What do anti-psychotics do to people who aren't hallucinating? What happens in the long term? What if you suddenly stop taking them? My character is 28 and has been on anti-psychotics since he was 14 because he actually was seeing monsters but obviously nobody believed him and thus, drugs. If he stfu and took the pills (because due to Plot, they actually did mute the monster thing significantly), how likely is it he'd still be on them at 28? What would happen if he suddenly went cold turkey?
Being honest, Anon, your character is looking at some serious side effects. Here are some of the most notable / dangerous ones:
Involuntary movements:
- Muscle spasms
- Feelings of inner restlessness
- Parkinsons-like symptoms
- Tardive dyskinesia (which is irreversible, even if your character stops taking the medication!) I can go into TD in more detail if y’all want - I did a presentation on it recently!
Metabolic:
- Weight gain
- Type II diabetes
Other important side effects:
- Sedation (often extreme)
- Increased chance for arrhythmia (with specific drugs)
And those are just the really serious ones! There’s a lot of other different ones too.
Certain classes of antipsychotics are more associated with different symptoms. For instance, the typical antipsychotics are more associated with movement symptoms, and atypical ones with metabolic ones. That’s not to say that an atypical antipsychotic can’t cause movement symptoms - it just does so at a much lower rate than a typical antipsychotic does.
Something really important to note - your character would likely not be on antipsychotics continuously for 14 years straight. Usually, a year or two after the first episode of psychosis, they’ll try to taper down and see if the antipsychotic is still necessary. If they have another episode, they’d go back on it, and they’d reevaluate after 3-5 years.
Oh, another thing - nowadays a lot of people taking antipsychotics long term actually don’t take pills; they get an injection. How frequently they get the shot depends on the drug, but it ranges from once every two weeks to once every three months.
Going cold turkey will indeed cause withdrawal symptoms - these symptoms are more specific to the drug in question.
Hope this helps!
@scriptshrink question - I was told (by a psych prof, but years ago) that (at least one, probably old-school?) antipsychotic could CAUSE hallucinations in people who don’t normally experience them (specifically, it would have been in reference to something that at least previously was common to use for schizophrenia and will have been around for decades. I think we were discussing a portrayal in a film – this prof loved to use popular culture examples, usually movies, and discuss and deconstruct them with us for what was realistic/plausible or not, a sort of way to get us to think critically and diagnostically while correcting popular misconceptions – specifically, the film was A Beautiful Mind, where a schizophrenic character is given an injection, and he within minutes responds like he’s been sedated. I remember the prof showing us this scene and commenting that the medication he was being given in the scene “wouldn’t do that to a non-schizophrenic”, and…that’s about the time I remember learning about the weird effect such a thing might have on non-psychotic folks?). Anyway. tldr, I notice that symptom’s not on the list though, so needless to say I’m curious and wondering where this idea came from and if it’s maybe medication-specific or if it’s just…not true (I don’t THINK I’m misremembering or misheard him, but I want to be sure)
Without knowing the drug in question I cannot say for sure, but generally* no, antipsychotics do not directly cause non-schizophrenic people to experience hallucinations.
Antipsychotics (especially atypical ones) are actually starting to see use in treating mood disorders like bipolar I & II or severe depression - even without psychosis ever being present. They wouldn’t be used if they induced psychosis.
I am really not sure where your professor got “non-schizophrenic people won’t experience sedation when taking antipsychotics” because they absolutely will. We use injections of antipsychotics (usually Haldol, Zyprexa, or Geodon) at my internship site when a patient becomes violent and all efforts to de-escalate or redirect the patient have failed. I obviously cannot go into detail to protect patient confidentiality, but suffice it to say that it is effective regardless of diagnosis.
* Note - I say “generally” because I don’t want to say it has never happened, but if it does it’s at such an extremely low rate that it’s not even really worth mentioning.