10 August 2007 (UTC)

Sounds a good way to make it balanced. This article needs alot of work....cheers, Casliber (talk · contribs) 15:27, 10 August 2007 (UTC)

Research / Upcoming Antipsychotics

Should there be a section describing current research and a list of drugs in the pipeline for each research/future treatment area?

cannabidiol

I've no idea where to put cannabidiol in this article. It's been shown to act as an anti-psychotic so can be described as one. However, the definition of both typical and atypical anti-psychotics describes these as prescribed drugs. I also don't know whether to call it a typical or an atypical anti-psychotic. Supposed 21:45, 28 August 2007 (UTC)

how about you just leave out cannabidiol? this article attracts enough nutcase irrelevency as it is. I'm sure YOU are sure you've seen fan-fucking-tastic evidence of it's anti-psychotic efficacy (along with that car that runs on water tha everyone's been hiding) but the simple fact is that you can read a textbook on psychosis, or do a degree in neuroscience, without seeing cannabidiol mentioned. Trying to insert this sort of information will confuse people rather than enhancing the sort of understanding of the topic an encyclopedia article is supposed to deliver. 131.172.99.15 (talk) 05:48, 13 June 2008 (UTC)snaxalotl

The reference given is really very poor. It certainly does not belong in a section on treatment and as such I have removed it. The study details some pre-clinical animal studies, a trial on patients who did not have schizophrenia (using ketamine as a model), a couple of case studies and a preliminary report from a trial of 43 patients. The only one of any significant interest is the trial of the 43 patients against amisulpride (given as Leweke FM, Koethe D, Gerth CW et al. (2005). Cannabidiol as an antipsychotic: a double-blind, controlled clinical trial on cannabidiol vs amisulpride in acute schizophrenics. 2005 Symposium on the Cannabinoids, Burlington, Vermont, International Cannabinoid Research Society. http://CannabinoidSociety.org.) however it unfortunately appears to be impossible to track down, I can only assume it was never published (or we are still waiting) - this is not good enough to belong in an encyclopaedia. If anything it could be mentioned that there is some research at a very early stage but nothing more than that.82.39.196.227 (talk) 23:09, 3 October 2008 (UTC)

Please read this Talk:Effects_of_cannabis#Cancer_section. I actually share your concerns about the sample size of studies and conclusions drawn from them, however I agree with the conclusions of Pundit|utter in his discussion of these issues in the link above which has implications as to wether we should include in this article the studies you make reference to.Supposed (talk) 20:24, 4 October 2008 (UTC)

In the wiki article, CBD is presented as if it is a real option (under the "Common antipsychotics" heading!) for schizophrenia treatment - which it obviously (at least in the real world) absolutely is not. Surely it can be moved elsewhere in the article, preferably under a more suitable heading which properly reflects the reliability of the study's conclusions? Or perhaps changing it to "Cannabidiol One of the main psychoactive components of cannabis. An unpublished randomised controlled trial has been reported to show that cannabidiol could be as effective as atypical antipsychotics in treating schizophrenia". At the very least could we not qualify that raw cannabis drug would not have the same effect? The referenced article itself mentions that THC causes symptoms similar to schizophrenia, and there are many other peer-reviewed papers (although similarly nothing concrete) linking cannabis use to psychosis.82.39.196.227 (talk) 23:02, 5 October 2008 (UTC)

I'm concerned by this as well. I'm intimately familiar with both marijuana and schizophrenia, and I have heard that marijuana can set schizophrenia off. This article could be dangerous. AThousandYoung (talk) 02:04, 6 April 2009 (UTC)

I've modified the text slightly to tone it down. Perhaps further editing would help. --Tryptofish (talk) 14:45, 6 April 2009 (UTC)

Cannabis is the worst thing you could give a schizophrenic. Speaking from experience, I'm terrified of the stuff because it brought all my nightmares and delusions back . . . I was rabid, pacing, and completely freaked out for two days, then crushingly depressed and paranoid for a week. PARANOIA is one of the chief symptoms of schizophrenia and one of the notorious side effects of pot. I'm gonna go ahead and take out this reference, because it's terrible advice, could be very dangerous (many schizophrenics lack medical care, but have easy access to marijuana, and this "study" would encourage them to try it, and then who knows what'll happen) and there is no way cannabis is ever going to be prescribed to the mentally ill. Cancer patients, sure. Schizophrenics, no. Magmagoblin2 (talk) 12:23, 15 October 2009 (UTC)

Hi, the purpose of wikipedia is to provide factually accurate largely scientific information in an encylopedic format. We simply report and cite the conclusion of experts in each field. Wikipedia is not a guide for people taking drugs. If people want to use it as a guide, that is not the business of wikipedia to police it. Besides the fact that you are talking about cannabis not cannabidiol specifically, there is plenty of evidence that people with schizophrenia self-medicate with cannabis, infact that's one of the very reasons why this research on cannabidiol has been done. Wikipedia is not in the business of satisfying the agenda of a concerned party, because of the accurate information presented may not be to their taste. That is censorship and has no place here. I should add that plenty of people in the USA are prescribed cannabis for psychiatric conditions. Even the American Psychiatric Association Assembly (a very large and important medical organization) unanimously Back Medical Marijuana. [1]Supposed (talk) 00:15, 16 October 2009 (UTC)

Making symptoms worse or adding side effects.

To anyone reading this - In my experience, antipsychotics will completely demolish one's sense of social anxiety, paranoia, and being in the dark. If you embrace your healthy sense of paranoia, taking these will make thinking about such things an arduous task. In addition, I used to have love for things like fire and the outdoors, but I no longer have significant feelings for them. —Preceding unsigned comment added by 69.250.158.97 (talk) 17:44, 30 May 2008 (UTC)

Also, in my comment about motivation and desire, there is a scientific study which shows that when rats are injected with antipsychotics and made to run a maze, they do several times better when they are thereafter injected with L-dopa (the bioavailable form of dopamine).

I have schizophrenia and have taken Risperdal and now Zyprexa.

This article describes the dramatic increase in synaptic dopamine bought about by release of endogenous dopamine by electrical stimulation and antipsychotic treatment, and the experiment was successfully repeated a number of times and established.

http://jpet.aspetjournals.org/cgi/content/abstract/232/2/492

Similar levels of dopamine (in the mM range) are achieved with amphetamine and can lead to disturbed sexuality. With such high levels of dopamine, serotonin usually ramps down - could this lower serotonin cause depression and guilt.

-Steve. —Preceding unsigned comment added by 131.181.251.66 (talk) 12:36, 9 October 2007 (UTC)

I've no idea, however as you're no doubt aware the article is in vitro which doesn't help Supposed (talk) 17:07, 15 April 2008 (UTC)

quetiapine, sedation and major-tranquilisers

Quetiapine is quite an effective tranquiliser at doses below 200mg. I was under the impression that quetiapine is referred to as a major-tranquiliser. I can certainly mimic some of the effects of benziadiazapines although it's not itself considered an anxiolytic. My question, is it just typical anti-psychotics that are referred to as major tranquilisers like the article says, because it appears to me that drugs like quetiapine may be even more sedating and anxiolytic in effect than some of the typical anti-psychotics. "Typical antipsychotics are also sometimes referred to as major tranquilizers, because some of them can tranquilize and sedate." Supposed (talk) 06:03, 17 April 2008 (UTC)

Problem is all the uses of labels. Major Tranquiliser is an old term applied to all antipsychotics, while benzodiazepines were minor tranquilisers. The terms aren't used much anymore. Any drug with sedating properties (suhc as quetiapine) will have some anxiolytic properties, however the term anxiolytic as such is generally restricted to drugs like Xanax (alprazolam). Hope that helps. Cheers, Casliber (talk · contribs) 06:41, 17 April 2008 (UTC)

Thanks for your response. "Major Tranquiliser is an old term applied to all antipsychotics, " hmm. Then I think we need to remove the word 'typical from the following sentence, "Typical antipsychotics are also sometimes referred to as major tranquilizers, because some of them can tranquilize and sedate." Is there anything reputable online that refers to all anti-psychotics as major tranquilers, or are you trying to say that the term is merely of historica significance, such that no anti-psychotics would be referred to as that today? Inregards to 'anxiolytic', the same paper that referred to cannabidiol as an anti-psychotic also referred to it as an anxiolytic. This is of particular signifance as in contrast to benzo's it's non addictive and illegal even on prescription. Supposed (talk) 16:02, 18 April 2008 (UTC)

RE ANXIOLYTIC, could you possibly help me clean the article up as there appears to have been an awful lot of crap added to it recently but I didn't keep an eye on it. [2] I haven't heard of cannabidiol actually inducing anxiety in people. Supposed (talk) 16:08, 18 April 2008 (UTC)

It has been said..

• I quote:

  It has been said that these studies require serious attention and that such effects were not clearly tested for by pharmaceutical companies prior to obtaining approval for placing the drugs on the market.[17]

  Is this really the words from the article cited (PMID 18263882)? I've no access and the abstract seems not to mention this theme. --CopperKettle (talk) 02:13, 19 December 2008 (UTC)

Third generation?

There is a subsection "Third generation antipsychotics". Very strange.. who's deciding that Abilify is "third-generation" and on what basis? --CopperKettle (talk) 15:17, 7 January 2009 (UTC)

There are more side-effects

...than just those listed in the side-effects part. Demotivation ought to be listed. 74.195.28.79 (talk) 22:51, 11 March 2009 (UTC)

Zotepine?

Zotepine is an second-generation antipsychotic commonly used in Japan and some countries in East Asia. It is absent in this page. Cause? Ryojames (talk) 10:40, 18 May 2009 (UTC)

I added it and associated info to the list of second-generation agents.--Metalhead94 (talk) 02:26, 3 July 2009 (UTC)

And on a second thought, it may have been left out due to have only been approved in Japan and Germany. It seems to me that a majority of articles on antipsychotics and pharmacueticals in general are overwhelmingly America-centric.--Metalhead94 (talk) 02:30, 3 July 2009 (UTC)

Conflicting Research

[3] It seems that increasing serotonin levels (through omega-3 fatty acids) actually decreased the symptoms of psychosis, but some antipsychotics are actually serotonin antagonists. This also seems to point to the same conclusion. However, this suggests that there is no link between serotonin levels and schizophrenia (or at least its first episode). MichaelExe (talk) 16:56, 7 September 2009 (UTC)

Hi Michael. I think I can answer that. Omega-3 fatty acids do not actually increase the amount of serotonin in the brain, to the best of my knowledge. According the the first source you cited, they get into the lipid bilayer and, by altering the fluidity of the membrane, alter the activity of the 5-HT2 receptor. Those first two sources you cited were using platelets as a model system to look at how the fatty acids might affect the receptor in membranes, not to look at fatty acids as a clinical medication in the brain. Overall, I don't think this information needs to be addressed in the page. --Tryptofish (talk) 17:06, 7 September 2009 (UTC)

Well, these sentences seem a bit confusing, then: "Previously, we have demonstrated a significant inverse correlation between 5-HT responsivity and psychosis severity in unmedicated patients with schizophrenia. Taken together, the present data support the notion that EPA may be mediating its therapeutic effects in schizophrenia via modulation of the 5-HT2 receptor complex." MichaelExe (talk) 19:31, 7 September 2009 (UTC)

Also, from Docosahexaenoic acid: "Low levels of DHA result in reduction of brain serotonin levels[4] and have been associated with ADHD, Alzheimer's disease, and depression, among other diseases, and there is mounting evidence that DHA supplementation may be effective in combating such diseases." Unfortunately, the cited website no longer exists, but a quick google search for "DHA Serotonin" has several results claiming that consumption of DHA (an omega-3 fatty acid) increases serotonin levels/production in the brain. MichaelExe (talk) 19:42, 7 September 2009 (UTC)

I've corrected the unsourced material at the DHA page. I'm afraid there is a lot of "stuff" out there about nutraceutical treatments for diseases that are scientifically speculative. If other editors disagree, I'm open to suggestions, but I'd lean against modifying this page to include material that is as preliminary as this. --Tryptofish (talk) 20:33, 7 September 2009 (UTC)

Prevalence of use?

The data under the heading "Prevalence of use" lists the prevalence of schizophrenia and bipolar disorder, not the prevalence of antipsychotic use. These drugs are increasingly prescribed to individuals not suffering from either of these disorders so that the number of individuals taking the mediation is actually many times the amount of those with either schizophrenia or bipolar disorder. They are used for depression and anxiety and sleeping problems, and are also routinely administered to the elderly in nursing homes to sedate them. —Preceding unsigned comment added by Ilmateur (talk • contribs) 22:18, 12 January 2010 (UTC)

Changes

Hi, I am bringing a couple of changes to the talk page to try and achieve consensus. This edit removed text for the reason that antipsychotics are not used in non-psychotic individuals and thus saying the review is wrong. Antipsychotics, are not just prescribed for psychosis, they are used for example for nausea and vomiting for example from chemotherapy, sometimes off-label for sleep disorders (especially in the USA), agitation and anxiety and autistic spectrum. The article was a review of the literature so it must have been documented. The withdrawal syndrome of antipsychotics is believed to be due to increased dopamine activity. The mainstream psychiatric viewpoint is that schizophrenia is caused by excessive dopamine activity. So to disagree that withdrawal effects of antipsychotics can cause psychosis in non-psychotic patients means one should also deny the mainstream biological theory of schizophrenia.--Literaturegeek | T@1k? 00:38, 17 May 2010 (UTC)

The other point was the content added to the controversy section, which was a review which stated that research may be flawed due to failure to take into account withdrawal effects of antipsychotics. I agree that on its own it was undue weight, so I have added two other reviews which support maintenance for psychosis. Although my personal view points are not relevant, I would like to say that I do believe that there are many people who require long-term maintenance for serious mental illness and I am quite happy to add balance supporting this viewpoint. I am not trying to push a POV against the long-term use of these drugs. I think it is important knowledge that antipsychotics produce withdrawal effects which can mimic the condition being treated and if maintenance studies have failed to control for this variable, then this controversy should be cited I feel.--Literaturegeek | T@1k? 01:31, 17 May 2010 (UTC)

I see you just added "There is some controversy over maintenance therapy." I think it needs to be stated maintenance therapy for what condition.Doc James (talk · contribs · email) 04:37, 17 May 2010 (UTC)

I think the Controversy section is much better now, thanks. I made a few copyedits, including making the first sentence more specific as suggested just above. I noticed, however, that the sentence about non-psychotic patients in the Withdrawal section was added back but then removed again: I wonder if the removal was a mistake? With the explanation given here, I would have no objection to adding it back, so long as a few words are added to clarify why the patients were taking the drugs, since it was confusing without that explanation. --Tryptofish (talk) 17:54, 17 May 2010 (UTC)

Thanks, glad that you are happy with the changes to the controversy section. Your copy edits look good to me. Yes that was removed by mistake when I reverted one of your other edits. I noticed it at the time but decided to leave it removed while I waited for your response to talk page. :) I will need to get the full text of the paper in order to see why the patients were taking the antipsychotics.--Literaturegeek | T@1k? 21:34, 19 May 2010 (UTC)

Good! --Tryptofish (talk) 21:37, 19 May 2010 (UTC)

My personel experience about antipsychotics.

I am a veteran with Schizophrenia and I have was on multiple types of antipsychotics for nineteen years. However, I do not consider myself psychotic at all. Scizophrenia is one or more of the folowing symptoms as far as I have been told by the doctors. They are hearing voices, delusional, paranoid, catatonic and\or seeing things. Psychotic as far as I know is violent. I am not, but am aware that some of these symptoms could cause psychotic behavior. What I really wanted to say is that the medications are what I would call a modern day lobotomy in that they do turn you into a sort of zombie. It slows your brain down and body down. This might be why my sugar was very very (13 H1C and it should be 6) high on clozapine and 260 lbs. Many of the drugs I took were just plain aweful. The side effects were there and changing all the time. Slobbering puddles on pillows by morning, sleeping too much, no emotion, sad, uncaring, anemic requiring iron, dystonia in the form of unconsious violent cracking of my neck to name few. Once off the medications without telling the doctors my sugar returned to normal I felt better through exercise and eating right, lost 50-60 pounds and learned not to tell the doctors my problems. I asked for a psychologist instead of a psychiatrist. I found they work together over there and if there is no improvement they do recommend drugs. It seemed the side effects and the doctors telling me there was something wrong with me is the problem. On prolixin, I wound up in the mental ward shaking violently. On Haldol, I could not stay seated and getting off the drug was a nightmare of having to stay in bed and not being able to sleep or stay still. If I wanted to take the drugs I would want the lowest possible dose because they are strong and take the the same time every day, don't drink or smoke, eat right and get excercise. Also, be around people you love and trust. Give everyone a chance to be one of them. Choose your friends wisely and find a job you enjoy. —Preceding unsigned comment added by Brian1596 (talk • contribs) 23:32, 17 June 2010 (UTC)

Psychotic does not mean violent (although occasionally psychotic people are violent) but means a severe loss of contact with reality, typified by delusions, severe paranoia and sometimes hallucinations. You maybe are mixing psychotic up with the hollywood version of psychopath. This talk page is not a forum for sharing personal experiences but is for improving the article content. Please see WP:TALK and WP:FORUM.--Literaturegeek | T@1k? 23:55, 17 June 2010 (UTC)

Why isn't this just called a "sedative"?

Why are these chemicals referred to as anti-"psychotics", when what they really basically are is a sedative?

If a patient is acting too wild and crazy for the caregivers to deal with, then the doctors give them this chemical to sedate and calm them, and if the patient still is too much to handle, the amount of chemical given can be cranked up to the point of stupefaction and catatonia.

Personally I believe the name choice is to make patients more willing to accept taking the chemical. It sounds better to be given a chemical to treat your "abnormal psychotic behaviors", than it is to say we're going to slow your thinking and numb you into a fuzzy compliance.

216.56.13.231 (talk) 02:32, 30 June 2010 (UTC)

It's called that here, because that's what the sources say. As for why it's called that elsewhere, this is the wrong place to discuss it. --Tryptofish (talk) 15:23, 30 June 2010 (UTC)

Statement needing sources

"This may refer to common side effects such as reduced activity, lethargy, and impaired motor control. Although these effects are unpleasant and in some cases harmful, they were at one time considered a reliable sign that the drug was working.[citation needed]" This is found in Elliot Valensteins Blaming the brain and he also cites his source in the book but unfortunately I don't have that book anymore. Can somebody who has the book provide the citation? 24.247.174.132 (talk) 17:15, 27 September 2010 (UTC)

WP:MEDRS, etc.

Another editor and I disagree about about this edit that I made: [12]. I had noticed this edit, by another editor: [13]. Looking at the biographical page that is linked in the edit summary, I agreed with that editor that the cited sources were at odds with WP:UNDUE, WP:FRINGE, and, most importantly, WP:MEDRS. I also think that some of the language about "systematic review" and "urgently needed" went against WP:NPOV (when taken in the above context) and WP:PEACOCK, while the part about "a call that had already been made when similar results were found in 2006" goes against WP:SYNTH. Overall, per WP:MEDRS, we have to be very careful about not presenting material that goes against the medical literature in ways that might mislead our readers; these are, after all, medications that remain approved for use. I hope that explains my deletion. --Tryptofish (talk) 22:21, 5 March 2011 (UTC)

Long-term Antipsychotic Treatment and Brain Volumes

Check that out.

http://archpsyc.ama-assn.org/cgi/content/short/68/2/128

During longitudinal follow-up, antipsychotic treatment reflected national prescribing practices in 1991 through 2009. Longer follow-up correlated with smaller brain tissue volumes and larger cerebrospinal fluid volumes. Greater intensity of antipsychotic treatment was associated with indicators of generalized and specific brain tissue reduction after controlling for effects of the other 3 predictors. More antipsychotic treatment was associated with smaller gray matter volumes. Progressive decrement in white matter volume was most evident among patients who received more antipsychotic treatment. Illness severity had relatively modest correlations with tissue volume reduction, and alcohol/illicit drug misuse had no significant associations when effects of the other variables were adjusted. —Preceding unsigned comment added by 74.59.147.209 (talk) 22:38, 23 March 2011 (UTC)

Note: please see WP:COPYVIO. --Tryptofish (talk) 19:43, 28 March 2011 (UTC)

A short quote that links to its original source hardly constitutes a copyright violation. Please read carefully the link you yourself provide on this policy especially as regards the proper use of non-free content. I would be stunned, in any case, if any copy right holder pursued a case involving quotation from an abstract.FiachraByrne (talk) 12:26, 5 April 2011 (UTC)

Additionally, the section in this article discussing brain volume changes as part of the section on side effects does not source the original study. I'm going to put in the original citation and give, I think, a more accurate interpretation of their findings.FiachraByrne (talk) 12:28, 5 April 2011 (UTC)

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