Very interesting thread, @Threads!
I have been prescribed in the past 3 years 27 different psychiatric medications: SSRIs, SNRIs, Tetracyclics, Benzos, Z-drugs, Buproprion, anti-psychotics, antimuscarinics and mood stabilizers.
Now I don't take anything except for Zolpidem Tartrate (Ambien/Stilnox) once in a while. It doesn't really help me falling asleep but I enjoy the intoxicating effects.
I had already read a lot of the studies you posted and I think that it's important to say that not all classes of psychiatric medications are the same and there are significant differences in the same classes too.
Let's start with anti-psychotics. They are probably the most dangerous class of psychiatric medications side effect wise and the title of "chemical lobotomy" is totally deserved. Side effects can include akathisia, pakinsonian symptoms, neuroleptic malignant syndrome, tardive dyskinesia, increased risk of obesity and diabetes, lethargy, rebound psychosis, emotional flattening, dysphoria, depression and others.
IMO they should NEVER be prescribed outside of the condition they are supposed to treat (psychosis, delusions, schizophrenia and, in rare cases, manic symptoms). The whole theory of antidepressant augmentation therapy (the reason I took antipsychotics) is BULLSHIT.
You want to boost your SSRI? Hell, you might as well start doing Heroin, sure is healthier than Olanzapine or Risperidone for your brain. There are far safer and more effective alternatives.
Antipsychotics are commonly divided in typical (first generation) and atypical (second generation).
Typical APs (like Haloperidol) are strong D2 receptor antagonist/inverse agonists (this is what causes the suppression of positive symptoms in schizophrenia and the anti-manic properties, but it's the same property that causes most of the side effects). Atypicals (like Olanzapine, Risperidone and Paliperidone) are D2R antagonist too, but have greater affinity for 5-HT2A receptors: this helps reducing dopamine-antagonism related side effects and schizophrenic negative symptoms.
They also have other targets, sometimes positive (5-HT1 agonism/partial agonism and other serotonergic receptor antagonism), sometimes not so much (H1, alpha-adrenergic and muscarinic antagonism).
All of them cause cognitive impairments, and there is evidence to support the theory that they cause long term brain damage (as the study on Haloperidol and Olanzapine you posted says) probably related to D2 blockade.
There are also atypical-atypical APs as I call them, some are well-known like Abilify (Aripiprazole) wich is a D2 partial agonist with relatively high intrinsic affinity (IA), wich doesn't seem to cause cognitive impairments and then there are investigational APs that don't mess with D2R, like strong selective 5-HT2A antagonist/inverse agonists, K-opioid antagonists and drugs to treat negative symptoms of schizophrenia (D1 agonists, racetams etc.).
APs wich lack activity at the D2 receptor could be used for example to treat psychotic symptoms in people affected from Parkinson's Disease, wich usually need D2 AGONISTS (like Ropinirole and Pramipexole) for treatment.
Like I said, APs are the least tolerated class of psychiatric drugs (I wonder why...) and are in most cases discontinued by who is taking them (wich isn't necessary negative, some studies say that in the long run they don't improve life quality).
For this reason they invented depot injections (extended release injections that last 1 month usually), so the patient is forced to take the medication against his/her will at the cost of added side effects (non-steady blood/drug concentration, pain in the injection site etc.).
"Fun" fact: APs are the only class of psychoactive drugs for wich this formulation is widely used (maybe Naltrexone is an exception...), this says a lot.
My experience: took only 1-2 doses of Olanzapine, Paliperidone, high-dose Quietiapine 'cause I couldn't tolerate them.
Used Abilify and Amisulpiride for some time (the first gave me akathisia, the latter didn't do shit and at that dose was just a 5-HT7 antagonist, so more of an antidepressant than antipsychotic).
Used Clotiapine (Entumin) and Talofen to sleep sometime. Well... don't use APs to sleep, it's idiotic, that's all I can say.
Now benzos.
Those are quite similar between them, all being GABA-A receptors positive allosteric modulators. Binding affinity and preference for different subunits are the main pharmacological differences.
Long term cognitive impairments are not confirmed, even in cases of abuse.
Short term ones are in a dose-dependent manner (though they can be positive if you are really anxious).
They should not be used for a prolonged period of time if not necessary: there's an increased risk of depression, tolerance and addiction. In some cases the WDs can be fatal.
I tried a shitload of them and got addicted a few times.
If used cautiously they can be a great tool for GAD/SAD/panic disorder and other conditions, for some people really are a lifesaver. I don't think that taking a Xanax once a week is worse than a couple of beers on a friday afternoon.
Then there are antidepressants and ADD/ADHD meds. Well everything can be an AD, from chocolate to SSRIs to opioids.
ADD/ADHD drugs are usually NDRIs, DA and NE releasers and sometimes some other totally different thing (racetams, Tianeptine etc.).
They are usually much safer than APs and benzos to use long term (maybe with the exception of Desoxyn, wich is d-methamphetamine).
There are certain group of people that react bad to those meds too of course but that goes without saying.
I have been prescribed in the past 3 years 27 different psychiatric medications: SSRIs, SNRIs, Tetracyclics, Benzos, Z-drugs, Buproprion, anti-psychotics, antimuscarinics and mood stabilizers.
Now I don't take anything except for Zolpidem Tartrate (Ambien/Stilnox) once in a while. It doesn't really help me falling asleep but I enjoy the intoxicating effects.
I had already read a lot of the studies you posted and I think that it's important to say that not all classes of psychiatric medications are the same and there are significant differences in the same classes too.
Let's start with anti-psychotics. They are probably the most dangerous class of psychiatric medications side effect wise and the title of "chemical lobotomy" is totally deserved. Side effects can include akathisia, pakinsonian symptoms, neuroleptic malignant syndrome, tardive dyskinesia, increased risk of obesity and diabetes, lethargy, rebound psychosis, emotional flattening, dysphoria, depression and others.
IMO they should NEVER be prescribed outside of the condition they are supposed to treat (psychosis, delusions, schizophrenia and, in rare cases, manic symptoms). The whole theory of antidepressant augmentation therapy (the reason I took antipsychotics) is BULLSHIT.
You want to boost your SSRI? Hell, you might as well start doing Heroin, sure is healthier than Olanzapine or Risperidone for your brain. There are far safer and more effective alternatives.
Antipsychotics are commonly divided in typical (first generation) and atypical (second generation).
Typical APs (like Haloperidol) are strong D2 receptor antagonist/inverse agonists (this is what causes the suppression of positive symptoms in schizophrenia and the anti-manic properties, but it's the same property that causes most of the side effects). Atypicals (like Olanzapine, Risperidone and Paliperidone) are D2R antagonist too, but have greater affinity for 5-HT2A receptors: this helps reducing dopamine-antagonism related side effects and schizophrenic negative symptoms.
They also have other targets, sometimes positive (5-HT1 agonism/partial agonism and other serotonergic receptor antagonism), sometimes not so much (H1, alpha-adrenergic and muscarinic antagonism).
All of them cause cognitive impairments, and there is evidence to support the theory that they cause long term brain damage (as the study on Haloperidol and Olanzapine you posted says) probably related to D2 blockade.
There are also atypical-atypical APs as I call them, some are well-known like Abilify (Aripiprazole) wich is a D2 partial agonist with relatively high intrinsic affinity (IA), wich doesn't seem to cause cognitive impairments and then there are investigational APs that don't mess with D2R, like strong selective 5-HT2A antagonist/inverse agonists, K-opioid antagonists and drugs to treat negative symptoms of schizophrenia (D1 agonists, racetams etc.).
APs wich lack activity at the D2 receptor could be used for example to treat psychotic symptoms in people affected from Parkinson's Disease, wich usually need D2 AGONISTS (like Ropinirole and Pramipexole) for treatment.
Like I said, APs are the least tolerated class of psychiatric drugs (I wonder why...) and are in most cases discontinued by who is taking them (wich isn't necessary negative, some studies say that in the long run they don't improve life quality).
For this reason they invented depot injections (extended release injections that last 1 month usually), so the patient is forced to take the medication against his/her will at the cost of added side effects (non-steady blood/drug concentration, pain in the injection site etc.).
"Fun" fact: APs are the only class of psychoactive drugs for wich this formulation is widely used (maybe Naltrexone is an exception...), this says a lot.
My experience: took only 1-2 doses of Olanzapine, Paliperidone, high-dose Quietiapine 'cause I couldn't tolerate them.
Used Abilify and Amisulpiride for some time (the first gave me akathisia, the latter didn't do shit and at that dose was just a 5-HT7 antagonist, so more of an antidepressant than antipsychotic).
Used Clotiapine (Entumin) and Talofen to sleep sometime. Well... don't use APs to sleep, it's idiotic, that's all I can say.
Now benzos.
Those are quite similar between them, all being GABA-A receptors positive allosteric modulators. Binding affinity and preference for different subunits are the main pharmacological differences.
Long term cognitive impairments are not confirmed, even in cases of abuse.
Short term ones are in a dose-dependent manner (though they can be positive if you are really anxious).
They should not be used for a prolonged period of time if not necessary: there's an increased risk of depression, tolerance and addiction. In some cases the WDs can be fatal.
I tried a shitload of them and got addicted a few times.
If used cautiously they can be a great tool for GAD/SAD/panic disorder and other conditions, for some people really are a lifesaver. I don't think that taking a Xanax once a week is worse than a couple of beers on a friday afternoon.
Then there are antidepressants and ADD/ADHD meds. Well everything can be an AD, from chocolate to SSRIs to opioids.
ADD/ADHD drugs are usually NDRIs, DA and NE releasers and sometimes some other totally different thing (racetams, Tianeptine etc.).
They are usually much safer than APs and benzos to use long term (maybe with the exception of Desoxyn, wich is d-methamphetamine).
There are certain group of people that react bad to those meds too of course but that goes without saying.
