This is the stuff that your doctor won’t tell you. And the reason he won’t tell you is that he would prefer you to be on medication than off it, no matter what the risks to your physical or mental health. Side effects of anti-psychotics are often marked down as further symptoms of illness by doctors and patients and their families. Also many millions of patients, don’t know that their behaviour and health conditions are being caused by their drugs, given to them to help them. For example schizophrenia has ‘negative symptoms’, such as apathy, depression, lack of motivation and so on, which although do occur as part of the illness, they also occur as side effects of the drugs. There is no known way of determining whether negative symptoms, from patient to patient, are being caused by the drugs or not, except if the patient is taken off that drug and those symptoms disappear. Most patients will not come off their drugs and/or won’t be supported to come off their drugs by their care teams and families. As a consequence the patients must carry on putting up with side effects. Also, it is very difficult indeed to come off anti-psychotics – in fact near to impossible.
If you wish to come off your drugs you must do it in consultation with your doctor and you must read some guidelines on doing this which can be found online from various websites, along with some books that are available from a bookstore. I do not recommend you come off drugs to avoid side effects. You must only come off drugs if you feel strong enough and well enough to do so and you have discussed it openly with your doctor and your doctor has offered his/her guidance and support.
Anti-psychotics: the first part of this list are common side effects across most of the anti-psychotics that are currently prescribed to sufferers. The second part is specific to Olanzapine (Zyprexa), the third part to Quetiapine (Seroquel) and last one to Aripiprazole (Abilify). All three are A-Typical medications. They have been chosen as a cross section of drugs and they are drugs that I have tried myself. Much of the list has been taken from the BNF (British National Formulary) book (no.61) (http://www.bnf.org/).
Side Effects Common to All Anti-Psychotics:
Drowsiness: this could mean up to sixteen hours asleep in bed per day.
Apathy: loss of interest in work, entertainment, family life or house hold chores. Can be misinterpreted as a sign of mental illness and more drugs maybe prescribed to treat it.
Agitation: pacing up and down and snappiness with others. Can be misinterpreted as a sign of mental illness and more drugs maybe prescribed to treat it.
Excitement and insomnia: similar to mania with sleeplessness. Can be misinterpreted as a sign of mental illness and more drugs maybe prescribed to treat it.
Convulsions: uncontrollable shaking of the body.
Dizziness:
Headache: constant headache can occur, with a band of dull pain around the forehead.
Confusion: loss of understanding of what you are doing. Can be misinterpreted as a sign of mental illness and more drugs maybe prescribed to treat it.
Gastro-intestinal disturbances: any disturbance of the stomach, including vomiting, diarrhoea and indigestion.
Nasal congestion: blocked nose.
Dry mouth: this can be constant, and requires drinking a lot of liquids. Can also be worsened by smoking.
Constipation:
Blurred vision: maybe mistaken for eye problems.
Angle-closure glaucoma: affects the eyes by damaging the optic nerve. This is often associated with diabetes.
Cardiovascular symptoms: heart problems including:
Hypotension: abnormally low blood pressure.
Tachycardia: abnormally high heart rate.
Arrhythmias: too high, too low or irregular heart beat.
ECG changes: Electrocardiograph. A machine to measure the electrical activity of the heart. If the readings change it signifies a problem.
Venous Thromboembolism: a blood clot in a vein.
Endocrine effects such as menstrual disturbances: The Endocrine system is the network of glands which produce hormones that regulate various bodily and mental functions.
Galactorrhoea: is the continuous flow of milk from a breast (lactation).
Gynaecomastia: the development of or enlargement of breasts in men.
Impotence: flaccid or failed errection.
Weight gain: weight gain can be dramatic on neuroleptic medication and can lead to diabetes, heart problems and strokes.
Blood Dyscrasias: abnormal materials in the blood often associated with diseases such as:
Agranulocytosis: low white blood cell count, often referring to one particular type of white blood cell. Associated with a suppressed immune system.
Leucopenia: low white blood cell count.
Photosensitisation: aversion to light.
Contact sensitisation: aversion to touch or touching certain things, such as wool, or hot water.
Rashes: sometimes in the form red lumps called hives.
Jaundice: a yellowing of the skin, caused by diseases of the liver.
Cholestatic: a blockage of the bile duct from the liver.
Corneal and lens opacities: little marks on the eyes.
Purplish pigmentation of the skin and eyes.
Tardive Dyskinesia: involuntary twitching and contorting of the face (once you have this it is irreversible).
Parkinsonian symptoms: some of the symptoms of Parkinson’s but without having Parkinsons. Mainly tremors.
Neuroleptic Malignant Syndrome: rigidity, fever, and the suspension of the autonomic activities of the brain. Stuff like breathing and walking. This reaction can lead to death.
Extrapyramidal symptoms: Pyramidal brain cells are the cells that help with motor movements of the muscles, including the fine movements for skilled work, such as fine art or surgery. When these symptoms occur, they cause tremors.
Rebound psychosis: if you come off your drugs, you may suffer psychosis which is being caused by withdrawal symptoms. This maybe marked down as a relapse, but unfortunately there is no way to tell the difference.
Side Effects Specific to Olanzapine:
Speech difficulty: slurred speech is a side effect of the old anti-psychotics and although less severe can occur with the new ones as well.
Exacerbation of Parkinson’s disease: makes patients with Parkinson’s worse.
Abnormal gait: walking abnormally.
Hallucinations: Can be misinterpreted as a sign of mental illness and more drugs maybe prescribed to treat it.
Akathisia: an inability to stay still.
Asthenia: weakness in the muscles and lack of motivation and tiredness/fatigue.
Increased appetite: cravings for carbohydrates (bread, potatoes, sweet food) can become severe.
Increased body temperature: the body should regulate its own core temperature at about 37ºC. Medication will sometimes disrupt body temperature regulation.
Raised Triglyceride concentration: increased fat in the blood.
Oedema: abnormal accumulation of fluid beneath the skin.
Hyperprolactinaemia: over production of a hormone, which is normally responsible for milk production in pregnant women or women with new babies. In men it can cause erectile dysfunction.
Eosinophilia: Eosinophils are a type of white blood cell that are specifically there to fight off parasites. In this side effect these cells are higher than they should be.
Bradycardia: slow heart rate.
QT-Interval prolongation: the QT-Interval is the gap in time, between the high part of the heart's electrical signal and the low part. This side effect lengthens this cycle.
Urinary incontinence: incontinence can be embarrassing and lead to more social isolation.
Seizures: seizures occur when the brain becomes overactive and increases its activity for a short time.
Hepatitis: inflammation of the liver.
Pancreatitis: inflammation of the pancreas.
Hypercholesterolaemia: high levels of cholesterol in the blood.
Hypothermia: core body temperature falls below 35ºC. Can lead to death.
Urinary retention: inability to urinate.
Priapism: permanent and painful erection.
Thrombocytopenia: a low blood platelet count.
Neutropenia: low count of the most common white blood cell.
Rhabdomyolysis: the breakdown of skeletal muscles.
Alopecia: hair loss.
Olanzapine injections (in addition to the above):
Sinus pause: a pause of one of the electrical impulses that keep the heart beating at a regular pace.
Hypoventilation: insufficient breathing so that the gas exchange (oxygen in, carbon dioxide out) in the lungs is insufficient to maintain the body.
Side Effects Specific to Quetiapine (Seroquel):
Dyspepsia: heartburn and indigestion.
Elevated Plasma-Triglyceride: high levels of fats in the blood.
Elevated Cholesterol concentrations: high levels of cholesterol.
Dysarthria: difficulty articulating thoughts and feelings.
Rhinitis: inflammation and irritation of the nose.
Dysphagia: difficulty swallowing.
Restless legs syndrome: a feeling of odd sensations in the legs (or other limbs) which causes an urge to move to get rid of the odd sensation. Not to be confused with anxiety based rapid movement of the leg while stationary.
Angioedema: sudden swelling of the skin and fleshy parts of the body. This can lead to suffocation if not dealt with quickly.
Stevens-Johnson Syndrome: a form of cell death which effects the skin. One layer of skin the epidermis separates from another layer the dermis.
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| Stevens-Johnson Syndrome. |
Suicidal behaviour (particularly on initiation): acting on suicidal thoughts. Can be misinterpreted as a sign of mental illness and more drugs maybe prescribed to treat it.
Side Effects Specific to Aripiprazole (Abilify):
Anorexia: a belief that a sufferer is fat, can lead to purging and refusal to eat. This is a very serious mental condition in its own right.
Oropharyngeal Spasm: spasms in the mouth.
Laryngospasm: vocal cord spasms.
Hypersalivation: dribbling a lot.
Chest pain: Can be misinterpreted as a sign of a more serious condition.
Anxiety: can be misinterpreted as a sign of mental illness and more drugs maybe prescribed to treat it.
Suicidal ideation: thinking about suicide can be misinterpreted as a symptom of mental illness and you maybe prescribed more medication to treat it.
Hyponatraemia: lowered sodium levels in the blood.
Stiffness: muscle stiffness.
Myalgia: muscle pain.
Sweating: sweating can lead to social isolation, which can be misinterpreted as a sign of increasing mental illness and can lead to more prescribing by your psychiatrist.
Weight loss: can be taken as a sign of further mental health problems, and can lead to further prescribing by your doctor.
Insomnia: loss of sleep particularly at the beginning of treatment, could lead to mania and psychosis.
