Psycho-Babble Medication Thread 46508

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Doc Gave Me an Antipsychotic - Am I crazy?

Posted by GLYN on October 16, 2000, at 19:33:12

I have been on Celexa for 6 weeks for anxiety which has helped but I still feel very nervous and anxious though I no longer have the phobic or anxious thoughts - just the symptoms - for which I am grateful. He has now recommende a drug called thioridazine (brand name Melleril) for the anxiety symptoms since he says he NEVER gives benzodiazapines anymore. It has s\cared me to get this drug and I'm terrified of taking it since it says that it is an antipsychotic and used primarily for schizophrenia. I checked with the pharmacist and she told me it can be used for anxiety and I only have a small dose (10mg three times a day or as needed). I thought I just had agorophobia and panic attacks but I do worry that the doc thinks I am going nuts and might hurt people which is why he gave me this. Then I though that if I thought that then I must be paranoid too and the anxiety has spiralled. Is it normal to use this for anxiety? Has anybody else used it? Any scary side effects? I basically wont be using it and my doc can can shove it for all I care because this stuff freaks me out. Is it fair to assume that whatever chemical it reduces in the brain (also connected to psychosis) will return with a vengance when I stop using it? I dont want to start seeing aliens or hearing voices because my mind is dependant on a drug that has screwed up my chemical imbalance.

IS there a good and simple test to determine if I am crazy? I know I'm not but I have been worrying about it since this drug was prescribed. Surely if I was crazy I would not fear being crazy but instead be convinced of my delusions and be afraid of them instead. AM I right? Please offer me some advice and be honest.

 

Re: Doc Gave Me an Antipsychotic - Am I crazy?

Posted by stjames on October 16, 2000, at 20:28:52

In reply to Doc Gave Me an Antipsychotic - Am I crazy?, posted by GLYN on October 16, 2000, at 19:33:12

You are not crazy. However I would not take Melleril, one on the newer AP's would have less side effects.

james

 

Re: Doc Gave Me an Antipsychotic - Am I crazy?

Posted by Mark H. on October 16, 2000, at 23:07:51

In reply to Doc Gave Me an Antipsychotic - Am I crazy?, posted by GLYN on October 16, 2000, at 19:33:12

Dear Glyn,

St. James is right, as usual. You're not crazy, and it is questionable from a medical standpoint for your physician to shun the benzodiazepines, which are relatively benign and highly effective in the treatment of anxiety, while prescribing one of the oldest major tranquilizers, a powerful anti-psychotic that is notorious for causing a serious nerve disorder with long-term use (look up "tardive dyskinesia"), for simple anxiety.

Doctors who refuse to prescribe Valium, Ativan, Xanax, Klonopin, etc., generally do so out of fear and ignorance. The exact same type of "let's just play it safe" thinking led to gross *overprescribing* of these same medications in the 1970s. However, there is plenty of room in between giving them to everyone for everything and not giving them to anyone because some people become addicted and blame their doctors when withdrawal proves to be an unpleasant experience (duh!).

A competent physician will be willing to let you try different anti-anxiety medications, since that is the ONLY way to find what will work best for you. Some people feel stupid or woozey on one medication, while others feel "normal" when they take it. There is no way that I know of to predict what type will work best for you, but giving you thioridazine to save you from Valium seems rather strange, to put it politely.

There's an excellent psychiatric self-test offered at the Canadian site www.mentalhealth.com (or perhaps it's www.mentalhealth.org -- check the other if the first doesn't work). Although you can take a single section, my advice is to take the whole battery -- it only takes about 45 minutes altogether. I was surprised at its accuracy.

Then, dear Glyn, please find a competent psychiatrist. Your doctor is doing you a disservice.

Best wishes,

Mark H.

 

Re: Doc Gave Me an Antipsychotic - Am I crazy?

Posted by pullmarine on October 16, 2000, at 23:26:49

In reply to Doc Gave Me an Antipsychotic - Am I crazy?, posted by GLYN on October 16, 2000, at 19:33:12

-He has now recommende a drug called thioridazine (brand name Melleril) for the anxiety symptoms since he says he NEVER gives benzodiazapines anymore.

1. If he's not giving you benzo's, he's one hell of a good doctor!!!


-It has s\cared me to get this drug and I'm terrified of taking it since it says that it is an antipsychotic and used primarily for schizophrenia.

2. anti-psychotics are used for many different reasons, one of them being anxiety.

-I thought I just had agorophobia and panic attacks but I do worry that the doc thinks I am going nuts and might hurt people which is why he gave me this.

3. If you're doc suspected anything like this, he make sure you were under adequate supervision.

-Then I though that if I thought that then I must be paranoid too and the anxiety has spiralled. Is it normal to use this for anxiety?

>Yes!

Has anybody else used it?

>Yes!

Any scary side effects?

>Not at such low doses.

I basically wont be using it and my doc can can shove it for all I care because this stuff freaks me out.

>your body, your mind, your moods, and your choice!

Is it fair to assume that whatever chemical it reduces in the brain (also connected to psychosis) will return with a vengance when I stop using it?

> NO! Absolutely not!!!

I dont want to start seeing aliens or hearing voices because my mind is dependant on a drug that has screwed up my chemical imbalance.

>That will not happen. If it does, sue your doc for every penny he's got.

IS there a good and simple test to determine if I am crazy?

>What do you mean by crazy? It's a term no one seems to be able to define.

I know I'm not but I have been worrying about it since this drug was prescribed. Surely if I was crazy I would not fear being crazy but instead be convinced of my delusions and be afraid of them instead.

>I think your having a great deal of anxiety (often a result of stress, and sometimes just part of one's nature), which does not mean you're crazy.

Please offer me some advice and be honest.

>a. Perhaps you should try the meds, and if they don't suit you, you can always stop or try something else.

b. If you don't take the meds, your anxiety will go away at somepoint anyway, but it may get much worse before it gets better.

c. stay away from all illegal drugs until your anxiety is under control.

d. If your anxiety is mild, exercise, yoga and meditation (or praying) can help. but in your case, your anxiety seems too high.

best of luck. and let us know how things go.

john

 

Re: Doc Gave Me an Antipsychotic - Am I crazy?

Posted by stjames on October 17, 2000, at 1:36:13

In reply to Re: Doc Gave Me an Antipsychotic - Am I crazy?, posted by Mark H. on October 16, 2000, at 23:07:51

> Dear Glyn,
St. James is right, as usual. You're not crazy, and it is questionable from a medical standpoint for your physician to shun the benzodiazepines, which are relatively benign and highly effective in the treatment of anxiety, while prescribing one of the oldest major tranquilizers, a powerful anti-psychotic that is notorious for causing a serious nerve disorder with long-term use (look up "tardive dyskinesia"), for simple anxiety.
Doctors who refuse to prescribe Valium, Ativan, Xanax, Klonopin, etc., generally do so out of fear and ignorance. The exact same type of "let's just play it safe" thinking led to gross *overprescribing* of these same medications in the 1970s. However, there is plenty of room in between giving them to everyone for everything and not giving them to anyone because some people become addicted and blame their doctors when withdrawal proves to be an unpleasant experience (duh!).
A competent physician will be willing to let you try different anti-anxiety medications, since that is the ONLY way to find what will work best for you. Some people feel stupid or woozey on one medication, while others feel "normal" when they take it.

james here.....

I agree with Mark. Benzo's are the prototype meds
for anxiety. All side effects and addiction to benzo's
are reversable. Not so with the AP's. The older one's can
leave one with movement disorders, even off the drug. The
newer ones "seem" better in this respect but time will
tell. Tardive Dyskinesa happens with the older AP's.
Tardive means late, i.e many years into treatment
a dyskinesia can start.

It seems to me benifit/risk ratio between benzo's or AP's for anexity
is pitting addiction aganist movement disorder. Addiction, while sure to
happen with regular dosing, is reversable and carrys no negative effects
other than the addiction itself. Also GABA, in the body, is a major player in anxiety, and
benzos work on GABA receptors. This is why benzo's are so effective
on anxiety.

It also bothers me that he/she gave you Meleril.
In the 1980's Meleril was the best we had but there
are much better AP's now with less side effects. Unless there was a consern
about you affording the newer AP's, which are expensive,
it would seem this doc is not current. If it were me I would 1) tell this doc I was not comfortable
with the side effect profile of AP's and ask to try benzo's first with
AP's as a fallback. 2) go elsewhere but be prepaired to do that anyway.

james

 

psychiatrist, psychotherapist, or psychoanalyst ?

Posted by GLYN on October 17, 2000, at 7:55:42

In reply to Re: Doc Gave Me an Antipsychotic - Am I crazy?, posted by stjames on October 17, 2000, at 1:36:13

Thanks for the advice guys - it sure is valuable. I tool wonder why I got this outmoded drug. I live in the UK where healthcare and drugs are free (well, we pay for them in taxes so I suppose they are not free) so I dont think cost was an issue. I suspect that my Doc is probably just due a refresher course in medicine by the sounds of things. There is no real shrink culture in the UK like there is in the States (probably why we are all so screwed up and uptight) so I dont understand the process. Whats the difference between a psychiatrist, a psychotherapist, a psychoanalyst and a psychologist and which is most appropriate for me to see. Can only some prescribe mediaction?

Once again, many thanks. THis place is a life line.

 

Re: psychiatrist, psychotherapist, or psychoanalyst ?

Posted by Mark H. on October 17, 2000, at 13:40:34

In reply to psychiatrist, psychotherapist, or psychoanalyst ?, posted by GLYN on October 17, 2000, at 7:55:42

A psychiatrist is an MD with additional specific training who can prescribe medications. A psychoanalyst usually refers to someone trained in the long-term, Freudian model of therapy. A psychotherapist is a psychologist or social worker (in the US, at least) who uses various talking therapies, usually of shorter duration and more outcome-oriented than traditional psychoanalysis. A psychologist is someone with advanced (post-graduate) education in psychology who may or may not be a clinical practitioner or therapist who sees patients and offers psychotherapy (some psychologists test children, some work for industry, some do research, etc.).

I started by going to my family doctor, who had extreme prejudices against experimenting with medications, and at least was kind enough to admit that he had insufficient training to perform as a psychiatrist.

In the US, psychiatrists are divided between using medication and not using medication, but a majority at this time practice psychopharmacology, which is the treatment of mental and emotional problems with medication.

Psychiatry is a medical specialty, so a psychiatrist is *usually* more qualified to help you find the right anti-anxiety treatment (including medication) than a general practitioner, especially if you don't respond well to the first couple of medications you try.

My psychiatrist pointed me to Psycho-Babble, bless his heart!

Best wishes,

Mark H.

 

Re: psychiatrist, psychotherapist, or psychoanalyst ?

Posted by Noa on October 17, 2000, at 18:04:38

In reply to Re: psychiatrist, psychotherapist, or psychoanalyst ?, posted by Mark H. on October 17, 2000, at 13:40:34

> >My psychiatrist pointed me to Psycho-Babble, bless his heart!

Wow, that is great.

 

AMBROSE BIERCE DEFINES MAD AS

Posted by pullmarine on October 17, 2000, at 18:51:25

In reply to Doc Gave Me an Antipsychotic - Am I crazy?, posted by GLYN on October 16, 2000, at 19:33:12

MAD, ADJ. AFFECTED WITH A HIGH DEGREE OF INTELLECTUAL INDEPENDENCE; NOT CONFORMING TO STANDARDS OF THOUGHT, SPEECH AND ACTION DERIVED BY THE CONFORMANTS FROM STUDY OF THEMSELVES; AT ODDS WITH THE MAJORITY; IN SHORT UNUSUAL. IT IS NOTEWORTHY TO POINT POINT OUT THAT PERSONS ARE PRONOUNCED MAD BY OFFICIALS DESTITUTE OF EVIDENCE THAT THEMSELVES ARE SANE.

JOHN

> I have been on Celexa for 6 weeks for anxiety which has helped but I still feel very nervous and anxious though I no longer have the phobic or anxious thoughts - just the symptoms - for which I am grateful. He has now recommende a drug called thioridazine (brand name Melleril) for the anxiety symptoms since he says he NEVER gives benzodiazapines anymore. It has s\cared me to get this drug and I'm terrified of taking it since it says that it is an antipsychotic and used primarily for schizophrenia. I checked with the pharmacist and she told me it can be used for anxiety and I only have a small dose (10mg three times a day or as needed). I thought I just had agorophobia and panic attacks but I do worry that the doc thinks I am going nuts and might hurt people which is why he gave me this. Then I though that if I thought that then I must be paranoid too and the anxiety has spiralled. Is it normal to use this for anxiety? Has anybody else used it? Any scary side effects? I basically wont be using it and my doc can can shove it for all I care because this stuff freaks me out. Is it fair to assume that whatever chemical it reduces in the brain (also connected to psychosis) will return with a vengance when I stop using it? I dont want to start seeing aliens or hearing voices because my mind is dependant on a drug that has screwed up my chemical imbalance.
>
> IS there a good and simple test to determine if I am crazy? I know I'm not but I have been worrying about it since this drug was prescribed. Surely if I was crazy I would not fear being crazy but instead be convinced of my delusions and be afraid of them instead. AM I right? Please offer me some advice and be honest.

 

Re: Doc Gave Me an Antipsychotic - Am I crazy?

Posted by Sunnely on October 17, 2000, at 19:01:18

In reply to Doc Gave Me an Antipsychotic - Am I crazy?, posted by GLYN on October 16, 2000, at 19:33:12

Hi Glyn,

I can't comment as to what exactly is your diagnosis. But if your diagnosis is only an anxiety disorder and not schizophrenia, then Mellaril is absolutely containdicated. (At least here in the U.S. I noticed that you're from the UK.)

As of July 7, 2000, Novartis, the maker of Mellaril (thioridazine HCl) sent every MD/Pharmacist a Dear Doctor/Pharmacist letter informing them of major modifications to the labeling of this medication. In summary, the following are the labeling modifications:

1. A boxed WARNING has been added to prominently advise clinicians that Mellaril (thioridazine HCl) has been shown to prolong the QTc interval (an electrocardiogram abnormality) in a dose related manner, and drugs with this potential, including Mellaril, have been associated with torsade de pointes-type arrhythmias and sudden death. (This condition is similar to the sudden heart deaths due to the use of Seldane, Hismanal, and Propulsid, now all off the US market. Pimozide, an antipsychotic which remains available in the US market, also has the potential to cause this serious problem and sudden deaths have been reported.)

2. Mellaril is now indicated ONLY for schizophrenic patients who fail to show an acceptable response to adequate courses of treatment with other antipsychotic drugs, either because of insufficient effectiveness or the inability to achieve an effective dose due to intolerable adverse effects.

3. Mellaril is now contraindicated with certain other drugs, including fluvoxamine (Luvox), propranolol (Inderal), pindolol (Visken), any drug that inhibits the cytochrome P450 2D6 isoenzyme, e.g., fluoxetine (Prozac) and paroxetine (Paxil), and agents known to prolong the QTc interval; Mellaril is also contraindicated in patients known to have reduced levels of the cytochrome P450 2D6 isoenzyme as well as in patients with congenital long QT syndrome or a history of cardiac arrhythmias.

4. Patients being considered for treatment with Mellaril should have a baseline ECG performed and serum potassium levels measured. Serum potassium should be normalized before starting treatment and patients with a QTc interval greater than 450 msec (milliseconds) should not receive Mellaril. Periodic ECG's and serum potassium levels during Mellaril treatment may be useful and Mellaril should be discontinued in patients who are found to have a QTc interval over 500 msec.

5. Treatment of Mellaril overdosage should entail immediate cardiovascular monitoring, to include continuous electrocardiogram monitoring to detect arrhythmias. Drugs that may produce additive QT-prolonging effects, such as disopyramide (Norpace), procainamide (Pronestyl), and quinidine (Cardioquin, Quinaglute), should be avoided in the treatment of Mellaril overdosage.

As a side note, blame Pfizer, the maker of Zeldox (ziprasidone), for the above-mentioned Mellaril labeling modifications.

 

Re: Doc Gave Me an Antipsychotic - Am I crazy?

Posted by GLYN on October 17, 2000, at 19:42:57

In reply to Re: Doc Gave Me an Antipsychotic - Am I crazy?, posted by Sunnely on October 17, 2000, at 19:01:18

I am cured.

If this is a drug that is supposed to heal me then I suddenly feel loads better in myself as I now realise how normal I am. Is there anyway I can get this letter and hand to my doc before he gives this junk to somebody else?

I'll stick to hot baths and camomile tea thanks.

Glyn

 

Re: Doc Gave Me an Antipsychotic - Am I crazy? GLYN

Posted by Sunnely on October 18, 2000, at 0:25:37

In reply to Re: Doc Gave Me an Antipsychotic - Am I crazy?, posted by GLYN on October 17, 2000, at 19:42:57

> I am cured.
>
> If this is a drug that is supposed to heal me then I suddenly feel loads better in myself as I now realise how normal I am. Is there anyway I can get this letter and hand to my doc before he gives this junk to somebody else?
>
> I'll stick to hot baths and camomile tea thanks.
>
> Glyn


Hi Glyn,

Try the FDA (US Food and Drug Administration) web site: http://www.fda.gov/medwatch/safety/2000/mellar.htm

 

Re: Doc Gave Me an Antipsychotic - Am I crazy?

Posted by laural on October 18, 2000, at 8:08:00

In reply to Doc Gave Me an Antipsychotic - Am I crazy?, posted by GLYN on October 16, 2000, at 19:33:12

". . .He has now recommende a drug called thioridazine (brand name Melleril) for the anxiety symptoms since he says he NEVER gives benzodiazapines anymore. It has s\cared me to get this drug. . . I checked with the pharmacist and she told me it can be used for anxiety and I only have a small dose (10mg three times a day or as needed).. . .I basically wont be using it and my doc can can shove it for all I care because this stuff freaks me out. Is it fair to assume that whatever chemical it reduces in the brain (also connected to psychosis) will return with a vengance when I stop using it?"

First, it does sound as said by yer doc then by the pharmacist that low dosages of Mellaril are used for anxiety. I have heard this also. Second, even if you had a thought disorder, it does not mean you have to either hurt anyone or be defined as crazy. I myself take an antipsychotic and while its for schizo-effective disorder and not technically a thought disorder, (I think) I really freaked out at first too. But I can now joke about being "crazy" because after a while you realize you're the same person you've always been, so what does it matter? The important thing is that the symptoms go away and if it reduces anxiety, and it sounds like you have a lot of it:), then great. I'm not sure how Mellaril works but it probably lowers dopamene levels although I'm not really sure how that would reduce anxiety--I know it would reduce my anxiety by not making me so paranoid. . .Anyway you should question maybe why you don't feel comfortable asking your doctor straight out if he/she thinks you have a psychosis Also, ever since I started celexa, my panic attacks have tapered off to none. Of course that was about the same time I stopped self-medicating. I would advise being clean and sober, although I do not mean to imply that you aren't--hope i could help soothe--laural

 

Benzos in Britian

Posted by danf on October 18, 2000, at 10:31:53

In reply to Re: Doc Gave Me an Antipsychotic - Am I crazy?, posted by laural on October 18, 2000, at 8:08:00

GLYN,

I expect you have a very slim chance of getting a benzo in the UK.

What many of the other responders do not realize is that things are different in the UK. anxiety is rarely treated with benzos.

Doesn't matter what kind of doc, GP or Psych, damn few people get benzos & when they do it is for short periods of time.

there are a number of factors.

mellaril is commonly used for anxiety in the UK. It works & is cheap
cost is a major concern for meds.

There is a different theory & philosophy of anxiety treatment in the UK.
anti psychotics are often used for anxiety treatment & beta blockers for panic attacks.

Benzos are classified as dangerous /addictive drugs there & the Gov discourages prescriptions.

Even if you change Docs, the view about benzo use is unlikely to change.

I would suggest you try the mellaril.

 

Re: Doc Gave Me an Antipsychotic - Am I crazy?

Posted by JohnL on October 19, 2000, at 3:43:51

In reply to Doc Gave Me an Antipsychotic - Am I crazy?, posted by GLYN on October 16, 2000, at 19:33:12

Antipsychotics are used for a lot of things. Like anxiety, depression, insomnia. As a matter of fact, I have statistics that show a certain population of people do well with an antipsychotic across the entire spectrum of psychiatric illnesses. That includes ADD or ADHD, addictions, mania, and everything else you can think of.

I prefer to call antipsychotics 'dopamine reducers'. That's basically what they do. Many psychiatric illnesses can have elevated dopamine as the root cause. Anxiety is an example. Dopamine-reducer is much more user-friendly.

You do not have to be crazy or schizophrenic to respond well to an antipsychotic. It sounds to me like your doctor knows what he's doing. It's the ones that don't know what they're doing that don't use antipsychotics.
John


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