Sunday, March 15, 2015

Pills against the ageless ills - Part I: Introduction and the state of affairs

You probably saw this one coming miles away, didn't you? So many posts about mental health-related themes, it was only a matter of time until the subject of meds would come up. And yeah, in the field of mental health - or the field of mental illness, whether you want to name it by its glass-half-full or its glass-half-empty term - you can't go a spit's distance without running into its pharmaceutical component. It's both good and bad. Good that there's a multi-pronged approach to tackling your problems, bad that you basically become a walking test lab for chemists, being experimented on with all sorts of poorly understood and potentially hazardous substances.

Over the years I've amassed quite the experience with a wide array of psychoactive medications, having been through a good number of changes. There's no grand conspiracy theory about the many changes, no evil pharmaceutical company reptile Illuminati plotting the destruction of my body and/or mind. The changes were purely practical. Something either had no effect whatsoever, or had unacceptable side-effects, so it was taken out, and something new was tried. You see, for those of you with no experience in the field, it's actually very, very rare to start out with a medication and it works for you perfectly and you stick with it. This isn't a case of doctors clearly identifying an illness, and having something that is guaranteed to work, like it is for many physical ailments. Unless you are willing to have a cerebral vivisection, I suppose, finding the root of your problem(s) is actually mostly guesswork, which is the first of two reasons things are more complicated. The second reason is that psychoactive meds don't have the same effect on different people, because every brain is different and works differently. So basically doctors tell you "not sure what the issue is, take this, not sure what it will do." They package it differently, of course, with more confidence in their knowledge and skills.

I will eventually devote a number of posts to things I have taken in the past, with some juicy details as to why I discontinued them. You're gonna love it, you know which part of the male body psychoactive meds like to negatively affect the most. I will also devote a post to the darkest chapter of psychoactive meds: Physical dependency. Anyone with anxiety or sleeping disorders will have at least scraped the surface of that particular subject. For this first post of the new series, however, I'd like to talk about the type of meds that are the most rare, and that you are the least likely to come across: The ones that actually have a positive effect on you.

Chlorprothixene is something many of you from various corners of the world will never have heard of because to my knowledge it is only licensed in certain European countries, Germany included. Why that is I have no idea, I have never had any adverse effects from it or heard of someone who has. Officially an antipsychotic, it has very little potency in actually treating psychosis or any symptoms thereof, which is why it is never used for that purpose. What it does have potency in is in its sedative effect, which is why it is used almost exclusively as a sleeping aid, sometimes as an anxiolytic. Now I can't say much for its supposed anxiolytic properties, it may have such for some people, but for me it has absolutely no effect on anxiety. But damn, did it change my life as a sleeping aid.  I used to have massive difficulty falling asleep and staying asleep, and it messed up pretty much every aspect of my life. Couldn't plan my days at all because I wouldn't have any idea when I'd fall asleep and when I'd wake up, and how rested and therefore functional I would be. 50mg of chlorprothixene a night, and the issue itself and all associated issues were solved. Take the pill and two hours later I'm asleep, and stay that way the whole night, and wake up well-rested. And there isn't any addictive potential like there would be in traditional sleeping aids, so it's a win-win situation for me. Been taking it for about two years now, and it's a major improvement to finally have a properly set sleep rhythm.

The other medication I am currently taking and have nothing but positive feelings about is ziprasidone (Geodon/Zeldox). Been taking it since early this year, replacing that godawful olanzapine (Zyprexa), and damn has my life made a change for the better. Also an antipsychotic, like the olanzapine it replaced, I don't actually know how well it works in treating psychosis, since I don't suffer from any. I am taking it for its anxiolytic off-label use, and benefit from a few more of its side-effects, like that it helps organise thoughts and feelings when they are a mess, and it even has some antidepressive effect on me. This is a marked difference from olanzapine, which also somewhat worked as an anxiolytic, but had no other positive effect on the mess in my head in general, and contrary to ziprasidone it also depressed the hell out of me. Basically, since the switch, I went from spending all day moping and yawning, generally feeling like doing nothing, ever, to actively living my life, trying new things, doing all the stuff I like to do but never had the motivation for, and with a much increased ability to focus and keep my attention. It's quite a change. The anxiolytic effect remained the same, which means I still struggle with background-level anxiety as I did before, but it also didn't get worse. And with all the positive effects I got in addition, it was very much well worth it.

Those are the two medications I am currently taking, and so far the only psychoactive medications I have had in my life that I am happy with. I take 20mg of ziprasidone in the morning, another 20mg at night, along with 50mg of chlorprothixene, and it's by far the best med regiment I have had in almost six years of psychiatric treatment. There's room for improvement, which may or may not come, but for now I am doing well. And it certainly beats some of the crap I've had to deal with in the past, which I will address in the next post of this new series.

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