Don’t let the word “antipsychotic” scare you…

I’ll repeat the title of this post: Don’t let the word “antipsychotic” scare you.  Antipsychotics are a good thing in the mental health treatment world, and they’re not just for people with schizophrenia!  Antipsychotics can be used to augment and greatly assist with treatment-resistant depression and other symptoms that go along with PTSD.  They have a lot of side effects (most of which are unpleasant, life-threatening, or both, if they’re the serious ones), but they’re worth it if they work.  Unfortunately, most of them, but not all of them, have that weight-gain side effect.  Why am I telling you this?  Because I’m on an antipsychotic that works really well for the depression and other PTSD symptoms that I’m having trouble with, and I’m switching to a different one – one that’s supposed to have good efficacy with possible weight loss.  Yes, I said weight loss!!!  So I don’t want you to be scared of me because I’m going to be talking about antipsychotics in this post.  I’m just as crazy as ever and always will be, but the management of my mental illness might take a turn for the better concerning my physical health, and therefore my climbing potential very soon!!!  Let me attempt to explain…

I’m on 15 medications.  That’s down from 19, so that’s good.  Several of those medications are to counteract the side effects of other medications that I’m on, so that “eliminates” a few, in my mind.  As far as psychotropics go, I’m on seven right now because I’m switching over from one antipsychotic – we’ll call it “Antipsychotic A” – to the other antipsychotic, which we’ll call “Antipsychotic B”.  Antipsychotic A works the best of any antipsychotic I’ve ever been on for the symptoms of my PTSD and the associated depression.  It’s extremely expensive because there’s no generic version of it yet on the market, and it’s got a very unique delivery system, utilizing compartments and laser-drilled holes and such for extended-release purposes.  Quite amazing, really.  That means, though, that you can’t break these things in half if you need to.  Been there, done that, wet the bed.  See my point?  Anyway, that’s Antipsychotic A, and I’m on the maximum dosage of that.  The problem?  Weight gain!!!  More weight gain.  I weigh approximately 19 stone.  You do the math.  Not pretty.  I was ripped and 125 lbs of pure muscle in the military, and ran, jumped, and dove with twice my weight in gear and weapons in the Desert in the Middle East at that weight!  I was invincible!  Now I’m literally twice the person I used to be (my other half is fat, although there’s still a lot of muscle under there) and my already wrecked joints are feeling it, not to mention the other health risks and problems that obesity presents!  That, and I’m embarrassed.  I wouldn’t want anyone I was in the military with to see me right now.  I’d be mortified and ashamed.  So, enter Antipsychotic B, which is supposed to work really well for the treatment-resistant depression that I’m having with the PTSD, in addition to the other symptoms (yes, I hear voices when I’m stressed and they’re called “auditory hallucinations”), and have the side effect of little weight gain and possible weight loss.  Yes, let me repeat the possible weight loss part of that statement!  If I could get ahead on the weight loss end of my medications, I’d be in a great position to start climbing harder, which would improve my mood more, which would help me to climb more, which would help me to lose more weight, and the cycle would continue!!!  Is that exciting or what?!?!

So here’s the tricky part: switching antipsychotics.  I’m on the maximum dosage of the one that works the best for me so far.  That’s a high dose to come off of.  What you have to do to switch these out, though, is get to the target dose of the new antipsychotic before you begin to take less of the antipsychotic you’re already on.  So, what’s the problem?  Potential serious/deadly side effects.  That’s all.  Just that.  In order to avoid that, we were going to titrate up on Antipsychotic B very slowly to our target dose and then titrate down on Antipsychotic A very slowly to get off of it and then see how I do on Antipsychotic B (I’m really hoping that it is effective and I lose weight!).  The tablets of Antipsychotic B that I received, though, look like tiny bricks, and they’re in a dosage that I’d have to cut this teeny, less-than-1/4-inch-long, tiny brick of medication into quarters to take if my doctor and I were going to stick to our plan.  Impossible!!!  So I called my doctor and asked him what to do.  Our only alternative was to break them in half, which is the target dose of Antipsychotic B that we’re going to start with!  And you have to remember that I’m still on a maximum dosage of Antipsychotic A.  I asked my doctor, “So what can I expect to happen if this all goes wrong?”  He named off a bunch of really bad things that could happen and I replied, “Well, let’s not have any of that happen, right?”

So I started Antipsychotic B yesterday morning, along with taking the maximum dosage of Antipsychotic A.  I felt funny about an hour after taking my meds.  Dreamy and confused, but beyond that, nothing horrible…yet.  This morning was my second day of the target dosage of Antipsychotic B along with the maximum dosage of Antipsychotic A and I’m waiting to see if the dreamy, confused mental state comes on again.  It’s been almost an hour.  I’ll know shortly.  Fortunately, I see my doctor today, so I can ask him if he wants me to reduce Antipsychotic A yet or to wait for two more days.  We’re doing this in four-day increments, or we were last time we had talked about it.

Okay, starting to feel funny.  Signing off.  Updates pending…