The Trouble with Medications

There is no surprise that I am a preacher of medication. As a schizophrenic, talk therapy, CBT (cognitive behaviour therapy), and other forms of treatment don’t really help with symptoms of schizophrenia. To get away from the debilitating combination of hallucinations and delusions, medication is a must take.

Personally, for me, I had been put on trial for many different antipsychotics during my year and a half stint being in and out of the psychiatric unit. I remember the first medication I was on, Risperdal (risperidone). The psychiatrist swapped it with Seroquel (quetiapine), due to my complaints of a swollen tongue. From then, I went from Abilify (aripiprazole), to Zeldox (ziprasidone), until finally I was put on Clozaril (clozapine), known to be the most powerful antipsychotic. After being put on Clozaril, my symptoms began to go away (1). All this was over the course of a year and a half. It should be noted that I am still taking Clozaril to this day and would not stop in fear of relapsing.

I guess the title of this post is rather confusing, but in essence I wanted to talk about other people I know with mental illness, particularly schizophrenics. I’ve met people, whether schizophrenic themselves, or have loved ones that are schizophrenics, who don’t take medication. These are people who are in and out of hospitals because of this reason, or because they had stopped taking the medication over time. The irony is that even though I know medication allows me to function in life, I don’t blame them for refusing to take them. Yes, I believe that they could change their lives by taking medication for the rest of their lives, but the fact that they don’t; I don’t think it is entirely their fault. I remember when I was a patient in the hospital, that there was a patient who didn’t want to take her medication because she thought it would make her fat. As ridiculous as this is, it is a common side effect of anti-psychotics, and I will explain my logic for why I don’t blame her for her actions.

Medication only works if it works well enough that you can think rationally. As mentioned above, it took the course of a year for me to get on the right medication that changed my life. Which is why I understand why someone would refuse medication—if it isn’t working well enough that they can think completely rationally.

The biggest problem with antipsychotic medication is the side effects. It is a huge incentive not to take medication. Long term side effects of most anti-psychotics include constant drowsiness, weight gain, constipation, seizures, and type II diabetes (2). I remember Seroquel making me so drowsy that I kept falling asleep during the day. Risperdal not only gave me a swollen tongue, but I would also get blurry vision. Furthermore, most delusions convince you that the voices are real; so why subject oneself to such health-debilitating medication “for no reason”. To top is off, being that paranoid delusions are the main form of delusions (3), you are either convinced that doctors are giving you medication to poison you, or because they think you are hearing voices even though you “know” that the voices must be real.

The second problem lies with the practice of psychiatry in general. Psychiatrists give out medications based on your meetings with him or her and your observed behaviour—they can only examine from the outside. I was discharged and admitted into the psychiatric unit twice for two reasons. The first reason is that I would lie to the psychiatrist during meetings about getting better—the voices in my head told me that was the right thing to do, and so I listened. The second reason is that a lot of the time, I would talk to my voices quietly, and in other manners that would make my behaviour look normal. The combination of these two problems caused me to be discharged from the hospital while still being ill.

These are some of the countless reasons why I empathize with schizophrenics who are not on medication—as crazy and irrational their actions can be because of this. The fact is that I had been in that situation. However, I would have to say that without medication, I would not be where I am right now.

Footnotes

(1) If you are wondering why psychiatrists don’t start people off with Clozaril if it is the most effective drug, it is because of the health risks of Clozaril. It is considered a last-resort drug for a couple of reasons. It can cause a severe drop in white blood cell count and thus death, as well as myocarditis, weight gain, and diabetes. With respect to the agranulocytosis (sudden drop in white blood cell count), I am required to take bloodwork every month. (Source: https://en.wikipedia.org/wiki/Clozapine)

(2) Sources: https://www.nimh.nih.gov/health/topics/mental-health-medications/index.shtml

               http://care.diabetesjournals.org/content/26/5/1597
(3) Source: https://www.webmd.com/schizophrenia/guide/schizophrenia-paranoia