Is medication the right choice?

By Kristina Randle, Ph.D., LCSW

Q. I was wondering if medication is the right choice for a person who has only experienced psychosis once. I stopped taking my meds because they made me feel horrible! I couldn’t think, I moved slowly, my personality changed, I experienced muscle stiffness, shaking, rashes, etc… I am a single parent and I need to be able function well.

Here is a little of my history; I know that some of these factors probably had something to do with my psychotic breakdown. When I was 3 years old I was in a car accident and have a closed head injury. I experimented with some drugs when I was 17-18 years old, mostly ecstasy. Emotionally I have been tested; my father sexually abused me when I was 18. My mom passed away from the car accident that I received my head injury but not until 8 years after being in a coma. I had an extremely abusive boyfriend who gave me a concussion and my life has been less than perfect since I can remember.

Everyone said that my body would adapt to the meds and that I had to give it a few weeks but I swear they just made me worse. I don’t want to take meds the rest of my life if I don’t need them. Or, if I do need them, how do I find one that won’t put my life on hold or make me sick? I have a daughter that needs her mother and I don’t want to get sick again but I can’t function while on these meds! I have tried Risperdal, Seroquel, and many more while in the hospital, am I doomed forever? Is this the best that life will be for me or are there other options?

A. Thank you for writing. Please know that not knowing some of the specific circumstances that led to your psychosis or how long the psychosis lasted makes my opinion relatively uninformed. I will do my best to answer your questions with the information that you have provided.

You mentioned that you had experienced psychosis only once. Having one psychotic break does not mean that you will have another. If you have been stable for some time since this event, without medication, it is possible that you can stay off the medication and remain stable. But I believe it is imperative that you have a strong supportive network of individuals, including a therapist and a doctor, among others, available to you while you are medication free. If you worked with a therapist and a doctor closely, perhaps the three of you could come up with an agreement that states that you’re not going to take the medication as long as you are stable (as determined by either the doctor or the therapist) but, if you begin to show signs of destabilization, you will begin the medication immediately. My main point here is that you should not stop taking the medication without the advice and supervision of a mental health professional.

If you are currently in a situation in which you are under constant distress, you have little to no supportive friends or family, you do not have a therapist, you’re in an abusive or otherwise unhealthy relationship, and so forth, and you’re not taking the medication, this would be unwise. In this scenario, you would be at a very high risk of having another psychotic episode. Having another psychotic episode would not only be detrimental to you, but to your daughter. She would have to witness her mother become psychotic and behave in a very confusing and chaotic manner, and then would have to endure the time away from you while you were in the hospital. You are correct when you said that your daughter needs a stable mother and it could be potentially damaging to her if she had to bear witness to another psychosis.

Another option to consider is to keep trying different medications, on very low doses, until you find one that you can tolerate. I am currently working with a woman who is taking a new medication called Invega that she finds to be very tolerable (and she’s been on them all and has hated them all). Everyone is different and will not be satisfied with the same medications but maybe this medication, or any other on a very low dose, would be acceptable for you. You can also try switching the medication to a different time of day. For instance, you can try taking the medication right before bed. This may help to reduce any side effects associated with antipsychotic medications.

I hope that you will be able to utilize some of these suggestions. I understand that taking antipsychotic medications, or any of the other psychiatric medications, can be difficult. The side effects associated with psychiatric medications are one of the principle reasons that people have trouble sticking to their prescribed medication regime. I wish you luck in finding a treatment, be it a medication or therapy, that can help you stay psychosis-free. Take care.

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Last reviewed: By John M. Grohol, Psy.D. on 7 Sep 2007

APA Reference
Randle, K. (2007). Is medication the right choice?. Psych Central. Retrieved on August 31, 2014, from http://psychcentral.com/ask-the-therapist/2007/09/07/is-medication-the-right-choice/

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