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What is the classification for 3rd generation anti-psychotics? I put bifeprunox under the list that already had abilify on it. I presume 3rd generation drugs are partial dopamine antagonist. —Preceding unsigned comment added by Sp0 ( talk • contribs) 05:44, 24 September 2008 (UTC)
In Skeptic magazine vol. 13 no. 3, 2007, there is an article, "The Trouble with Psychiatry," by John Sorboro, M.D. He says the following on page 42:
Even what most psychiatrists assume would be an obvious and universal approach of drug therapy to treat the most "biologic" of psychiatric diseases, schizophrenia lacks the kind of clarity most people assume exists. Recent landmark trials over 12-18 month periods funded by the US and British government involving the treatment of schizophrenia, found that regardless of medication used, many patients stopped taking medication, the medications demostrated a relatively poor efficacy, and new expensive medications did not perform any better than the old inexpensive ones.
he cites:
Bola, J.R 2006 "Medication-Free Research in early epsisode schizophrenia: evidence of long -term harm?" schizophrenia bulletin
Lieberman J A 2005, "Effectiveness of antipsychotic drugs in patients with chronic schizophrenia" new england journal of medicine
Rosenheck, R.A 2006 "Outcomes, costs, and policy caution: A Commentary on the cost utility of the latest antipstchotic drugs in schizophrenia study" Archives of general psychiatry. Sp0 ( talk) 00:46, 10 May 2008 (UTC)
There's not much new here - it's WELL understood that psychosis is very difficult to manage and poorly understood, and the drugs available (which ARE effective) are the best of a bad bunch rather than brilliant treatments. I think it's generally appreciated that any improvement of new drugs is not light years ahead of older drugs, and despite Sorboro and the research cited there is also a lot of medical opinion and research that suggests later generations are generally at least a bit better or a bit less harmful. Remember that what counts as a "better" drug in practice is based on a complicated balancing act that partly depends on your value system regarding different benefits and side-effects, and depends very much on the individual patient. Having said that, I think it's pretty reasonable to have a brief, not-too-strenuous disclaimer that there is good research that suggests there is less than full support for the wholesale movement of everybody onto later generation drugs.
131.172.99.15 (
talk)
06:08, 13 June 2008 (UTC)snaxalotl
I think the second paragraph, detailing as it does the dangers of antipsychotics, is particularly important now that many psychiatrists are augmenting reasonably safe drugs, e.g. SSRI's, with atypicals. It is important to the reader to be acquainted with the considerable risks involved with being treated with these drugs-and use might reasonable be confined to psychosis and not add-ons for depression, anxiety, etc.. A well done and important section, even though that's a POV comment.
Dehughes ( talk) 23:01, 20 October 2010 (UTC)
now... i'm reading the article, and i've been wondering... "Dr.Sandeep Patil's team proved that LY2140023 appeared to work as an antipsychotic when tested upon rodents." - i cant help but wonder, how do you measure how psychotic a rodent is? are psychiatric drugs really supposed to show efficacy on animals during clinical trials? are drugs given to humans at random, just because they didn't manage to kill a rodent? i know this is what the source says, and its supposed to be a reliable one, but this sounds too unrealistic to me. Fdskjs ( talk) 01:50, 12 April 2008 (UTC)
agree. you absolutely CANNOT say that some drug works as an antipsychotic on rodents. you can only say that some drug has some certain effect within some certain animal model of psychosis. anyone who doesn't understand how to do this has no business making an entry like the one you describe. this is the sort of article that attracts a lot of nutters, and I think it's generally a good idea to summarily weed out anything that is "not very good" or "not very clear", because if something really needs explaining to complete the article, someone who knows what they are talking about will eventually come along and do it. Honestly, large amounts of this article look like it's been mangled by someone with a psychology freshman understanding of psychosis. I have a copy from a couple of years back that read s like a real encyclopedia entry. 131.172.99.15 ( talk) 06:20, 13 June 2008 (UTC)snaxalotl
Someone should mention anti-psychiatry's opposition to these drugs. -- Daniel C. Boyer 17:33 Jan 13, 2003 (UTC)
I don't agree that the main objection is coerced medication (but I definitely agree this should be a serious ongoing concern). There are enormous numbers of people who think psychosis drugs interfere with a perfectly normal mode of being (e.g. classic 60's anti-psychiatry movement), or that you can just buckle down and THINK your way out of schizophrenia (e.g. all scientologists). I absolutely don't think it's valid to express these views as established scientific fact in a general encyclopedia article, but I think it should be mentioned that these views exist and who holds them. This is a significant sociological fact. I can think of at least one household name who claims to be a widely read expert on psychiatry, despite having a complete misunderstanding of some of the most basic issues in the field. 131.172.99.15 ( talk) 06:29, 13 June 2008 (UTC)snaxalotl
This article is a bit chaotic but I've added a few things and hopefully cleared up the most obvious red herrings.
I'll try and spend some time to organise and reference it a little better in the near future. - Vaughan 12:25, 1 Aug 2003 (UTC)
Minor change from 'The term antipsychotic is applied to any drug used to treat psychotic disorders...' to 'The term antipsychotic is applied to a group of drugs used to treat psychotic disorders...' as (for example) benzos and antidepressants can be used to treat psychotic episodes, however these are not considered to be antipsychotics.
- Vaughan 12:30, 1 Aug 2003 (UTC)
I think this is somewhat wrong. as you say, these drugs treat episodes, not the disorder per se. antipsychotics produce a generalized improvement in function (within the context that everyone understands they're more ok than great), so I don't think the examples conflict with the original. the new version is fine, though. —Preceding unsigned comment added by 131.172.99.15 ( talk) 06:38, 13 June 2008 (UTC)
The article on dopamine mentions that some anti-psychotics that affect dopamine activity can act as amotivators. Is anyone able to elaborate on this?
Look below in "Making symptoms worse / side effects".
128.151.161.49 17:34, 6 March 2006 (UTC)Iain Marcuson
The part about off-label uses for antipsychotics is incorrect. Pimozide and Haloperidol are indeed used for Tourette's Syndrome, but those are FDA approved drugs for that condition. Off-label refers to treating a disorder with a drug that is not approved for such usage, such as using an anti-seizure medication to correct a mood disorder.
One thing I notice isn’t mentioned clearly in the article is the disastrous effect some of these drugs can have on people. In 1997 I suffered a mental breakdown and had what was called a severe psychotic episode (basically due to extreme stress), I was sectioned and put in mental hospital and was put on Droperidol, paroxetine and a short course of high dose lorazepam. My symptoms from these 'anti-psychotics' became very severe. I became suicidal while in hospital and I never had been ever before. Worse, as the drugs ‘cured’ my bipolar 'depression' my reality began to slip and for a while after I was out of hospital I lost my core reality completely. I had gone from being psychotic and manic depressive to full blown schizophrenia. Eventually I began to regain reality, and have at least partly recovered but it has been a very difficult process and I don't even know if I would be alive now if it wasn’t for my families (especially my mothers) huge help.
I am probably the ultimate non-typical mental patient, until my breakdown I had been well rooted in reality for all my then 27 years. I was and am a computer scientist, I was specialising in AI and machine intelligence, I had a reasonably good knowledge of neurology and psychology, had been actively studying human consciousness for several years and was specialising in vision systems. What makes me even more untypical was that I had just made a breakthrough and was contemplating something not worth millions but many billions of dollars, and it was the stress of this this that I partly blame for the original breakdown.
The source of all my problems was that the doctors treated me like a sausage in a sausage factory, most of the people in that (uk) hospital got the same drugs as me and its obvious that its not so much the drugs fault so much as the way they were prescribed - the doctors and the system. Understandably I now have a deep fear and a certain hatred of psychiatrists because of this - just like seemingly most other mental patients. Another point not mentioned is the huge physical damage the drugs do to people, the line of emaciated half corpses that were most of the patients in that hospital reminded me unmistakably of Dachau.
I apologise for the length of this but its not easy to put things simply. Lucien86 05:58, 4 June 2006 (UTC)
Sorry Lucien but it sounds like you were misdiagnosed, essentially malingering. A nervous breakdown and "acting out" often leads people to be misdiagnosed. The problem was lack of honest communication between you and the doctor. Not all mental patients hate psychiatrists. Even many who do do so irrationally or selfishly . . . many wouldn't function without psychiatric treatment. Your claim of a breakthrough in AI worth "billions of dollars" sounds pretty dubious . . . and your entire attitude sounds much like the TYPICAL immature, narcissistic mental patient. Magmagoblin2 ( talk) 12:32, 15 October 2009 (UTC)
As this is an encylopedic article, could we break this down into something more understanable to the common person? I mean, the article isn't in a science magazine, nor is it being presented at a science convention of some sort. It's for the common persons and the researchers. Is it possible to make this more understandable? I read through it and I'm not an expert, but that's exactly my point. Colonel Marksman 06:31, 16 December 2006 (UTC)
To be fair, this isn't the kind of topic generally looked up by anyone but a student or specialist, and as such, will find much more value in being indepth and technical the way it is, rather than simplified for your average user. More simplified explainations can be found in the various pages for specific antipsychotics, which is quite possibly where the information you're looking for or interested in is covered? ;-)
neodarkcell
Personally I agree that it could and should be more readable, which doesn't preclude depth
EverSince
03:02, 23 December 2006 (UTC)
Not looked up by anyone but med students or specialists? First, specialists are well versed in the knowledge presented in this wiki and likely to find it elementary. Second, what about PATIENTS?
It seems like this would be less awkward under the title "Antipsychotics," since the article is about the class of drug, not a single thing. Night Gyr ( talk/ Oy) 03:51, 11 January 2007 (UTC)
There is a link under the subheading "Side Effects" (Tardive dyskinesia) that redirects to what appears to be a pseudoscience website www.yoism.org. Although there are indeed pictures there of what appear to be something like tardive dyskinesia, viewers must sift through alot of highly opinionated non-scientific garbage to get to anything of interest. Would it be ok to remove this link? Surely there must be other sources that would do better here? I will look for some. Neurophysik 05:25, 27 February 2007 (UTC)
Are antipsychotics indicated to prevent suicide? E.g. would they be given to someone who is suicidal because of depression?-- 137.205.76.219 16:38, 17 March 2007 (UTC)
this section is more or less complete crap. good prognosis in developing countries is unrelated to occurrence rates or neuroleptics, but probably the superior management that arises from being better accepted and integrated into the community. Note that the /appearance/ of schizophrenia is highly dependent on management strategies, and also note that cross cultural studies have huge methodological difficulties, and aren't that common. the basic rule for schizophrenia is that there /is/ no good treatment, only the best of a bad bunch, and I'd hate to see the hippies, anti-psychiatrists and scientologists encouraging people to abandon neuroleptics because of crank science
Should there be a section describing current research and a list of drugs in the pipeline for each research/future treatment area? — Preceding unsigned comment added by 24.218.137.40 ( talk) 20:00, 29 June 2007 (UTC)
I've no idea where to put cannabidiol in this article. It's been shown to act as an anti-psychotic so can be described as one. However, the definition of both typical and atypical anti-psychotics describes these as prescribed drugs. I also don't know whether to call it a typical or an atypical anti-psychotic. Supposed 21:45, 28 August 2007 (UTC)
how about you just leave out cannabidiol? this article attracts enough nutcase irrelevency as it is. I'm sure YOU are sure you've seen fan-fucking-tastic evidence of it's anti-psychotic efficacy (along with that car that runs on water tha everyone's been hiding) but the simple fact is that you can read a textbook on psychosis, or do a degree in neuroscience, without seeing cannabidiol mentioned. Trying to insert this sort of information will confuse people rather than enhancing the sort of understanding of the topic an encyclopedia article is supposed to deliver. 131.172.99.15 ( talk) 05:48, 13 June 2008 (UTC)snaxalotl
The reference given is really very poor. It certainly does not belong in a section on treatment and as such I have removed it. The study details some pre-clinical animal studies, a trial on patients who did not have schizophrenia (using ketamine as a model), a couple of case studies and a preliminary report from a trial of 43 patients. The only one of any significant interest is the trial of the 43 patients against amisulpride (given as Leweke FM, Koethe D, Gerth CW et al. (2005). Cannabidiol as an antipsychotic: a double-blind, controlled clinical trial on cannabidiol vs amisulpride in acute schizophrenics. 2005 Symposium on the Cannabinoids, Burlington, Vermont, International Cannabinoid Research Society. http://CannabinoidSociety.org.) however it unfortunately appears to be impossible to track down, I can only assume it was never published (or we are still waiting) - this is not good enough to belong in an encyclopaedia. If anything it could be mentioned that there is some research at a very early stage but nothing more than that. 82.39.196.227 ( talk) 23:09, 3 October 2008 (UTC)
I'm concerned by this as well. I'm intimately familiar with both marijuana and schizophrenia, and I have heard that marijuana can set schizophrenia off. This article could be dangerous. AThousandYoung ( talk) 02:04, 6 April 2009 (UTC)
Cannabis is the worst thing you could give a schizophrenic. Speaking from experience, I'm terrified of the stuff because it brought all my nightmares and delusions back . . . I was rabid, pacing, and completely freaked out for two days, then crushingly depressed and paranoid for a week. PARANOIA is one of the chief symptoms of schizophrenia and one of the notorious side effects of pot. I'm gonna go ahead and take out this reference, because it's terrible advice, could be very dangerous (many schizophrenics lack medical care, but have easy access to marijuana, and this "study" would encourage them to try it, and then who knows what'll happen) and there is no way cannabis is ever going to be prescribed to the mentally ill. Cancer patients, sure. Schizophrenics, no. Magmagoblin2 ( talk) 12:23, 15 October 2009 (UTC)
To anyone reading this - In my experience, antipsychotics will completely demolish one's sense of social anxiety, paranoia, and being in the dark. If you embrace your healthy sense of paranoia, taking these will make thinking about such things an arduous task. In addition, I used to have love for things like fire and the outdoors, but I no longer have significant feelings for them. —Preceding unsigned comment added by 69.250.158.97 ( talk) 17:44, 30 May 2008 (UTC)
Also, in my comment about motivation and desire, there is a scientific study which shows that when rats are injected with antipsychotics and made to run a maze, they do several times better when they are thereafter injected with L-dopa (the bioavailable form of dopamine).
I have schizophrenia and have taken Risperdal and now Zyprexa.
This article describes the dramatic increase in synaptic dopamine bought about by release of endogenous dopamine by electrical stimulation and antipsychotic treatment, and the experiment was successfully repeated a number of times and established.
http://jpet.aspetjournals.org/cgi/content/abstract/232/2/492
Similar levels of dopamine (in the mM range) are achieved with amphetamine and can lead to disturbed sexuality. With such high levels of dopamine, serotonin usually ramps down - could this lower serotonin cause depression and guilt.
-Steve. —Preceding unsigned comment added by 131.181.251.66 ( talk) 12:36, 9 October 2007 (UTC)
I've no idea, however as you're no doubt aware the article is in vitro which doesn't help Supposed ( talk) 17:07, 15 April 2008 (UTC)
Added Haloperidol which is never shown under 1st generation antipsychotics. Madglee ( talk) 00:03, 15 April 2008 (UTC)
Quetiapine is quite an effective tranquiliser at doses below 200mg. I was under the impression that quetiapine is referred to as a major-tranquiliser. I can certainly mimic some of the effects of benziadiazapines although it's not itself considered an anxiolytic. My question, is it just typical anti-psychotics that are referred to as major tranquilisers like the article says, because it appears to me that drugs like quetiapine may be even more sedating and anxiolytic in effect than some of the typical anti-psychotics. "Typical antipsychotics are also sometimes referred to as major tranquilizers, because some of them can tranquilize and sedate." Supposed ( talk) 06:03, 17 April 2008 (UTC)
This article does not list Asenapine but it lists Bifeprunox — Preceding unsigned comment added by 71.103.92.5 ( talk) 10:20, 25 June 2008 (UTC)
It has been said that these studies require serious attention and that such effects were not clearly tested for by pharmaceutical companies prior to obtaining approval for placing the drugs on the market.[17]
There is a subsection "Third generation antipsychotics". Very strange.. who's deciding that Abilify is "third-generation" and on what basis? -- CopperKettle ( talk) 15:17, 7 January 2009 (UTC)
...than just those listed in the side-effects part. Demotivation ought to be listed. 74.195.28.79 ( talk) 22:51, 11 March 2009 (UTC)
Zotepine is an second-generation antipsychotic commonly used in Japan and some countries in East Asia. It is absent in this page. Cause? Ryojames ( talk) 10:40, 18 May 2009 (UTC)
[3] It seems that increasing serotonin levels (through omega-3 fatty acids) actually decreased the symptoms of psychosis, but some antipsychotics are actually serotonin antagonists. This also seems to point to the same conclusion. However, this suggests that there is no link between serotonin levels and schizophrenia (or at least its first episode). MichaelExe ( talk) 16:56, 7 September 2009 (UTC)
The data under the heading "Prevalence of use" lists the prevalence of schizophrenia and bipolar disorder, not the prevalence of antipsychotic use. These drugs are increasingly prescribed to individuals not suffering from either of these disorders so that the number of individuals taking the mediation is actually many times the amount of those with either schizophrenia or bipolar disorder. They are used for depression and anxiety and sleeping problems, and are also routinely administered to the elderly in nursing homes to sedate them. —Preceding unsigned comment added by Ilmateur ( talk • contribs) 22:18, 12 January 2010 (UTC)
The material in question was actually on Wikipedia first, and copied from Wikipedia by an external site. The matter has been resolved.
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By 'Google sampling' the text, I've now encountered two specific instances where material has been copied and pasted to the article from copyrighted sources by editor Tweak279 over the past several days. Adding an attribution to quoted material is of course required by policy, but neither of the additions that I've encountered so far indicate that the material is a word for word 'lifting' of the source material itself without any indication of it being a direct quotation. Both instances that I've encountered so far appear to be sourced to: [4]. I'm going to revert the material added by Tweak279, until this potentially serious breach of policy is examined more closely and resolved. Please do not continue to add potentially controversial material to articles without engaging other editors in dialog in an attempt at reaching consensus. thanks Deconstructhis ( talk) 17:14, 13 March 2010 (UTC)
Thanks for providing that history, it's basically what I was asking for back here [11]. Is anyone familiar enough with Wiki's required licencing procedures for acknowledging use to look into this further at this point? cheers Deconstructhis ( talk) 20:44, 16 March 2010 (UTC)
Actually,I'm not an administrator. Deconstructhis ( talk) 21:08, 16 March 2010 (UTC)
I do'nt care about my case, I havne't got one to answer. My concern is that Wikipedia seems to be populated by protectionistic idiots who think people who try to add ACTUAL CONTENT TO WIKIPEDIA are fame game for being treated like ****s. Tweak279 ( talk) 21:18, 16 March 2010 (UTC)
It's always been my understanding that if an entire article is republished from Wiki by someone, there's a requirement in the licensing that the source of the material be acknowledged; I'm only guessing, but I'm assuming by extension, that portions lifted verbatim should also be accompanied by notice as well. As I indicated above, I'm unsure if there's a formal mechanism for informing Wikipedia of these sorts of breaches or not. If I get a chance, I'll explore this later on and get back to you on it. cheers Deconstructhis ( talk) 22:29, 16 March 2010 (UTC)
Summary: There were allegations that a Wikipedia editor copied some material from a 2008 HealthyPlace ( article); however, some of the content was added ( diff) back in 2007. I sent HealthyPlace an email notifying them of the Creative Commons license ( Wikipedia:Text_of_Creative_Commons_Attribution-ShareAlike_3.0_Unported_License) and will post an update if/when I get a response. II | ( t - c) 00:36, 17 March 2010 (UTC) Errr this actually makes it sound as if some of teh material WAS copied by the accused editor?? Tweak279 ( talk) 08:38, 17 March 2010 (UTC) When in fact ALL the content was here before it was on HealthyPlace and another editor simply made a stupid mistake. Tweak279 ( talk) 08:41, 17 March 2010 (UTC) |
Hi, I am bringing a couple of changes to the talk page to try and achieve consensus. This edit removed text for the reason that antipsychotics are not used in non-psychotic individuals and thus saying the review is wrong. Antipsychotics, are not just prescribed for psychosis, they are used for example for nausea and vomiting for example from chemotherapy, sometimes off-label for sleep disorders (especially in the USA), agitation and anxiety and autistic spectrum. The article was a review of the literature so it must have been documented. The withdrawal syndrome of antipsychotics is believed to be due to increased dopamine activity. The mainstream psychiatric viewpoint is that schizophrenia is caused by excessive dopamine activity. So to disagree that withdrawal effects of antipsychotics can cause psychosis in non-psychotic patients means one should also deny the mainstream biological theory of schizophrenia.-- Literaturegeek | T@1k? 00:38, 17 May 2010 (UTC)
The other point was the content added to the controversy section, which was a review which stated that research may be flawed due to failure to take into account withdrawal effects of antipsychotics. I agree that on its own it was undue weight, so I have added two other reviews which support maintenance for psychosis. Although my personal view points are not relevant, I would like to say that I do believe that there are many people who require long-term maintenance for serious mental illness and I am quite happy to add balance supporting this viewpoint. I am not trying to push a POV against the long-term use of these drugs. I think it is important knowledge that antipsychotics produce withdrawal effects which can mimic the condition being treated and if maintenance studies have failed to control for this variable, then this controversy should be cited I feel.-- Literaturegeek | T@1k? 01:31, 17 May 2010 (UTC)
My personel experience about antipsychotics.
I am a veteran with Schizophrenia and I have was on multiple types of antipsychotics for nineteen years. However, I do not consider myself psychotic at all. Scizophrenia is one or more of the folowing symptoms as far as I have been told by the doctors. They are hearing voices, delusional, paranoid, catatonic and\or seeing things. Psychotic as far as I know is violent. I am not, but am aware that some of these symptoms could cause psychotic behavior. What I really wanted to say is that the medications are what I would call a modern day lobotomy in that they do turn you into a sort of zombie. It slows your brain down and body down. This might be why my sugar was very very (13 H1C and it should be 6) high on clozapine and 260 lbs. Many of the drugs I took were just plain aweful. The side effects were there and changing all the time. Slobbering puddles on pillows by morning, sleeping too much, no emotion, sad, uncaring, anemic requiring iron, dystonia in the form of unconsious violent cracking of my neck to name few. Once off the medications without telling the doctors my sugar returned to normal I felt better through exercise and eating right, lost 50-60 pounds and learned not to tell the doctors my problems. I asked for a psychologist instead of a psychiatrist. I found they work together over there and if there is no improvement they do recommend drugs. It seemed the side effects and the doctors telling me there was something wrong with me is the problem. On prolixin, I wound up in the mental ward shaking violently. On Haldol, I could not stay seated and getting off the drug was a nightmare of having to stay in bed and not being able to sleep or stay still. If I wanted to take the drugs I would want the lowest possible dose because they are strong and take the the same time every day, don't drink or smoke, eat right and get excercise. Also, be around people you love and trust. Give everyone a chance to be one of them. Choose your friends wisely and find a job you enjoy. —Preceding unsigned comment added by Brian1596 ( talk • contribs) 23:32, 17 June 2010 (UTC)
Why are these chemicals referred to as anti-"psychotics", when what they really basically are is a sedative?
If a patient is acting too wild and crazy for the caregivers to deal with, then the doctors give them this chemical to sedate and calm them, and if the patient still is too much to handle, the amount of chemical given can be cranked up to the point of stupefaction and catatonia.
Personally I believe the name choice is to make patients more willing to accept taking the chemical. It sounds better to be given a chemical to treat your "abnormal psychotic behaviors", than it is to say we're going to slow your thinking and numb you into a fuzzy compliance.
216.56.13.231 ( talk) 02:32, 30 June 2010 (UTC)
"This may refer to common side effects such as reduced activity, lethargy, and impaired motor control. Although these effects are unpleasant and in some cases harmful, they were at one time considered a reliable sign that the drug was working.[citation needed]" This is found in Elliot Valensteins Blaming the brain and he also cites his source in the book but unfortunately I don't have that book anymore. Can somebody who has the book provide the citation? 24.247.174.132 ( talk) 17:15, 27 September 2010 (UTC)
Another editor and I disagree about about this edit that I made: [12]. I had noticed this edit, by another editor: [13]. Looking at the biographical page that is linked in the edit summary, I agreed with that editor that the cited sources were at odds with WP:UNDUE, WP:FRINGE, and, most importantly, WP:MEDRS. I also think that some of the language about "systematic review" and "urgently needed" went against WP:NPOV (when taken in the above context) and WP:PEACOCK, while the part about "a call that had already been made when similar results were found in 2006" goes against WP:SYNTH. Overall, per WP:MEDRS, we have to be very careful about not presenting material that goes against the medical literature in ways that might mislead our readers; these are, after all, medications that remain approved for use. I hope that explains my deletion. -- Tryptofish ( talk) 22:21, 5 March 2011 (UTC)
Check that out.
http://archpsyc.ama-assn.org/cgi/content/short/68/2/128
During longitudinal follow-up, antipsychotic treatment reflected national prescribing practices in 1991 through 2009. Longer follow-up correlated with smaller brain tissue volumes and larger cerebrospinal fluid volumes. Greater intensity of antipsychotic treatment was associated with indicators of generalized and specific brain tissue reduction after controlling for effects of the other 3 predictors. More antipsychotic treatment was associated with smaller gray matter volumes. Progressive decrement in white matter volume was most evident among patients who received more antipsychotic treatment. Illness severity had relatively modest correlations with tissue volume reduction, and alcohol/illicit drug misuse had no significant associations when effects of the other variables were adjusted. —Preceding unsigned comment added by 74.59.147.209 ( talk) 22:38, 23 March 2011 (UTC)
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I changed this section a bit because it fucked up the formatting in the following sections. Hope nobody minds. Firrtree ( talk) 17:23, 20 October 2012 (UTC)
The entirety of this articl about antipsychotics is laced with POV and is far from neutral in the way it approaches the topic. The red flag for this state of affairs iss the use of a 1950s ad for Thorazine, a drug which was classified a "major tranquilizer" not an anti-psychotic. It's use at the commencement of this article is tantamount to making use of "Reefer Madness" as an introduction to an article about marijuana. All of medicine 50 years ago seems primitive by comparison to the viewpoint of current times. Ironically, my own observations of the powerful good which Thorazine was capable of occurred when I worked with an ad hoc group of peer counselors in the dormitories where at least once a month someone experienced a bad LSD trip. Bad as in, if I hang by my feet on this 4th flour balcony I can almost touch the ground. I saved this young man's life when I myself was 18 because I reached down and with the help of another equally weak 18 year-old was able to pull him to safety. We sometimes had to resort to calling for medical help in the form of a sympathetic doctor who would arrive, give the bad tripping student a shot of Thorazine and within 20-30 minutes the LSD user would return to a rational being and thank us repeatedly. But I stray from the point that Thorazine has no place whatsoever in this article as it never was classifed as an anti-spychotic by the FDA. I believe that the Thorazone ad should be wholly removed for this among other reasons. QuintBy ( talk) 08:24, 13 October 2012 (UTC)
... the first antipsychotic drugs were discovered by accident in the 1950s when a putative antihistamine (chlorpromazine) was serendipitously observed to have an antipsychotic effects when tested in schizophrenic patients. Chlorpromazine indeed has antihistaminic activity, but its therapeutic action in schizophrenia are not mediated by this property. Once Chlorpromazine was observed to be an effective antipsychotic agent, it was tested experimentally to uncover its mechanism of antipsychotic action [blocking of dopamine 2 receptors - my interpolation
— S.M.Stahl, Essential Psychopharmacology, p.402
I remember a paragraph in the article several months ago that said maintenance therapy wasn't more effective than placebo. I think there was a citation or two and maybe a link to some study. Does anyone remember it? Or why it was deleted? Also, can anyone link me to the version of the article which still has that paragraph (I can't find one)? Firrtree ( talk) 17:17, 20 October 2012 (UTC)
Please see Adverse effect. The Side Effects covered here are unintended and UNDESIREABLE. Is not then the mostly used term "adverse effects"? Nopedia ( talk) 22:32, 28 December 2012 (UTC)
This is from an article on depression, but it may explain equally well the findings that antipsychotics (at least the ones studied) shrink the brain. Someone might want to work it into the article, as it's quite important information:
"Conventional drug therapy leaves much to be desired from the metabolic perspective and needs to be re-evaluated with some urgency. If administered to persons whose capacity for replenishing intraglial glycogen and intraglial and intraneuronal ATP stores is impaired mood elevators that act by enhancing neurotransmitter release and increasing the slope of neuron action potentials may compound the severity of the energy deficit present by increasing the demand for ATP hydrolysis beyond the capacity to replenish ATP stores. Any severity of any energy deficit present is likely to be compounded by those antidepressants that impair mitochondrial oxidative phosphorylation. It might also be compounded by drugs used to treat co-existing cardiovascular disorders, notably beta blockers and statins. Of great concern is that any medication or mixing of medications that either induces or compounds the severity of an intracerebral energy deficit might increase the likelihood of developing neurodegenerative disorders in later years especially if the medications are administered for extended periods."
Source: "Depression: a metabolic perspective" Richard Fiddian Green, 27 October 2012, BMJ.
I'll also leave it for others to decide whether they want to add this information to the Wiki article on antidepressants. At least for now. Firrtree ( talk) 20:01, 17 January 2013 (UTC)
Hi. I was drawn back to the body of this text by a recent edit removing text [14] that followed a help desk question on the side effects of antipsychotics detailed in this article [15]. I have no particular complaint about this removal as the text, which was unsourced, did not belong in that section I think, but it did draw to my attention some problems in the article.
The Antipsychotic#Structural effects section repeats in greater detail claims already made in the Antipsychotic#Side effects section about the potential impact of antipsychotic usage on brain volumes. Shouldn't these sections come in sequence one after the other and not duplicate information. Also, the statements on decreased brain volume and antipsychotic usage in the side effects section are largely based on a single primary study (which I originally added although I think Tryptofish toned down my original contribution). There are secondary sources/review articles on this topic and would it not be more appropriate to reference these? The Antipsychotic#Mechanism of action section has three paragraphs and a single citation. Is the entire text derived from a single source? FiachraByrne ( talk) 17:22, 18 February 2013 (UTC)
Just a list from a crude search in pubmed (antipsychotics AND brain volume (in all fields) and publication type "review": ( http://www.ncbi.nlm.nih.gov/pubmed/?term=%28%28antipsychotics%29+AND+brain+volume%29+AND+%22review%22[Publication+Type] 40 results]): FiachraByrne ( talk) 23:31, 20 February 2013 (UTC)
Search pubmed (antipsychotics AND brain (in all fields) and publication type "review": [Publication+Type 2092 results - only first 100 results checked):
Just removed the following text which was added to the Structural affects section (originally from dementia article)
In the UK around 144,000 people with dementia are unnecessarily prescribed antipsychotic drugs, around 2000 patients die as a result of taking the drugs each year. [3] Selegiline does not appear effective either. [4]
Main claim is sourced to Guardian, but derived from this report [17]. Needs better sourcing &, if it is included, which section should it go in? FiachraByrne ( talk) 08:59, 25 February 2013 (UTC)
I introduced a new paragraph explaining the way antipsychotics work. I made extensive research in the subject, read lots of papers but unfortunately editors keep removing my conclusions and accuse me of biased content. I would like to discuss this so that we can reach a consensus. — Preceding unsigned comment added by Booklaunch ( talk • contribs) 15:21, 12 May 2013 (UTC)
Hum, that is incorrect, I mentioned the reduced emotional functioning (flat affect), which is pretty much due to being tranquilized. It was in bold letters. and I said "desirable" meaning that was being administered for. Booklaunch ( talk) 17:37, 12 May 2013 (UTC)
Harrow, M (2013 Mar 19). "Does Long-Term Treatment of Schizophrenia With Antipsychotic Medications Facilitate Recovery?". Schizophrenia bulletin.
PMID
23512950. {{
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Doc James ( talk · contribs · email) (if I write on your page reply on mine) 20:07, 12 May 2013 (UTC)
So now the article is even longer, as in long term use Booklaunch ( talk) 20:45, 12 May 2013 (UTC)
I mention here some of the problems I have found:
The mechanism of action of antipsychotics is very simple.
Unreferenced, anyway, hardly simple.
Zad
68
14:43, 13 May 2013 (UTC)Some of the content points towards useful directions, but as of today is not helpful in the article due to problems mentioned. -- Garrondo ( talk) 21:18, 12 May 2013 (UTC)
While I initially reverted the edition I was unintentionally breaking the 3RR so I reverted myself. I would like to ask other editors for further imput.-- Garrondo ( talk) 21:41, 12 May 2013 (UTC)
Zad
68
13:24, 13 May 2013 (UTC)I also re-reverted myself regarding a change in wording to this section (See here and here)
I copy here my reasoning at the editor's talk regarding why I consider his changes inadequate. I hope somebody gives further comments. -- Garrondo ( talk) 21:40, 12 May 2013 (UTC)
I have reverted the change of wording to the structural effects section in the Antypsychotics article. Conclussion of the abstract is worded in extremely hyptotetical tone, and that tone should be kept in Wikipedia, otherwise we would be conducting Original Research.-- Garrondo ( talk) 20:54, 12 May 2013 (UTC)
This paper is not credible as it assumes brain abnormalities in unmedicated schizophrenia patients. Where is the paper/source/book/video showing abnormalities in non medicated (never been medicated, virgin, out of victorian working house) schizophrenia patients please? Thanks Booklaunch ( talk) 06:43, 13 May 2013 (UTC)
Agree with Garrondo that the recent change to Structural effects did not appear to be good as it removed a more recent systematic review and seriously overstated findings. I have reverted the proposed article content change while we discuss on Talk page to develop consensus regarding it.
Zad
68
13:27, 13 May 2013 (UTC)
"also known as neuroleptic even though not all antipsychotics have neuroleptic effect". Then what is a neuroleptic/the neuroleptic effect; neuroleptic redirects to antipsychotic, implying they (neuroleptic and antipsychotic) are one and the same, which contradicts the quoted sentence. ZFT ( talk) 01:59, 25 September 2013 (UTC)
I suggest the inclussion of more information about the permanent or semi-permanent side effects of the antipsychotic drugs. For example, while most side effects of antipsychotic drugs resolve quickly after discontinuation, several side effects are permanent or semi-permanent, such as tardive akathisia (in 98% irriversible), tardive dysckinesia, tardive dystonia, tardive dysphrenia, tardive psychosis, cataracts, glaucoma, side effects on the heart such as QT interval prolongation which leads to torsades des pointes (potentially fatal), etc. Many side effects are fatal: eg. stroke, neuroleptic malignant syndrome (may kill within 24 hrs if untreated), etc.
In the list of side effects, only very few common side effects are listed. The probability of some of them happening is greater than 1%, yes, but this is misleading, as many of them, for example insomnia, can happen with a probability of up to 40%. So I would recommend to change it to read "a probability of more than 1% up to 50%"
I would also recommend including the following: "The probability of side effects, ranging from less than 1% to 50%, is tipically obtained from drug trials of a few thaousand people for a few months. Since each person has different neurochemistry and genetics, the probability of side effects ocurring on one particular person is unpredictable, and it could happen at any time" — Preceding unsigned comment added by 190.52.139.38 ( talk) 15:26, 6 October 2013 (UTC)
The section on 5HT2A claimed two things that are not substantiated. One, it claimed that antipsychotics antagonize the receptor, instead of partially agonizing it, which is an important distinction, in particular with this receptor. It also claimed that agonism of this receptor is associated with psychosis. This is not well-substantiated, as antipsychotics do agonize the drug, not antagonize it, and also because psychedelic drug use, which also agonize to antagonize this receptor, are associated with lower psychosis risk.
I added reviews claiming that different alleles are associated with psychosis, and also that higher receptor concentrations in certain areas associate with psychosis. I also added brief mention to SSRIs and psychedelic drugs. — Preceding unsigned comment added by 205.208.122.240 ( talk) 22:14, 16 December 2013 (UTC)
Ok I fixed what you messed up, atypical antipsychotics DO antagonize the 5HT2A receptor, not agonize, I believe that you are confusing the tendency of atypical antipsychotics to partially agonize the 5HT1A receptor with the 2A receptor. Psychedelic drugs agonize the 5HT2A receptor and have been shown to potentiate psychosis in schizophrenic patients. — Preceding unsigned comment added by 208.123.246.67 ( talk) 07:57, 26 January 2014 (UTC)
Off topic chat
|
---|
Anti-psychotics = inspired by LSD-like substances Anti-psychotics, like urotherapy is inspired by LSD-like substances. Originally called "trepanning", and later called "lobotomy", "anti-psychotics" seeks to do similar things, "chemically". However no-one is cured, just like trepanning and lobotomy. Instead trepanning, and lobotomy is connected to hallucinogenic art. It is actually quite common to see divided minds on LSD-like substances. Some examples from popular culture: Pink Floyd - Division Bell, H.R. Giger - Atomkinder, Mac Logo Smiley. Psychiatry often still proposes LSD as a theraputic agent, along with many other drugs, equally without any rational basis. They never cured anyone, while people are getting cured WITHOUT drugs, just by simple religion. "God is one and without partners". A positive lifestyle in an oversexualized society, makes a lot of sense. PBWY. |
This section is biased. It cherry-picks sources and reads like a sale pitch against antipsychotics. The section should be rewritten to include actual medical use of antipsychotics in schizophrenia and its existing content should be moved to the "Controversy" section. Jm292 ( talk) 02:59, 16 November 2013 (UTC)
I agree we can probably do a better job of highlighting how usage / prescribing does not match the evidence. This is a great deal of sources to support this for dementia but also some for other indications like sleep. Doc James ( talk · contribs · email) (if I write on your page reply on mine) 12:34, 2 February 2014 (UTC)
In general this article is unreadable. It is ironic that the disjointedness apparent here is symptomatic of psychosis, don't you think? It needs a total rewrite. Some hints: lists do NOT add to the understandability of the prose, and should be separated (either into a table or a dedicated page). typical vs atypical isn't, as it appears here, very useful in advancing the subject. If they are substantially different, then separate the discussion of them. If they are not, then don't use them as subdivisions in each of the other sections! How can you write a section on comparison of side-effects when the list of drugs is as large as this one's?? It is unintelligible as written. Now, I came to this article to find a common (I almost wrote "typical" but that would mean something else here, wouldn't it?) antipsychotic. Aside from a laundry list of 60 or so, I could find nothing. The Sales section is pathetic. It states:"Antipsychotics were once among the biggest selling and most profitable of all drugs..." AND [in 2008 they were] "the biggest selling drugs in the US..." No effort is made to reconcile the conflict between the implied status of no longer being the biggest selling, and being the biggest selling (in the USA). Sloppy and pathetic. I'd think that with a highly regulated business this large, that it wouldn't be that difficult to pick-out the top sellers; but then again, I like to think of myself as sane. 216.96.76.190 ( talk) 18:10, 16 December 2014 (UTC)
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Some months ago, another editor questioned the assertion that neuroleptic and major tranquilizer are no longer commonly used in professional literature; requesting a citation. Neuroleptic is absolutely still in common use as I know from being a mental health professional. I have no intention of creating a primary source hence my knowledge is not an appropriate source. However, unless someone can add an appropriate citation, the statement of obsolescence needs to be deleted. Dstern1 ( talk) 17:43, 13 June 2016 (UTC)
Reply to Doc James: I added some categories to the section “see also” ( diff) to make these categories more salient and provide a convenient way to browse among related articles. Categories are highly underused by readers of the encyclopedia as anybody can ascertain by comparing the statistic of a category to some related articles. I conjecture that the reason is that the general public is not aware of Wikipedia's category system. This is a way to make it more known and therefore a way to make it useful.
This system is not redundant with navboxes; and it performs a related, but not the same function. Users can browse in principle, all drug-reated articles from these categories. Although all the categories I included Category:Psychoactive drugs are accessible through it, I included the other 3 because they are especially relevant for the topic, to make sure that interested users won't miss them (as currently happens with just listing categories at the bottom of the article).
Mario Castelán Castro ( talk) 01:49, 6 September 2016 (UTC).
This is a rather picky question! I updated a couple of references that were flagged as having a more recent Cochrane version available. One of them is a systematic review on the drug Perazine. The conclusions of both reports are similar (more work needed). On review of the full-length results, I noticed that the review paper uses RR, and the wiki chart is in OR. If you think for the purpose of this wikipedia article, using RR and OR interchangeably is alright, that is fine by me! I have enough of a stats background to know that OR and RR are not the same. My stats are a little rusty these days to be able to make a judgement call as to how important it is in this context. I googled RR and OR and found this cochrane website describing the difference http://handbook.cochrane.org/chapter_9/9_2_2_3_warning_or_and_rr_are_not_the_same.htm Unfortunately I don't have time to go through all the drugs in the wiki table and compare if an RR or OR was calculated in the original reviews. If you are super interested in this, the authors of the cochrane review on perazine wrote the following (quoted): "Binary data For binary outcomes we calculated a standard estimation of the risk ratio (RR) and its 95% confidence interval (CI). It has been shown that RR is more intuitive (Boissel 1999) than odds ratios and that odds ratios tend to be interpreted as RR by clinicians (Deeks 2000)." cochrane ref: https://www.ncbi.nlm.nih.gov/pubmed/24425538 Thanks. JenOttawa ( talk) 17:43, 11 November 2016 (UTC)
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Is at the first position, as according to Wikipedia policy, instead of an alternative within a further-into-the-article position 1a16additional ( talk) 12:07, 14 October 2017 (UTC)
as far I could tell from the nature of the inclusions of material and the quality of the sources used, the material was strong enough for inclusion, I'm interested to see you've exercised your opinion Jytdog is removing most of the material, although there is a little remaining from the entire editorial contribution you and the Doctor are expressing having some doubts about. You understand I'd like to know how the content is inadmissable, tell me how so, if you would, then we might be enlightened as to this situation, where I look for information to add to the article, produced by globally recognised organisations, professors, employees of universities and the like, which for some reason, Jytdog, is not relevant to the article. So show me how this is possible if you will, then we might both know how it is possible. Or I'll think that, for some reason, you are supporting the bias of a medically trained professional, who for some reason, thinks his own personal preferences represent a global situation, and expresses the wishes and needs of the English speaking people of the world, who wouldn't need to read the deleted content.
For example - psychotropic
supported by the following sources:
P.J. Perry (Professor of Psychiatry at the College of Medicine and Professor at the College of Pharmacy, University of Iowa) American Psychiatric Publication Incorporated
http://www.brendanlsmith.com/ is an independent source
the World Health Organization is important enough to have a wikipedia article
H.J. Bein Springer Science & Business Media is a reliable publishing house
24 relevant drugs are listed /info/en/?search=List_of_psychotropic_medications
http://abcnews.go.com/blogs/health/2011/12/02/what-you-need-to-know-about-psychotropic-drugs/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2690138/
https://www.ncbi.nlm.nih.gov/pubmed/20669865
https://www.nice.org.uk/guidance/ktt19/resources/psychotropic-medicines-in-people-with-learning-disabilities-whose-behaviour-challenges-pdf-58757961132997 source: National Institute for Health and Care Excellence
Autism source: DJ. Posey, KA. Stigler, CA. Erickson, and CJ. McDougle - Antipsychotics in the treatment of autism 2008 Journal of Clinical Investigation ( The American Society for Clinical investigation) January 2; 118(1): 6–14. doi:10.1172/JCI32483 Accessed October 14th, 2017
also shows the content is going to be included
http://www.bmj.com/content/334/7603/1069 BMJ 2007; 334 doi: https://doi.org/10.1136/bmj.39216.583333.80 (Published 24 May 2007) Cite this as: BMJ 2007;334:1069
https://www.scientificamerican.com/article/antianxiety-drugs-successfully-treat-autism/ - " Currently, treatments for autism are usually prescribed off-label and focus on helping treat aggression or hyperactivity with medications including Ritalin and antipsychotic medications ..."
https://www.intechopen.com/books/autism-spectrum-disorders-from-genes-to-environment/antipsychotics-in-the-treatment-of-autism DOI: 10.5772/18608
http://www.dtic.mil/docs/citations/ADA591182 - Corporate Author : Cincinatti University Ohio
23h112e ( talk) 14:56, 16 October 2017 (UTC)
No I haven't yet, because the information from the sources seems (is) relevant, and so I didn't deem it necessary. Indicate the reason why you think the content I would like to add is not applicable, since the content is supported by sources like any other content which might be at a future time added. 23h112e ( talk) 16:13, 26 October 2017 (UTC)
In the section that lists types of medication I think it would be helpful to add tradenames and other names in parenthesis. For instance, I came to this page to verify that Seroquel is in face an antipsychotic. It would have been immensely helpful to see this "Quetiapine (Seroquel)...." — Preceding unsigned comment added by 159.39.19.139 ( talk) 15:24, 11 December 2017 (UTC)
I suggest you change "Other" into maybe Other Treatment Plans or Other Medical uses. Overall the article provided a lot of great information but my only edit to the article would be your the heading of your topic. One of your sources for the special populations topic was great with elaborating on those individuals and their needs. Your sources supported your topic. - T.Davis — Preceding unsigned comment added by LaShaeDavis ( talk • contribs) 17:11, 18 February 2019 (UTC)
The claim that antipsychotics do more harm than good is WP:EXCEPTIONAL. Also, it seems that it goes against the common wisdom in psychiatry. While the sources given are not WP:FRINGE, it is a common claim in anti-psychiatry that mainstream psychiatry does more harm than good.
Also, I would point out some sources of bias:
So, these factors would have had to be controlled during research. Tgeorgescu ( talk) 01:15, 6 October 2016 (UTC)
OK, as a student and a consumer, this debate needs to stop. the evidence is now ample that antipsychotics are neurotoxic and can cause permanent extrapyramidal symptoms like #akathisia. antidepressants are showing similar ill effects because our treatment of mental health issues with newly patented drugs IS CRAZY. 2602:306:B8D4:EB80:900B:9FE1:D08A:B5F8 ( talk) 09:40, 1 October 2017 (UTC)
Here’s a good one. They shrink the brain. [32] — Wikiman2718 ( talk) 06:35, 21 June 2019 (UTC)
It can be summarized as "Antipsychotics may be an option, together with stimulants, in people with ADHD and aggressive behavior when other treatments have not worked. [8]"
We should stick with secondary sources per WP:MEDRS Doc James ( talk · contribs · email) 20:35, 30 July 2019 (UTC)
In the first few words of the article, one of the definitions of antipsychotics cited is "major tranquilizers". I feel this is misleading and not supported by a proper medical reference. It references a textbook (a primary source) written by people who can't be considered "experts" in their field as I can't find any other works published by them (maybe I'm looking in the wrong places??). It is misleading in that many of the atypicals couldn't remotely be considered tranquilizers; in fact, the opposite is the case for most of them in that they're taken in the morning because they have mild stimulant properties. Would people be okay with me removing the reference to "major tranquilizers"? I was going to be bold and just remove it, but I felt it would be better to give it a few days on the talk page to see if my feelings are shared by the community.
Looking forward to your responses. - Schaea ( talk) 20:10, 28 March 2020 (UTC)
I'm happy to use the term adherence. To protect my character :p, both terms seem to exist in the literature and nice guidelines:
e.g.
Searching google:
--
Talpedia (
talk)
19:26, 25 June 2020 (UTC)
"To improve adherence, people with severe mental illness are sometimes compelled to treatment through a process called committment, in which they can be forced to accept treatment (including antipsychotics). A person can also be committed to treatment outside of a hospital, called outpatient commitment. "
I want to remove "with severe mental illness" and replace it with "patients". Or maybe "people who have been diagnosed with mental health disorders". community treatment orders are used in Canada, Australia and the UK. In Australia study found around 20% of people with FEP were placed on CTOs. These people cannot be considered to have a severe mental illness since some 20-30% will recover with no further symptoms ( https://www.researchgate.net/publication/312043640_Community_Treatment_Order_Identifying_the_need_for_more_evidence_based_justification_of_its_use_in_first_episode_psychosis_patients) The author notes:
"[CTO use] may be related to clinicians' wish to minimize duration of inpatient stay, hospitalization being commonly considered as potentially deleterious in young patients with regards to social integration and promotion of engagement into treatment. It may also be related to insufficient staffing of outpatient services and lack of availability to really work in depth on engagement and provision of home based support of patients. Finally, CTOs may also have been used as a mean to minimize disengagement which is known to be frequent among FEP patients."
So outpatient commitment seems to be used for reducing the chance of relapse for those who are *at risk* of developing a disorder rather than having one. The source also references "a specific cluster of patients placed under CTO, composed of young males suffering from schizophrenia, with a lower level of education and a high rate of history of substance use disorder." so the decision making seems to be in part due to social reasons.
-- Talpedia ( talk) 18:32, 25 June 2020 (UTC)
Is is worth mentioning here? Yes, I think it is. The manner in which antipsychotics are used is relevant, and the fact that people are forced to take them against their will at the threat of being hospitalized is relevant.
-- Talpedia ( talk) 21:32, 25 June 2020 (UTC)
-- Talpedia ( talk) 23:15, 25 June 2020 (UTC)
-- Talpedia ( talk) 00:04, 26 June 2020 (UTC)
There is a world of grey in the middle there. Large doses, side effects from antipsychotic that resemble psychotic symptoms, lack of review while committed, heavy pressure for use of prophylactic drugs, unacknowledged manic side effects of antidepressants, ill-informed mental health nurses, failure to distinguish between "normal behaviour" and manic behaviour once psychotic symptoms have subsided, kakfaesque legal authority, use of threat of commitment to force "volunatry" treatment. My image of contemporary psychiatry is very accurate thank you very much.
-- Talpedia ( talk) 09:06, 26 June 2020 (UTC)
Hey, I agree that these tables are quite niche knowledge. However, I think they are pretty useful for anyone researching which antipsychotics to take, and I think this might be a common use of this page.
I'm not sure if this is a good argument, I haven't seen many arguments here based on "this is very important for group X" win. Might it be better to move this off to a separate page? List of antipsychotics or semething like that? Talpedia ( talk) 20:35, 8 March 2021 (UTC)
Reverted edits are both WP:FRINGE and dated (outdated). Debunked at https://www.nature.com/articles/s41386-021-00980-0 Tgeorgescu ( talk) 15:22, 15 March 2021 (UTC)
indeed, but she is a psychiatrist publishing in peer reviewed journals. It's perhaps unsurprising that critique comes from people with quite a different theoretical outlook. Talpedia ( talk) 19:33, 16 March 2021 (UTC)Joanna Moncrieff has an axe to grind
Evidence shows adverse effect such as Alzheimer's disease [9], [10] Cognitive dysfunction [11] [12], [13] Dementia worsening, [14] [15] etc.
RIT RAJARSHI ( talk) 07:37, 30 May 2021 (UTC)
References
Moncrieff-2006
was invoked but never defined (see the
help page).Jobe2005
was invoked but never defined (see the
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Ironically, chemical lobotomy is frequently given to those with dementia, dramatically shortening their rremaining lifespans. Probably because it makes them docile in the short term. DrBoller ( talk)
This page is an archive of past discussions. Do not edit the contents of this page. If you wish to start a new discussion or revive an old one, please do so on the current talk page. |
What is the classification for 3rd generation anti-psychotics? I put bifeprunox under the list that already had abilify on it. I presume 3rd generation drugs are partial dopamine antagonist. —Preceding unsigned comment added by Sp0 ( talk • contribs) 05:44, 24 September 2008 (UTC)
In Skeptic magazine vol. 13 no. 3, 2007, there is an article, "The Trouble with Psychiatry," by John Sorboro, M.D. He says the following on page 42:
Even what most psychiatrists assume would be an obvious and universal approach of drug therapy to treat the most "biologic" of psychiatric diseases, schizophrenia lacks the kind of clarity most people assume exists. Recent landmark trials over 12-18 month periods funded by the US and British government involving the treatment of schizophrenia, found that regardless of medication used, many patients stopped taking medication, the medications demostrated a relatively poor efficacy, and new expensive medications did not perform any better than the old inexpensive ones.
he cites:
Bola, J.R 2006 "Medication-Free Research in early epsisode schizophrenia: evidence of long -term harm?" schizophrenia bulletin
Lieberman J A 2005, "Effectiveness of antipsychotic drugs in patients with chronic schizophrenia" new england journal of medicine
Rosenheck, R.A 2006 "Outcomes, costs, and policy caution: A Commentary on the cost utility of the latest antipstchotic drugs in schizophrenia study" Archives of general psychiatry. Sp0 ( talk) 00:46, 10 May 2008 (UTC)
There's not much new here - it's WELL understood that psychosis is very difficult to manage and poorly understood, and the drugs available (which ARE effective) are the best of a bad bunch rather than brilliant treatments. I think it's generally appreciated that any improvement of new drugs is not light years ahead of older drugs, and despite Sorboro and the research cited there is also a lot of medical opinion and research that suggests later generations are generally at least a bit better or a bit less harmful. Remember that what counts as a "better" drug in practice is based on a complicated balancing act that partly depends on your value system regarding different benefits and side-effects, and depends very much on the individual patient. Having said that, I think it's pretty reasonable to have a brief, not-too-strenuous disclaimer that there is good research that suggests there is less than full support for the wholesale movement of everybody onto later generation drugs.
131.172.99.15 (
talk)
06:08, 13 June 2008 (UTC)snaxalotl
I think the second paragraph, detailing as it does the dangers of antipsychotics, is particularly important now that many psychiatrists are augmenting reasonably safe drugs, e.g. SSRI's, with atypicals. It is important to the reader to be acquainted with the considerable risks involved with being treated with these drugs-and use might reasonable be confined to psychosis and not add-ons for depression, anxiety, etc.. A well done and important section, even though that's a POV comment.
Dehughes ( talk) 23:01, 20 October 2010 (UTC)
now... i'm reading the article, and i've been wondering... "Dr.Sandeep Patil's team proved that LY2140023 appeared to work as an antipsychotic when tested upon rodents." - i cant help but wonder, how do you measure how psychotic a rodent is? are psychiatric drugs really supposed to show efficacy on animals during clinical trials? are drugs given to humans at random, just because they didn't manage to kill a rodent? i know this is what the source says, and its supposed to be a reliable one, but this sounds too unrealistic to me. Fdskjs ( talk) 01:50, 12 April 2008 (UTC)
agree. you absolutely CANNOT say that some drug works as an antipsychotic on rodents. you can only say that some drug has some certain effect within some certain animal model of psychosis. anyone who doesn't understand how to do this has no business making an entry like the one you describe. this is the sort of article that attracts a lot of nutters, and I think it's generally a good idea to summarily weed out anything that is "not very good" or "not very clear", because if something really needs explaining to complete the article, someone who knows what they are talking about will eventually come along and do it. Honestly, large amounts of this article look like it's been mangled by someone with a psychology freshman understanding of psychosis. I have a copy from a couple of years back that read s like a real encyclopedia entry. 131.172.99.15 ( talk) 06:20, 13 June 2008 (UTC)snaxalotl
Someone should mention anti-psychiatry's opposition to these drugs. -- Daniel C. Boyer 17:33 Jan 13, 2003 (UTC)
I don't agree that the main objection is coerced medication (but I definitely agree this should be a serious ongoing concern). There are enormous numbers of people who think psychosis drugs interfere with a perfectly normal mode of being (e.g. classic 60's anti-psychiatry movement), or that you can just buckle down and THINK your way out of schizophrenia (e.g. all scientologists). I absolutely don't think it's valid to express these views as established scientific fact in a general encyclopedia article, but I think it should be mentioned that these views exist and who holds them. This is a significant sociological fact. I can think of at least one household name who claims to be a widely read expert on psychiatry, despite having a complete misunderstanding of some of the most basic issues in the field. 131.172.99.15 ( talk) 06:29, 13 June 2008 (UTC)snaxalotl
This article is a bit chaotic but I've added a few things and hopefully cleared up the most obvious red herrings.
I'll try and spend some time to organise and reference it a little better in the near future. - Vaughan 12:25, 1 Aug 2003 (UTC)
Minor change from 'The term antipsychotic is applied to any drug used to treat psychotic disorders...' to 'The term antipsychotic is applied to a group of drugs used to treat psychotic disorders...' as (for example) benzos and antidepressants can be used to treat psychotic episodes, however these are not considered to be antipsychotics.
- Vaughan 12:30, 1 Aug 2003 (UTC)
I think this is somewhat wrong. as you say, these drugs treat episodes, not the disorder per se. antipsychotics produce a generalized improvement in function (within the context that everyone understands they're more ok than great), so I don't think the examples conflict with the original. the new version is fine, though. —Preceding unsigned comment added by 131.172.99.15 ( talk) 06:38, 13 June 2008 (UTC)
The article on dopamine mentions that some anti-psychotics that affect dopamine activity can act as amotivators. Is anyone able to elaborate on this?
Look below in "Making symptoms worse / side effects".
128.151.161.49 17:34, 6 March 2006 (UTC)Iain Marcuson
The part about off-label uses for antipsychotics is incorrect. Pimozide and Haloperidol are indeed used for Tourette's Syndrome, but those are FDA approved drugs for that condition. Off-label refers to treating a disorder with a drug that is not approved for such usage, such as using an anti-seizure medication to correct a mood disorder.
One thing I notice isn’t mentioned clearly in the article is the disastrous effect some of these drugs can have on people. In 1997 I suffered a mental breakdown and had what was called a severe psychotic episode (basically due to extreme stress), I was sectioned and put in mental hospital and was put on Droperidol, paroxetine and a short course of high dose lorazepam. My symptoms from these 'anti-psychotics' became very severe. I became suicidal while in hospital and I never had been ever before. Worse, as the drugs ‘cured’ my bipolar 'depression' my reality began to slip and for a while after I was out of hospital I lost my core reality completely. I had gone from being psychotic and manic depressive to full blown schizophrenia. Eventually I began to regain reality, and have at least partly recovered but it has been a very difficult process and I don't even know if I would be alive now if it wasn’t for my families (especially my mothers) huge help.
I am probably the ultimate non-typical mental patient, until my breakdown I had been well rooted in reality for all my then 27 years. I was and am a computer scientist, I was specialising in AI and machine intelligence, I had a reasonably good knowledge of neurology and psychology, had been actively studying human consciousness for several years and was specialising in vision systems. What makes me even more untypical was that I had just made a breakthrough and was contemplating something not worth millions but many billions of dollars, and it was the stress of this this that I partly blame for the original breakdown.
The source of all my problems was that the doctors treated me like a sausage in a sausage factory, most of the people in that (uk) hospital got the same drugs as me and its obvious that its not so much the drugs fault so much as the way they were prescribed - the doctors and the system. Understandably I now have a deep fear and a certain hatred of psychiatrists because of this - just like seemingly most other mental patients. Another point not mentioned is the huge physical damage the drugs do to people, the line of emaciated half corpses that were most of the patients in that hospital reminded me unmistakably of Dachau.
I apologise for the length of this but its not easy to put things simply. Lucien86 05:58, 4 June 2006 (UTC)
Sorry Lucien but it sounds like you were misdiagnosed, essentially malingering. A nervous breakdown and "acting out" often leads people to be misdiagnosed. The problem was lack of honest communication between you and the doctor. Not all mental patients hate psychiatrists. Even many who do do so irrationally or selfishly . . . many wouldn't function without psychiatric treatment. Your claim of a breakthrough in AI worth "billions of dollars" sounds pretty dubious . . . and your entire attitude sounds much like the TYPICAL immature, narcissistic mental patient. Magmagoblin2 ( talk) 12:32, 15 October 2009 (UTC)
As this is an encylopedic article, could we break this down into something more understanable to the common person? I mean, the article isn't in a science magazine, nor is it being presented at a science convention of some sort. It's for the common persons and the researchers. Is it possible to make this more understandable? I read through it and I'm not an expert, but that's exactly my point. Colonel Marksman 06:31, 16 December 2006 (UTC)
To be fair, this isn't the kind of topic generally looked up by anyone but a student or specialist, and as such, will find much more value in being indepth and technical the way it is, rather than simplified for your average user. More simplified explainations can be found in the various pages for specific antipsychotics, which is quite possibly where the information you're looking for or interested in is covered? ;-)
neodarkcell
Personally I agree that it could and should be more readable, which doesn't preclude depth
EverSince
03:02, 23 December 2006 (UTC)
Not looked up by anyone but med students or specialists? First, specialists are well versed in the knowledge presented in this wiki and likely to find it elementary. Second, what about PATIENTS?
It seems like this would be less awkward under the title "Antipsychotics," since the article is about the class of drug, not a single thing. Night Gyr ( talk/ Oy) 03:51, 11 January 2007 (UTC)
There is a link under the subheading "Side Effects" (Tardive dyskinesia) that redirects to what appears to be a pseudoscience website www.yoism.org. Although there are indeed pictures there of what appear to be something like tardive dyskinesia, viewers must sift through alot of highly opinionated non-scientific garbage to get to anything of interest. Would it be ok to remove this link? Surely there must be other sources that would do better here? I will look for some. Neurophysik 05:25, 27 February 2007 (UTC)
Are antipsychotics indicated to prevent suicide? E.g. would they be given to someone who is suicidal because of depression?-- 137.205.76.219 16:38, 17 March 2007 (UTC)
this section is more or less complete crap. good prognosis in developing countries is unrelated to occurrence rates or neuroleptics, but probably the superior management that arises from being better accepted and integrated into the community. Note that the /appearance/ of schizophrenia is highly dependent on management strategies, and also note that cross cultural studies have huge methodological difficulties, and aren't that common. the basic rule for schizophrenia is that there /is/ no good treatment, only the best of a bad bunch, and I'd hate to see the hippies, anti-psychiatrists and scientologists encouraging people to abandon neuroleptics because of crank science
Should there be a section describing current research and a list of drugs in the pipeline for each research/future treatment area? — Preceding unsigned comment added by 24.218.137.40 ( talk) 20:00, 29 June 2007 (UTC)
I've no idea where to put cannabidiol in this article. It's been shown to act as an anti-psychotic so can be described as one. However, the definition of both typical and atypical anti-psychotics describes these as prescribed drugs. I also don't know whether to call it a typical or an atypical anti-psychotic. Supposed 21:45, 28 August 2007 (UTC)
how about you just leave out cannabidiol? this article attracts enough nutcase irrelevency as it is. I'm sure YOU are sure you've seen fan-fucking-tastic evidence of it's anti-psychotic efficacy (along with that car that runs on water tha everyone's been hiding) but the simple fact is that you can read a textbook on psychosis, or do a degree in neuroscience, without seeing cannabidiol mentioned. Trying to insert this sort of information will confuse people rather than enhancing the sort of understanding of the topic an encyclopedia article is supposed to deliver. 131.172.99.15 ( talk) 05:48, 13 June 2008 (UTC)snaxalotl
The reference given is really very poor. It certainly does not belong in a section on treatment and as such I have removed it. The study details some pre-clinical animal studies, a trial on patients who did not have schizophrenia (using ketamine as a model), a couple of case studies and a preliminary report from a trial of 43 patients. The only one of any significant interest is the trial of the 43 patients against amisulpride (given as Leweke FM, Koethe D, Gerth CW et al. (2005). Cannabidiol as an antipsychotic: a double-blind, controlled clinical trial on cannabidiol vs amisulpride in acute schizophrenics. 2005 Symposium on the Cannabinoids, Burlington, Vermont, International Cannabinoid Research Society. http://CannabinoidSociety.org.) however it unfortunately appears to be impossible to track down, I can only assume it was never published (or we are still waiting) - this is not good enough to belong in an encyclopaedia. If anything it could be mentioned that there is some research at a very early stage but nothing more than that. 82.39.196.227 ( talk) 23:09, 3 October 2008 (UTC)
I'm concerned by this as well. I'm intimately familiar with both marijuana and schizophrenia, and I have heard that marijuana can set schizophrenia off. This article could be dangerous. AThousandYoung ( talk) 02:04, 6 April 2009 (UTC)
Cannabis is the worst thing you could give a schizophrenic. Speaking from experience, I'm terrified of the stuff because it brought all my nightmares and delusions back . . . I was rabid, pacing, and completely freaked out for two days, then crushingly depressed and paranoid for a week. PARANOIA is one of the chief symptoms of schizophrenia and one of the notorious side effects of pot. I'm gonna go ahead and take out this reference, because it's terrible advice, could be very dangerous (many schizophrenics lack medical care, but have easy access to marijuana, and this "study" would encourage them to try it, and then who knows what'll happen) and there is no way cannabis is ever going to be prescribed to the mentally ill. Cancer patients, sure. Schizophrenics, no. Magmagoblin2 ( talk) 12:23, 15 October 2009 (UTC)
To anyone reading this - In my experience, antipsychotics will completely demolish one's sense of social anxiety, paranoia, and being in the dark. If you embrace your healthy sense of paranoia, taking these will make thinking about such things an arduous task. In addition, I used to have love for things like fire and the outdoors, but I no longer have significant feelings for them. —Preceding unsigned comment added by 69.250.158.97 ( talk) 17:44, 30 May 2008 (UTC)
Also, in my comment about motivation and desire, there is a scientific study which shows that when rats are injected with antipsychotics and made to run a maze, they do several times better when they are thereafter injected with L-dopa (the bioavailable form of dopamine).
I have schizophrenia and have taken Risperdal and now Zyprexa.
This article describes the dramatic increase in synaptic dopamine bought about by release of endogenous dopamine by electrical stimulation and antipsychotic treatment, and the experiment was successfully repeated a number of times and established.
http://jpet.aspetjournals.org/cgi/content/abstract/232/2/492
Similar levels of dopamine (in the mM range) are achieved with amphetamine and can lead to disturbed sexuality. With such high levels of dopamine, serotonin usually ramps down - could this lower serotonin cause depression and guilt.
-Steve. —Preceding unsigned comment added by 131.181.251.66 ( talk) 12:36, 9 October 2007 (UTC)
I've no idea, however as you're no doubt aware the article is in vitro which doesn't help Supposed ( talk) 17:07, 15 April 2008 (UTC)
Added Haloperidol which is never shown under 1st generation antipsychotics. Madglee ( talk) 00:03, 15 April 2008 (UTC)
Quetiapine is quite an effective tranquiliser at doses below 200mg. I was under the impression that quetiapine is referred to as a major-tranquiliser. I can certainly mimic some of the effects of benziadiazapines although it's not itself considered an anxiolytic. My question, is it just typical anti-psychotics that are referred to as major tranquilisers like the article says, because it appears to me that drugs like quetiapine may be even more sedating and anxiolytic in effect than some of the typical anti-psychotics. "Typical antipsychotics are also sometimes referred to as major tranquilizers, because some of them can tranquilize and sedate." Supposed ( talk) 06:03, 17 April 2008 (UTC)
This article does not list Asenapine but it lists Bifeprunox — Preceding unsigned comment added by 71.103.92.5 ( talk) 10:20, 25 June 2008 (UTC)
It has been said that these studies require serious attention and that such effects were not clearly tested for by pharmaceutical companies prior to obtaining approval for placing the drugs on the market.[17]
There is a subsection "Third generation antipsychotics". Very strange.. who's deciding that Abilify is "third-generation" and on what basis? -- CopperKettle ( talk) 15:17, 7 January 2009 (UTC)
...than just those listed in the side-effects part. Demotivation ought to be listed. 74.195.28.79 ( talk) 22:51, 11 March 2009 (UTC)
Zotepine is an second-generation antipsychotic commonly used in Japan and some countries in East Asia. It is absent in this page. Cause? Ryojames ( talk) 10:40, 18 May 2009 (UTC)
[3] It seems that increasing serotonin levels (through omega-3 fatty acids) actually decreased the symptoms of psychosis, but some antipsychotics are actually serotonin antagonists. This also seems to point to the same conclusion. However, this suggests that there is no link between serotonin levels and schizophrenia (or at least its first episode). MichaelExe ( talk) 16:56, 7 September 2009 (UTC)
The data under the heading "Prevalence of use" lists the prevalence of schizophrenia and bipolar disorder, not the prevalence of antipsychotic use. These drugs are increasingly prescribed to individuals not suffering from either of these disorders so that the number of individuals taking the mediation is actually many times the amount of those with either schizophrenia or bipolar disorder. They are used for depression and anxiety and sleeping problems, and are also routinely administered to the elderly in nursing homes to sedate them. —Preceding unsigned comment added by Ilmateur ( talk • contribs) 22:18, 12 January 2010 (UTC)
The material in question was actually on Wikipedia first, and copied from Wikipedia by an external site. The matter has been resolved.
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By 'Google sampling' the text, I've now encountered two specific instances where material has been copied and pasted to the article from copyrighted sources by editor Tweak279 over the past several days. Adding an attribution to quoted material is of course required by policy, but neither of the additions that I've encountered so far indicate that the material is a word for word 'lifting' of the source material itself without any indication of it being a direct quotation. Both instances that I've encountered so far appear to be sourced to: [4]. I'm going to revert the material added by Tweak279, until this potentially serious breach of policy is examined more closely and resolved. Please do not continue to add potentially controversial material to articles without engaging other editors in dialog in an attempt at reaching consensus. thanks Deconstructhis ( talk) 17:14, 13 March 2010 (UTC)
Thanks for providing that history, it's basically what I was asking for back here [11]. Is anyone familiar enough with Wiki's required licencing procedures for acknowledging use to look into this further at this point? cheers Deconstructhis ( talk) 20:44, 16 March 2010 (UTC)
Actually,I'm not an administrator. Deconstructhis ( talk) 21:08, 16 March 2010 (UTC)
I do'nt care about my case, I havne't got one to answer. My concern is that Wikipedia seems to be populated by protectionistic idiots who think people who try to add ACTUAL CONTENT TO WIKIPEDIA are fame game for being treated like ****s. Tweak279 ( talk) 21:18, 16 March 2010 (UTC)
It's always been my understanding that if an entire article is republished from Wiki by someone, there's a requirement in the licensing that the source of the material be acknowledged; I'm only guessing, but I'm assuming by extension, that portions lifted verbatim should also be accompanied by notice as well. As I indicated above, I'm unsure if there's a formal mechanism for informing Wikipedia of these sorts of breaches or not. If I get a chance, I'll explore this later on and get back to you on it. cheers Deconstructhis ( talk) 22:29, 16 March 2010 (UTC)
Summary: There were allegations that a Wikipedia editor copied some material from a 2008 HealthyPlace ( article); however, some of the content was added ( diff) back in 2007. I sent HealthyPlace an email notifying them of the Creative Commons license ( Wikipedia:Text_of_Creative_Commons_Attribution-ShareAlike_3.0_Unported_License) and will post an update if/when I get a response. II | ( t - c) 00:36, 17 March 2010 (UTC) Errr this actually makes it sound as if some of teh material WAS copied by the accused editor?? Tweak279 ( talk) 08:38, 17 March 2010 (UTC) When in fact ALL the content was here before it was on HealthyPlace and another editor simply made a stupid mistake. Tweak279 ( talk) 08:41, 17 March 2010 (UTC) |
Hi, I am bringing a couple of changes to the talk page to try and achieve consensus. This edit removed text for the reason that antipsychotics are not used in non-psychotic individuals and thus saying the review is wrong. Antipsychotics, are not just prescribed for psychosis, they are used for example for nausea and vomiting for example from chemotherapy, sometimes off-label for sleep disorders (especially in the USA), agitation and anxiety and autistic spectrum. The article was a review of the literature so it must have been documented. The withdrawal syndrome of antipsychotics is believed to be due to increased dopamine activity. The mainstream psychiatric viewpoint is that schizophrenia is caused by excessive dopamine activity. So to disagree that withdrawal effects of antipsychotics can cause psychosis in non-psychotic patients means one should also deny the mainstream biological theory of schizophrenia.-- Literaturegeek | T@1k? 00:38, 17 May 2010 (UTC)
The other point was the content added to the controversy section, which was a review which stated that research may be flawed due to failure to take into account withdrawal effects of antipsychotics. I agree that on its own it was undue weight, so I have added two other reviews which support maintenance for psychosis. Although my personal view points are not relevant, I would like to say that I do believe that there are many people who require long-term maintenance for serious mental illness and I am quite happy to add balance supporting this viewpoint. I am not trying to push a POV against the long-term use of these drugs. I think it is important knowledge that antipsychotics produce withdrawal effects which can mimic the condition being treated and if maintenance studies have failed to control for this variable, then this controversy should be cited I feel.-- Literaturegeek | T@1k? 01:31, 17 May 2010 (UTC)
My personel experience about antipsychotics.
I am a veteran with Schizophrenia and I have was on multiple types of antipsychotics for nineteen years. However, I do not consider myself psychotic at all. Scizophrenia is one or more of the folowing symptoms as far as I have been told by the doctors. They are hearing voices, delusional, paranoid, catatonic and\or seeing things. Psychotic as far as I know is violent. I am not, but am aware that some of these symptoms could cause psychotic behavior. What I really wanted to say is that the medications are what I would call a modern day lobotomy in that they do turn you into a sort of zombie. It slows your brain down and body down. This might be why my sugar was very very (13 H1C and it should be 6) high on clozapine and 260 lbs. Many of the drugs I took were just plain aweful. The side effects were there and changing all the time. Slobbering puddles on pillows by morning, sleeping too much, no emotion, sad, uncaring, anemic requiring iron, dystonia in the form of unconsious violent cracking of my neck to name few. Once off the medications without telling the doctors my sugar returned to normal I felt better through exercise and eating right, lost 50-60 pounds and learned not to tell the doctors my problems. I asked for a psychologist instead of a psychiatrist. I found they work together over there and if there is no improvement they do recommend drugs. It seemed the side effects and the doctors telling me there was something wrong with me is the problem. On prolixin, I wound up in the mental ward shaking violently. On Haldol, I could not stay seated and getting off the drug was a nightmare of having to stay in bed and not being able to sleep or stay still. If I wanted to take the drugs I would want the lowest possible dose because they are strong and take the the same time every day, don't drink or smoke, eat right and get excercise. Also, be around people you love and trust. Give everyone a chance to be one of them. Choose your friends wisely and find a job you enjoy. —Preceding unsigned comment added by Brian1596 ( talk • contribs) 23:32, 17 June 2010 (UTC)
Why are these chemicals referred to as anti-"psychotics", when what they really basically are is a sedative?
If a patient is acting too wild and crazy for the caregivers to deal with, then the doctors give them this chemical to sedate and calm them, and if the patient still is too much to handle, the amount of chemical given can be cranked up to the point of stupefaction and catatonia.
Personally I believe the name choice is to make patients more willing to accept taking the chemical. It sounds better to be given a chemical to treat your "abnormal psychotic behaviors", than it is to say we're going to slow your thinking and numb you into a fuzzy compliance.
216.56.13.231 ( talk) 02:32, 30 June 2010 (UTC)
"This may refer to common side effects such as reduced activity, lethargy, and impaired motor control. Although these effects are unpleasant and in some cases harmful, they were at one time considered a reliable sign that the drug was working.[citation needed]" This is found in Elliot Valensteins Blaming the brain and he also cites his source in the book but unfortunately I don't have that book anymore. Can somebody who has the book provide the citation? 24.247.174.132 ( talk) 17:15, 27 September 2010 (UTC)
Another editor and I disagree about about this edit that I made: [12]. I had noticed this edit, by another editor: [13]. Looking at the biographical page that is linked in the edit summary, I agreed with that editor that the cited sources were at odds with WP:UNDUE, WP:FRINGE, and, most importantly, WP:MEDRS. I also think that some of the language about "systematic review" and "urgently needed" went against WP:NPOV (when taken in the above context) and WP:PEACOCK, while the part about "a call that had already been made when similar results were found in 2006" goes against WP:SYNTH. Overall, per WP:MEDRS, we have to be very careful about not presenting material that goes against the medical literature in ways that might mislead our readers; these are, after all, medications that remain approved for use. I hope that explains my deletion. -- Tryptofish ( talk) 22:21, 5 March 2011 (UTC)
Check that out.
http://archpsyc.ama-assn.org/cgi/content/short/68/2/128
During longitudinal follow-up, antipsychotic treatment reflected national prescribing practices in 1991 through 2009. Longer follow-up correlated with smaller brain tissue volumes and larger cerebrospinal fluid volumes. Greater intensity of antipsychotic treatment was associated with indicators of generalized and specific brain tissue reduction after controlling for effects of the other 3 predictors. More antipsychotic treatment was associated with smaller gray matter volumes. Progressive decrement in white matter volume was most evident among patients who received more antipsychotic treatment. Illness severity had relatively modest correlations with tissue volume reduction, and alcohol/illicit drug misuse had no significant associations when effects of the other variables were adjusted. —Preceding unsigned comment added by 74.59.147.209 ( talk) 22:38, 23 March 2011 (UTC)
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I changed this section a bit because it fucked up the formatting in the following sections. Hope nobody minds. Firrtree ( talk) 17:23, 20 October 2012 (UTC)
The entirety of this articl about antipsychotics is laced with POV and is far from neutral in the way it approaches the topic. The red flag for this state of affairs iss the use of a 1950s ad for Thorazine, a drug which was classified a "major tranquilizer" not an anti-psychotic. It's use at the commencement of this article is tantamount to making use of "Reefer Madness" as an introduction to an article about marijuana. All of medicine 50 years ago seems primitive by comparison to the viewpoint of current times. Ironically, my own observations of the powerful good which Thorazine was capable of occurred when I worked with an ad hoc group of peer counselors in the dormitories where at least once a month someone experienced a bad LSD trip. Bad as in, if I hang by my feet on this 4th flour balcony I can almost touch the ground. I saved this young man's life when I myself was 18 because I reached down and with the help of another equally weak 18 year-old was able to pull him to safety. We sometimes had to resort to calling for medical help in the form of a sympathetic doctor who would arrive, give the bad tripping student a shot of Thorazine and within 20-30 minutes the LSD user would return to a rational being and thank us repeatedly. But I stray from the point that Thorazine has no place whatsoever in this article as it never was classifed as an anti-spychotic by the FDA. I believe that the Thorazone ad should be wholly removed for this among other reasons. QuintBy ( talk) 08:24, 13 October 2012 (UTC)
... the first antipsychotic drugs were discovered by accident in the 1950s when a putative antihistamine (chlorpromazine) was serendipitously observed to have an antipsychotic effects when tested in schizophrenic patients. Chlorpromazine indeed has antihistaminic activity, but its therapeutic action in schizophrenia are not mediated by this property. Once Chlorpromazine was observed to be an effective antipsychotic agent, it was tested experimentally to uncover its mechanism of antipsychotic action [blocking of dopamine 2 receptors - my interpolation
— S.M.Stahl, Essential Psychopharmacology, p.402
I remember a paragraph in the article several months ago that said maintenance therapy wasn't more effective than placebo. I think there was a citation or two and maybe a link to some study. Does anyone remember it? Or why it was deleted? Also, can anyone link me to the version of the article which still has that paragraph (I can't find one)? Firrtree ( talk) 17:17, 20 October 2012 (UTC)
Please see Adverse effect. The Side Effects covered here are unintended and UNDESIREABLE. Is not then the mostly used term "adverse effects"? Nopedia ( talk) 22:32, 28 December 2012 (UTC)
This is from an article on depression, but it may explain equally well the findings that antipsychotics (at least the ones studied) shrink the brain. Someone might want to work it into the article, as it's quite important information:
"Conventional drug therapy leaves much to be desired from the metabolic perspective and needs to be re-evaluated with some urgency. If administered to persons whose capacity for replenishing intraglial glycogen and intraglial and intraneuronal ATP stores is impaired mood elevators that act by enhancing neurotransmitter release and increasing the slope of neuron action potentials may compound the severity of the energy deficit present by increasing the demand for ATP hydrolysis beyond the capacity to replenish ATP stores. Any severity of any energy deficit present is likely to be compounded by those antidepressants that impair mitochondrial oxidative phosphorylation. It might also be compounded by drugs used to treat co-existing cardiovascular disorders, notably beta blockers and statins. Of great concern is that any medication or mixing of medications that either induces or compounds the severity of an intracerebral energy deficit might increase the likelihood of developing neurodegenerative disorders in later years especially if the medications are administered for extended periods."
Source: "Depression: a metabolic perspective" Richard Fiddian Green, 27 October 2012, BMJ.
I'll also leave it for others to decide whether they want to add this information to the Wiki article on antidepressants. At least for now. Firrtree ( talk) 20:01, 17 January 2013 (UTC)
Hi. I was drawn back to the body of this text by a recent edit removing text [14] that followed a help desk question on the side effects of antipsychotics detailed in this article [15]. I have no particular complaint about this removal as the text, which was unsourced, did not belong in that section I think, but it did draw to my attention some problems in the article.
The Antipsychotic#Structural effects section repeats in greater detail claims already made in the Antipsychotic#Side effects section about the potential impact of antipsychotic usage on brain volumes. Shouldn't these sections come in sequence one after the other and not duplicate information. Also, the statements on decreased brain volume and antipsychotic usage in the side effects section are largely based on a single primary study (which I originally added although I think Tryptofish toned down my original contribution). There are secondary sources/review articles on this topic and would it not be more appropriate to reference these? The Antipsychotic#Mechanism of action section has three paragraphs and a single citation. Is the entire text derived from a single source? FiachraByrne ( talk) 17:22, 18 February 2013 (UTC)
Just a list from a crude search in pubmed (antipsychotics AND brain volume (in all fields) and publication type "review": ( http://www.ncbi.nlm.nih.gov/pubmed/?term=%28%28antipsychotics%29+AND+brain+volume%29+AND+%22review%22[Publication+Type] 40 results]): FiachraByrne ( talk) 23:31, 20 February 2013 (UTC)
Search pubmed (antipsychotics AND brain (in all fields) and publication type "review": [Publication+Type 2092 results - only first 100 results checked):
Just removed the following text which was added to the Structural affects section (originally from dementia article)
In the UK around 144,000 people with dementia are unnecessarily prescribed antipsychotic drugs, around 2000 patients die as a result of taking the drugs each year. [3] Selegiline does not appear effective either. [4]
Main claim is sourced to Guardian, but derived from this report [17]. Needs better sourcing &, if it is included, which section should it go in? FiachraByrne ( talk) 08:59, 25 February 2013 (UTC)
I introduced a new paragraph explaining the way antipsychotics work. I made extensive research in the subject, read lots of papers but unfortunately editors keep removing my conclusions and accuse me of biased content. I would like to discuss this so that we can reach a consensus. — Preceding unsigned comment added by Booklaunch ( talk • contribs) 15:21, 12 May 2013 (UTC)
Hum, that is incorrect, I mentioned the reduced emotional functioning (flat affect), which is pretty much due to being tranquilized. It was in bold letters. and I said "desirable" meaning that was being administered for. Booklaunch ( talk) 17:37, 12 May 2013 (UTC)
Harrow, M (2013 Mar 19). "Does Long-Term Treatment of Schizophrenia With Antipsychotic Medications Facilitate Recovery?". Schizophrenia bulletin.
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Doc James ( talk · contribs · email) (if I write on your page reply on mine) 20:07, 12 May 2013 (UTC)
So now the article is even longer, as in long term use Booklaunch ( talk) 20:45, 12 May 2013 (UTC)
I mention here some of the problems I have found:
The mechanism of action of antipsychotics is very simple.
Unreferenced, anyway, hardly simple.
Zad
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14:43, 13 May 2013 (UTC)Some of the content points towards useful directions, but as of today is not helpful in the article due to problems mentioned. -- Garrondo ( talk) 21:18, 12 May 2013 (UTC)
While I initially reverted the edition I was unintentionally breaking the 3RR so I reverted myself. I would like to ask other editors for further imput.-- Garrondo ( talk) 21:41, 12 May 2013 (UTC)
Zad
68
13:24, 13 May 2013 (UTC)I also re-reverted myself regarding a change in wording to this section (See here and here)
I copy here my reasoning at the editor's talk regarding why I consider his changes inadequate. I hope somebody gives further comments. -- Garrondo ( talk) 21:40, 12 May 2013 (UTC)
I have reverted the change of wording to the structural effects section in the Antypsychotics article. Conclussion of the abstract is worded in extremely hyptotetical tone, and that tone should be kept in Wikipedia, otherwise we would be conducting Original Research.-- Garrondo ( talk) 20:54, 12 May 2013 (UTC)
This paper is not credible as it assumes brain abnormalities in unmedicated schizophrenia patients. Where is the paper/source/book/video showing abnormalities in non medicated (never been medicated, virgin, out of victorian working house) schizophrenia patients please? Thanks Booklaunch ( talk) 06:43, 13 May 2013 (UTC)
Agree with Garrondo that the recent change to Structural effects did not appear to be good as it removed a more recent systematic review and seriously overstated findings. I have reverted the proposed article content change while we discuss on Talk page to develop consensus regarding it.
Zad
68
13:27, 13 May 2013 (UTC)
"also known as neuroleptic even though not all antipsychotics have neuroleptic effect". Then what is a neuroleptic/the neuroleptic effect; neuroleptic redirects to antipsychotic, implying they (neuroleptic and antipsychotic) are one and the same, which contradicts the quoted sentence. ZFT ( talk) 01:59, 25 September 2013 (UTC)
I suggest the inclussion of more information about the permanent or semi-permanent side effects of the antipsychotic drugs. For example, while most side effects of antipsychotic drugs resolve quickly after discontinuation, several side effects are permanent or semi-permanent, such as tardive akathisia (in 98% irriversible), tardive dysckinesia, tardive dystonia, tardive dysphrenia, tardive psychosis, cataracts, glaucoma, side effects on the heart such as QT interval prolongation which leads to torsades des pointes (potentially fatal), etc. Many side effects are fatal: eg. stroke, neuroleptic malignant syndrome (may kill within 24 hrs if untreated), etc.
In the list of side effects, only very few common side effects are listed. The probability of some of them happening is greater than 1%, yes, but this is misleading, as many of them, for example insomnia, can happen with a probability of up to 40%. So I would recommend to change it to read "a probability of more than 1% up to 50%"
I would also recommend including the following: "The probability of side effects, ranging from less than 1% to 50%, is tipically obtained from drug trials of a few thaousand people for a few months. Since each person has different neurochemistry and genetics, the probability of side effects ocurring on one particular person is unpredictable, and it could happen at any time" — Preceding unsigned comment added by 190.52.139.38 ( talk) 15:26, 6 October 2013 (UTC)
The section on 5HT2A claimed two things that are not substantiated. One, it claimed that antipsychotics antagonize the receptor, instead of partially agonizing it, which is an important distinction, in particular with this receptor. It also claimed that agonism of this receptor is associated with psychosis. This is not well-substantiated, as antipsychotics do agonize the drug, not antagonize it, and also because psychedelic drug use, which also agonize to antagonize this receptor, are associated with lower psychosis risk.
I added reviews claiming that different alleles are associated with psychosis, and also that higher receptor concentrations in certain areas associate with psychosis. I also added brief mention to SSRIs and psychedelic drugs. — Preceding unsigned comment added by 205.208.122.240 ( talk) 22:14, 16 December 2013 (UTC)
Ok I fixed what you messed up, atypical antipsychotics DO antagonize the 5HT2A receptor, not agonize, I believe that you are confusing the tendency of atypical antipsychotics to partially agonize the 5HT1A receptor with the 2A receptor. Psychedelic drugs agonize the 5HT2A receptor and have been shown to potentiate psychosis in schizophrenic patients. — Preceding unsigned comment added by 208.123.246.67 ( talk) 07:57, 26 January 2014 (UTC)
Off topic chat
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Anti-psychotics = inspired by LSD-like substances Anti-psychotics, like urotherapy is inspired by LSD-like substances. Originally called "trepanning", and later called "lobotomy", "anti-psychotics" seeks to do similar things, "chemically". However no-one is cured, just like trepanning and lobotomy. Instead trepanning, and lobotomy is connected to hallucinogenic art. It is actually quite common to see divided minds on LSD-like substances. Some examples from popular culture: Pink Floyd - Division Bell, H.R. Giger - Atomkinder, Mac Logo Smiley. Psychiatry often still proposes LSD as a theraputic agent, along with many other drugs, equally without any rational basis. They never cured anyone, while people are getting cured WITHOUT drugs, just by simple religion. "God is one and without partners". A positive lifestyle in an oversexualized society, makes a lot of sense. PBWY. |
This section is biased. It cherry-picks sources and reads like a sale pitch against antipsychotics. The section should be rewritten to include actual medical use of antipsychotics in schizophrenia and its existing content should be moved to the "Controversy" section. Jm292 ( talk) 02:59, 16 November 2013 (UTC)
I agree we can probably do a better job of highlighting how usage / prescribing does not match the evidence. This is a great deal of sources to support this for dementia but also some for other indications like sleep. Doc James ( talk · contribs · email) (if I write on your page reply on mine) 12:34, 2 February 2014 (UTC)
In general this article is unreadable. It is ironic that the disjointedness apparent here is symptomatic of psychosis, don't you think? It needs a total rewrite. Some hints: lists do NOT add to the understandability of the prose, and should be separated (either into a table or a dedicated page). typical vs atypical isn't, as it appears here, very useful in advancing the subject. If they are substantially different, then separate the discussion of them. If they are not, then don't use them as subdivisions in each of the other sections! How can you write a section on comparison of side-effects when the list of drugs is as large as this one's?? It is unintelligible as written. Now, I came to this article to find a common (I almost wrote "typical" but that would mean something else here, wouldn't it?) antipsychotic. Aside from a laundry list of 60 or so, I could find nothing. The Sales section is pathetic. It states:"Antipsychotics were once among the biggest selling and most profitable of all drugs..." AND [in 2008 they were] "the biggest selling drugs in the US..." No effort is made to reconcile the conflict between the implied status of no longer being the biggest selling, and being the biggest selling (in the USA). Sloppy and pathetic. I'd think that with a highly regulated business this large, that it wouldn't be that difficult to pick-out the top sellers; but then again, I like to think of myself as sane. 216.96.76.190 ( talk) 18:10, 16 December 2014 (UTC)
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Some months ago, another editor questioned the assertion that neuroleptic and major tranquilizer are no longer commonly used in professional literature; requesting a citation. Neuroleptic is absolutely still in common use as I know from being a mental health professional. I have no intention of creating a primary source hence my knowledge is not an appropriate source. However, unless someone can add an appropriate citation, the statement of obsolescence needs to be deleted. Dstern1 ( talk) 17:43, 13 June 2016 (UTC)
Reply to Doc James: I added some categories to the section “see also” ( diff) to make these categories more salient and provide a convenient way to browse among related articles. Categories are highly underused by readers of the encyclopedia as anybody can ascertain by comparing the statistic of a category to some related articles. I conjecture that the reason is that the general public is not aware of Wikipedia's category system. This is a way to make it more known and therefore a way to make it useful.
This system is not redundant with navboxes; and it performs a related, but not the same function. Users can browse in principle, all drug-reated articles from these categories. Although all the categories I included Category:Psychoactive drugs are accessible through it, I included the other 3 because they are especially relevant for the topic, to make sure that interested users won't miss them (as currently happens with just listing categories at the bottom of the article).
Mario Castelán Castro ( talk) 01:49, 6 September 2016 (UTC).
This is a rather picky question! I updated a couple of references that were flagged as having a more recent Cochrane version available. One of them is a systematic review on the drug Perazine. The conclusions of both reports are similar (more work needed). On review of the full-length results, I noticed that the review paper uses RR, and the wiki chart is in OR. If you think for the purpose of this wikipedia article, using RR and OR interchangeably is alright, that is fine by me! I have enough of a stats background to know that OR and RR are not the same. My stats are a little rusty these days to be able to make a judgement call as to how important it is in this context. I googled RR and OR and found this cochrane website describing the difference http://handbook.cochrane.org/chapter_9/9_2_2_3_warning_or_and_rr_are_not_the_same.htm Unfortunately I don't have time to go through all the drugs in the wiki table and compare if an RR or OR was calculated in the original reviews. If you are super interested in this, the authors of the cochrane review on perazine wrote the following (quoted): "Binary data For binary outcomes we calculated a standard estimation of the risk ratio (RR) and its 95% confidence interval (CI). It has been shown that RR is more intuitive (Boissel 1999) than odds ratios and that odds ratios tend to be interpreted as RR by clinicians (Deeks 2000)." cochrane ref: https://www.ncbi.nlm.nih.gov/pubmed/24425538 Thanks. JenOttawa ( talk) 17:43, 11 November 2016 (UTC)
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Is at the first position, as according to Wikipedia policy, instead of an alternative within a further-into-the-article position 1a16additional ( talk) 12:07, 14 October 2017 (UTC)
as far I could tell from the nature of the inclusions of material and the quality of the sources used, the material was strong enough for inclusion, I'm interested to see you've exercised your opinion Jytdog is removing most of the material, although there is a little remaining from the entire editorial contribution you and the Doctor are expressing having some doubts about. You understand I'd like to know how the content is inadmissable, tell me how so, if you would, then we might be enlightened as to this situation, where I look for information to add to the article, produced by globally recognised organisations, professors, employees of universities and the like, which for some reason, Jytdog, is not relevant to the article. So show me how this is possible if you will, then we might both know how it is possible. Or I'll think that, for some reason, you are supporting the bias of a medically trained professional, who for some reason, thinks his own personal preferences represent a global situation, and expresses the wishes and needs of the English speaking people of the world, who wouldn't need to read the deleted content.
For example - psychotropic
supported by the following sources:
P.J. Perry (Professor of Psychiatry at the College of Medicine and Professor at the College of Pharmacy, University of Iowa) American Psychiatric Publication Incorporated
http://www.brendanlsmith.com/ is an independent source
the World Health Organization is important enough to have a wikipedia article
H.J. Bein Springer Science & Business Media is a reliable publishing house
24 relevant drugs are listed /info/en/?search=List_of_psychotropic_medications
http://abcnews.go.com/blogs/health/2011/12/02/what-you-need-to-know-about-psychotropic-drugs/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2690138/
https://www.ncbi.nlm.nih.gov/pubmed/20669865
https://www.nice.org.uk/guidance/ktt19/resources/psychotropic-medicines-in-people-with-learning-disabilities-whose-behaviour-challenges-pdf-58757961132997 source: National Institute for Health and Care Excellence
Autism source: DJ. Posey, KA. Stigler, CA. Erickson, and CJ. McDougle - Antipsychotics in the treatment of autism 2008 Journal of Clinical Investigation ( The American Society for Clinical investigation) January 2; 118(1): 6–14. doi:10.1172/JCI32483 Accessed October 14th, 2017
also shows the content is going to be included
http://www.bmj.com/content/334/7603/1069 BMJ 2007; 334 doi: https://doi.org/10.1136/bmj.39216.583333.80 (Published 24 May 2007) Cite this as: BMJ 2007;334:1069
https://www.scientificamerican.com/article/antianxiety-drugs-successfully-treat-autism/ - " Currently, treatments for autism are usually prescribed off-label and focus on helping treat aggression or hyperactivity with medications including Ritalin and antipsychotic medications ..."
https://www.intechopen.com/books/autism-spectrum-disorders-from-genes-to-environment/antipsychotics-in-the-treatment-of-autism DOI: 10.5772/18608
http://www.dtic.mil/docs/citations/ADA591182 - Corporate Author : Cincinatti University Ohio
23h112e ( talk) 14:56, 16 October 2017 (UTC)
No I haven't yet, because the information from the sources seems (is) relevant, and so I didn't deem it necessary. Indicate the reason why you think the content I would like to add is not applicable, since the content is supported by sources like any other content which might be at a future time added. 23h112e ( talk) 16:13, 26 October 2017 (UTC)
In the section that lists types of medication I think it would be helpful to add tradenames and other names in parenthesis. For instance, I came to this page to verify that Seroquel is in face an antipsychotic. It would have been immensely helpful to see this "Quetiapine (Seroquel)...." — Preceding unsigned comment added by 159.39.19.139 ( talk) 15:24, 11 December 2017 (UTC)
I suggest you change "Other" into maybe Other Treatment Plans or Other Medical uses. Overall the article provided a lot of great information but my only edit to the article would be your the heading of your topic. One of your sources for the special populations topic was great with elaborating on those individuals and their needs. Your sources supported your topic. - T.Davis — Preceding unsigned comment added by LaShaeDavis ( talk • contribs) 17:11, 18 February 2019 (UTC)
The claim that antipsychotics do more harm than good is WP:EXCEPTIONAL. Also, it seems that it goes against the common wisdom in psychiatry. While the sources given are not WP:FRINGE, it is a common claim in anti-psychiatry that mainstream psychiatry does more harm than good.
Also, I would point out some sources of bias:
So, these factors would have had to be controlled during research. Tgeorgescu ( talk) 01:15, 6 October 2016 (UTC)
OK, as a student and a consumer, this debate needs to stop. the evidence is now ample that antipsychotics are neurotoxic and can cause permanent extrapyramidal symptoms like #akathisia. antidepressants are showing similar ill effects because our treatment of mental health issues with newly patented drugs IS CRAZY. 2602:306:B8D4:EB80:900B:9FE1:D08A:B5F8 ( talk) 09:40, 1 October 2017 (UTC)
Here’s a good one. They shrink the brain. [32] — Wikiman2718 ( talk) 06:35, 21 June 2019 (UTC)
It can be summarized as "Antipsychotics may be an option, together with stimulants, in people with ADHD and aggressive behavior when other treatments have not worked. [8]"
We should stick with secondary sources per WP:MEDRS Doc James ( talk · contribs · email) 20:35, 30 July 2019 (UTC)
In the first few words of the article, one of the definitions of antipsychotics cited is "major tranquilizers". I feel this is misleading and not supported by a proper medical reference. It references a textbook (a primary source) written by people who can't be considered "experts" in their field as I can't find any other works published by them (maybe I'm looking in the wrong places??). It is misleading in that many of the atypicals couldn't remotely be considered tranquilizers; in fact, the opposite is the case for most of them in that they're taken in the morning because they have mild stimulant properties. Would people be okay with me removing the reference to "major tranquilizers"? I was going to be bold and just remove it, but I felt it would be better to give it a few days on the talk page to see if my feelings are shared by the community.
Looking forward to your responses. - Schaea ( talk) 20:10, 28 March 2020 (UTC)
I'm happy to use the term adherence. To protect my character :p, both terms seem to exist in the literature and nice guidelines:
e.g.
Searching google:
--
Talpedia (
talk)
19:26, 25 June 2020 (UTC)
"To improve adherence, people with severe mental illness are sometimes compelled to treatment through a process called committment, in which they can be forced to accept treatment (including antipsychotics). A person can also be committed to treatment outside of a hospital, called outpatient commitment. "
I want to remove "with severe mental illness" and replace it with "patients". Or maybe "people who have been diagnosed with mental health disorders". community treatment orders are used in Canada, Australia and the UK. In Australia study found around 20% of people with FEP were placed on CTOs. These people cannot be considered to have a severe mental illness since some 20-30% will recover with no further symptoms ( https://www.researchgate.net/publication/312043640_Community_Treatment_Order_Identifying_the_need_for_more_evidence_based_justification_of_its_use_in_first_episode_psychosis_patients) The author notes:
"[CTO use] may be related to clinicians' wish to minimize duration of inpatient stay, hospitalization being commonly considered as potentially deleterious in young patients with regards to social integration and promotion of engagement into treatment. It may also be related to insufficient staffing of outpatient services and lack of availability to really work in depth on engagement and provision of home based support of patients. Finally, CTOs may also have been used as a mean to minimize disengagement which is known to be frequent among FEP patients."
So outpatient commitment seems to be used for reducing the chance of relapse for those who are *at risk* of developing a disorder rather than having one. The source also references "a specific cluster of patients placed under CTO, composed of young males suffering from schizophrenia, with a lower level of education and a high rate of history of substance use disorder." so the decision making seems to be in part due to social reasons.
-- Talpedia ( talk) 18:32, 25 June 2020 (UTC)
Is is worth mentioning here? Yes, I think it is. The manner in which antipsychotics are used is relevant, and the fact that people are forced to take them against their will at the threat of being hospitalized is relevant.
-- Talpedia ( talk) 21:32, 25 June 2020 (UTC)
-- Talpedia ( talk) 23:15, 25 June 2020 (UTC)
-- Talpedia ( talk) 00:04, 26 June 2020 (UTC)
There is a world of grey in the middle there. Large doses, side effects from antipsychotic that resemble psychotic symptoms, lack of review while committed, heavy pressure for use of prophylactic drugs, unacknowledged manic side effects of antidepressants, ill-informed mental health nurses, failure to distinguish between "normal behaviour" and manic behaviour once psychotic symptoms have subsided, kakfaesque legal authority, use of threat of commitment to force "volunatry" treatment. My image of contemporary psychiatry is very accurate thank you very much.
-- Talpedia ( talk) 09:06, 26 June 2020 (UTC)
Hey, I agree that these tables are quite niche knowledge. However, I think they are pretty useful for anyone researching which antipsychotics to take, and I think this might be a common use of this page.
I'm not sure if this is a good argument, I haven't seen many arguments here based on "this is very important for group X" win. Might it be better to move this off to a separate page? List of antipsychotics or semething like that? Talpedia ( talk) 20:35, 8 March 2021 (UTC)
Reverted edits are both WP:FRINGE and dated (outdated). Debunked at https://www.nature.com/articles/s41386-021-00980-0 Tgeorgescu ( talk) 15:22, 15 March 2021 (UTC)
indeed, but she is a psychiatrist publishing in peer reviewed journals. It's perhaps unsurprising that critique comes from people with quite a different theoretical outlook. Talpedia ( talk) 19:33, 16 March 2021 (UTC)Joanna Moncrieff has an axe to grind
Evidence shows adverse effect such as Alzheimer's disease [9], [10] Cognitive dysfunction [11] [12], [13] Dementia worsening, [14] [15] etc.
RIT RAJARSHI ( talk) 07:37, 30 May 2021 (UTC)
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Ironically, chemical lobotomy is frequently given to those with dementia, dramatically shortening their rremaining lifespans. Probably because it makes them docile in the short term. DrBoller ( talk)