Your brain on antipsychotics: Tardive Dyskinesia

I will be up front with the fact that I am absolutely NOT anti-medication. I believe anyone preaching no medication under any circumstances is either, at best, ignorant and severely misguided, or, at worst, well, that falls in the "if you can't say something nice..." category.

I also hate my meds. Nothing is ever as simple as it seems.

There are times, places, and situations for just about everything. I will talk about medication because it can be a big factor in mental illness, but I will not tell you that you must take it, and most certainly will never say to bar it in every circumstance. I want you to educate yourself on all treatment options so you can make informed decisions regarding your healthcare.

So today I'm going to jump right into antipsychotics.

Antipsychotics are medications that are often used to treat schizophrenia or bipolar disorder. Or if you have acute psychosis or something along those lines. I mean, "psychotic" is in the name of the drug. In schizophrenia, they are used to control hallucinations (seeing/hearing things that are not there) and delusions (cannot tell the difference between what is real and what is not). In bipolar disorder, they may be used to treat depression, but they are commonly used to treat mania or mixed episodes, without or without psychosis. (You read correctly, you are not required to be psychotic to take an antipsychotic.) It can be used as a mood stabilizer for people who have not had success with mood stabilizers. They have a number of off-label uses (Treating things with a drug that was never designed to treat, like using a weight loss drug to treat toe fungus, or vice versa), which, you will soon see, is probably not a great idea.

I have been on a few antipsychotics, and they are a lot to take in. Seriously, weigh all your options before choosing this oprtion, as the side effects can range from irritating to the point of 'this may be permanent'. There are a few things you definitely want to watch out for on these bad boys. The exact symptoms vary between the different types of antipsychotics, some extremely strange, but here are two of the most notorious commonalities:

• Tardive diskenesia.

• Memory problems.

The exact risk will vary between each drug, so make sure to research the specific drug you're on or are looking to start taking. They vary so much that I will not even try to categorize or give anything a number here.

In this post, I will focus on Tardive dyskinesia.

Tardive dyskinesia is a movement disorder. Some part of your body moves, jerks, or wiggles, but you cannot consciously control it. According to the Cleveland Clinic (link below), symptoms include:

• Facial muscles

• Tongue

• Neck

• Trunk muscles

• Limbs

So, anything goes, really. I think most people have had the little spasms in their eyelids or hands on rare occasions. I had those prior to any medication. That is not TD. These are very visible movements and usually distressing, embarrassing, and can be, to some extent, debilitating. Lip smacking, finger tapping, cheek puffing, facial tics, various tongue movements, such as sticking your tongue out. You cannot control these, no matter how hard you try.

As a side note, when you see a crazy person in an institution on television, that stereotype, the repetitive movements, flailing, drooling, mumbling, and blank stare may be caused by high dosages of these types of medication, not their actual illness.

There are various bodies of research with estimates as to the chance of getting Tardive Dyskinesia (TD) when on antipsychotics, but there are a few general things you should know.

• Getting TD is not inevitable.

• TD may take years to develop once you start taking an antipsychotic.

• When you stop taking the medication that caused it, the TD may not go away.

• TD can begin after you have stopped taking the medication.

• The chance of TD increases with the increase in the dosage of the antipsychotic.

• The chance of TD increases with the length of time an antipsychotic is taken.

• Atypical second-generation antipsychotics (these are newer) seem to have a fairly sizeable drop in TD occurrences.

Do NOT just stop taking your medication without consulting with your psych. If you are on an antipsychotic and are concerned, make an appointment with your healthcare professional to discuss it. You are not guaranteed to get it on any antipsychotics, and coming off of them abruptly can be dangerous.

Explore other alternative therapies and medication before starting an antipsychotic.

Start at a low dose and increase it slowly, only when necessary to control symptoms. Communicate with your healthcare professionals. Be an active participant and ask any questions you may have, such as "What are the side effects?" "How long does this medication take to take effect?" "Can I start on the lowest dose?" "Do I have any other treatment options?" I mean that for any healthcare professional, any disorder, any medication.

ProTip: If you have any strange medical conditions pop up, Google the conditions and your medication names one at a time to see if there could be a correlation. I'm talking about anything from thin hair to weight gain, brain fog, gastrointestinal issues, or allergies. Anything you'd like to consult with a doctor about, really. I've discovered connections that my doctors were completely unaware of.

Doctors are smart (sometimes), but they do not have infinite memories and are just people like you; they just spent a really, really long time in college. No one can remember all the drugs and their interactions. Research is your friend.

I'm not trying to scare you away from antipsychotics. I am not psychotic, but I am on an antipsychotic now and have previously been on others. I have had Tardive Dyskinesia and lived to tell the tale, now dyskinesia-free. I do not give out drug names of what I am taking, as I do not advocate for any drug company, and what happened to me is not necessarily what happens to you, because body metrics (height, weight, brain chemistry, metabolism, etc) can be wildly different between individuals. But I weighed my options, and my decision was to continue with this course of treatment.

Educated, not afraid.

Sources/Resources

Cleveland Clinic Tardive Dyskinesia Article