Should I start an antipsychotic?

Before my descent into benzo w/d hell, I was on Prozac for 23yrs during which time I never achieved remission. It definitely helped and I was able to function to a certain extent but my symptoms of depression and anxiety never fully went away. I’ve been in discussions lately with my psychiatrist about adding a low dose antipsychotic (either Abilify or Risperadal) to my AD (am currently on 20mg Lexapro). Both of us have been wary of adding anything extra to the mix whilst I’m still tapering V but his thought the other week was that he thinks the antipsychotic might have helped my condition before I was in w/d and could help now generally and possibly with my w/d. I have used Seroquel quite regularly over the years (every three weeks or a month, I would get into a very agitated depressive state and a three to four days of 25mg Seroquel would lift me up and out of it).

 

I am worried about the long term effects of an antipsychotic (weight gain, Tardive Dyskinisea) as well as the fact that, if I suffer from these side effects and decide to come off the meds, it’s something else I will have to w/d from.

 

Am I shooting myself in the foot not giving the antipsychotic a chance now or should I wait until I am off V before trying anything new? Has anyone else had to add an antipsychotic to their AD to achieve remission?

Antipsychotics are regarded as the worst of the worst, the very worst class of psychiatric drugs. If you're considering the nuclear option you should be aware of the alternatives. Have you ever considered sedating antidepressants such as agomelatine, or older mirtzapine? They have no effects upon monoamine transporters, so (in theory) they shouldn't mess with your escitalopram use.

Am I shooting myself in the foot not giving the antipsychotic a chance now or should I wait until I am off V before trying anything new? Has anyone else had to add an antipsychotic to their AD to achieve remission?

 

Remission from what?

I know someone who spent years trying to taper off pf benzo and was in complete hell with agitation, terror, rage etc.

Gave in and went on antipsychotic

Is now back in world living life for first time in many  years.

 

Nobody can tell what will help anyone but if things help ppl they shld take the,.

 

Pamster, remission from depression and anxiety.

 

Pacenik, I have considered adding Valdoxen and will discuss it again with my psychiatrist at our next appointment. Was going to discuss it anyway as an alternative to going up in the Lexapro. He proposed doing that as I had the gene test done and it turns out I am a super metaboliser of Lexapro so me being on 20mg is basically the equivalent of a normal metaboliser being on 10-15mg. He thinks a higher dose of Lexapro would be more helpful for my anxiety and OCD, something I had long before benzos were in the mix. I’m also a super metaboliser of Valium which he thinks is part of the reason I’m having such a hard time in w/d. Every cut I do feels like double that amount to my body.

 

Thank you for your reply, Ajusta, I think it’s something to consider, especially since the Seroquel used to help me before all this benzo stuff.

Hey there,

I would say just really research the AP. In my experience they simply numb you to the point of zero emotions. You can function and be in the world...but it's like you are on safe mode and can't access your feelings at all. My opinion is that it should be reserved for someone who has true psychosis ONLY, Because the risks are so great.

I took risperdahl and zyprexa years ago for post partum (long before benzos). Wasn't on it long thankfully, but definitely know how it feels and what side effects are like. Plus, I wanted to eat the entire refrigerator.

Fast forward to last year...during horrible WD CT of 2 ADs and Ativan, I was given very large doses of haladohl and zyprexa for sleep...it did not work and was NOT pretty.

Anyway, I do understand that all people are different, and you should discuss with your doctor.

I just happen to HATE APs

 

If seroquel helped you than go on seroquel l🙂

Hope,

 

I was put on Seroquel for sleep, and it did help accomplish that. The price has been FAR too large, it has wrecked my health in other ways and now I have to taper off that after the benzo. Before you take ANY AP, read the full list of risks, because ALL of that stuff really happens. In my opinion, the AP's should NOT be used off-label, I find the risks far too great and I think they are very carelessly prescribed. That is of course only an opinion. but we are SO sensitive to medications during withdrawal, and I'd hate for you to use a nuclear option unless it is absolutely vital.

 

Hope you find what you need!!

Thanks to the buddies who replied since I posted my first thank you.

I was put on Zyprexa right after being cold turkeyed from 1mg of Klonopin during a psychiatric unit stay. I immediately started grinding my jaw. Slowly it went away but I stayed on the Zyprexa until the first of August. I've been doing better and want to eventually get off all meds, so I started with that one. Withdrawal SUCKED. Not as bad as benzo withdrawal, but I was shocked at how bad. I'm finally getting through it, but unfortunately have developed tardive dyskinesia and constantly do a chewing motion. I can't even stop myself and my jaw hurts so bad. I'm TERRIFIED that it's permanent.

 

I definitely believe that some people need anti-psychotics and that they can help.... I do believe they made me worse. It's such a hard decision because it varies so much between each person.

I think with the risk of complications and the statistical fact of early death on average associated with long-term use of these medicines, you should only consider these options as a last resort in a life threatening situation. I would look at non-drug treatment options for depression and anxiety, especially since the prognosis is that both will improve when you're over your benzo withdrawal.

 

I know it's psychiatry speak but personally, complete remission of symptoms of depression and anxiety is unrealistic and undesirable anyway. The goal should be to contain them to a manageable level, not obliterate them. Whatever you find that can cancel out depression and anxiety will cancel out a lot more too. I'm sorry for anybody whose life is improved by these things and just saddened by how many think it's the best option when it really probably isn't.

 

There is absolutely zero opportunity cost to missing out on an antipsychotic. You would not be shooting yourself in the foot by not giving it a chance.

I have been on a few psych drugs, including Seroquel.  Getting off the Seroquel was one of the worst experiences of my life, it gave me massive SI.  You may want to consider this WD if you will eventually want to get of the antipsychotic in the future.

 

If it were me, I would run far, far away from the antipsychotic.  Just my 2 cents...

I was put on Zyprexa right after being cold turkeyed from 1mg of Klonopin during a psychiatric unit stay. I immediately started grinding my jaw. Slowly it went away but I stayed on the Zyprexa until the first of August. I've been doing better and want to eventually get off all meds, so I started with that one. Withdrawal SUCKED. Not as bad as benzo withdrawal, but I was shocked at how bad. I'm finally getting through it, but unfortunately have developed tardive dyskinesia and constantly do a chewing motion. I can't even stop myself and my jaw hurts so bad. I'm TERRIFIED that it's permanent.

 

I definitely believe that some people need anti-psychotics and that they can help.... I do believe they made me worse. It's such a hard decision because it varies so much between each person.

 

I developed Dystonia in my jaw and man it’s painful I feel you. I also see you are on Trileptal, I was on it for 3 years. I just came off of it 2 months ago after tapering off of it for 18 months.

I know it's psychiatry speak but personally, complete remission of symptoms of depression and anxiety is unrealistic and undesirable anyway. The goal should be to contain them to a manageable level, not obliterate them.

 

I couldn't agree more. It's psychiatry-speak (or think) that you'll get "remission" from depression/ anxiety. (What? Who convinced us that they are diseases???) Having been on a variety of psych drugs for 11 years that didn't do a thing for me but make me numb and briefly psychotic, I found the best decision was to eliminate them from my life. Once I accepted that heck, yes, I get depressed and anxious now and then, and sought other ways of treating them, life became much better. It's been so much more productive to work at understanding why I'm depressed or anxious than to swallow pills. No one on here seemingly wants to hear that therapy (real talk therapy, not CBT) can help greatly, but it certainly helped me. Of course it's not as convenient as pills -- you actually have to get dressed, keep your appointments and actually work at understanding yourself. (Oh, and you can do all this vie telehealth). Or you can believe that there's a magic pill out there that will fix you . . . if only you can find it. I bought into this last idea for years, with the help of my ever-agreeable psychiatrist, and the best thing I ever did was to finally say "NO". I believe I tried 13 different ADs, SSRIs, SNRIs, anti-psychotics over the years and amaze myself that I actually believed my shrink's hokum that the next pill would fix me right up.

 

So, just my 2 1/2 cents' worth. 

 

Best,

 

Katz

I havent read other posts yet ... but im just gunna say it... Hell to the No. stay away at all costs. I was out on zyprexa to help sleep. instead i turned into a zombie with zero emotions.