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Anorexia recovery and anti-psychotics


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Hello!

Right, so in light of what I've been complaining about recently (for background infor on this, check my previous post here), I brought it up with my psychiatrist. She told me she thinks I'm "losing touch with reality" which if left unchecked, could lead to a psychotic episode and wind up with me in hospital. Absolutely terrifying. I didn't think it was this serious, but she thinks it's very serious. Now though, it doesn't feel like that appointment happened and that I must have been lying because it wasn't me, which is exactly the problem I spoke to her about. Really distressing.

So anyway, she's perscribed me olanzapine, which is an anti-psychotic. There are so many side effects of such drugs, like weight gain of up to 37lb and increased appetite (which seem terrifying to me as I'm officially a bmi of 18.5 as of today), sexual dysfunction (which would be awful as I'm finally getting a sex drive back), sleepiness, increased risk of diabetes, water retention, loss of stregth, constipation etc. Basically a lot of side effects. Horrible, scary side effects.

So now I don't know what to do. I don't want to take this drug and I've had adverse reactions to medications before and I really am scared of the side effects.

I don't think I'm psychotic. Maybe I am. Argh. What do I do?

x.

7 Replies (last)

Hi Scrunchy, I can see that this is frightening you,  but if you are worried about this mediaction, you should get a second opinion. From what I understand, AND I AM NOT A DOCTOR, it is usually a drug used in diagnosed schizophrenia, or mania, and as with any drug, there is usually a fine balance between the benefits and the snags, or side -effects. On teh plus side, the list of side efefcts you are given shows 'common' ones, which affect only around 1 in 10 people, and 'less common' ones affecting more like 1 in 100, so if you do get side effects, you shouldn't get them all!! One of my children had to be on lots and lots of nasty medications last year, and he had probably 1/5 of the advertised side effects. Nasty, yes, but the drugs were absolutely essential at the time...

How would you feel about taking them, and going back for an early review, so you can discuss any side effects, and see if your doctor has an alternative should it be necessary?

#2  
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I'm not a doctor, but I work in a pharmacy and have taken lots of classes on drugs at my university. I find it really odd that she would choose olanzapine as the first drug to try out - usually they start people out on Abilify or something without as many documented side effects. That said, drugs affect people differently and the side effect profile can vary considerably. I also question why she would prescribe an antipsychotic before considering an antidepressant (have you taken antidepressants before?) or cognitive behavioral therapy - did she make an official diagnosis of schizophrenia? I get frustrated that doctors prescribe so many drugs off-label (ie, without making an in-depth diagnosis or taking time to consider other underlying factors that are contributing to your feeling this way). Maybe she wants you to try it because she's worried about your safety (antipsychotics take less time to "kick in" than antidepressants).

Do you think maybe your symptoms are occurring because your BMI is still too low? I guess what I'm trying to say is, I think you should do what feels right for you at this time - I'm just really confused as to why your doctor would jump right into prescribing an antipsychotic (especially olanzapine)... maybe I'm missing information, though.

dansmum I want a second opinion, but I don't really know how to get one because I can't afford to go private and I don't know how to get one through the NHS. I will ask my gp about it though. I know it's usually perscribed for bi polar or schizophrenia, but that is what she is worried about. She said I am losing touch with reality and is treating me for possible psychosis. She terrified me by suggesting that this could lead to a serious psychotic episode, which would basically be one of these these disorders. Sleepiness and weight gain are basically side effects in everyone, though I did manage to speak to a pharmacist about it and she said that initally, I'd only notice the sleepiness. I don't want to take them though. Just inately I don't want them. I don't feel like I'm psychotic as I know my experiences are not reality. I don't feel they are nescessary right now, but now I'm scared of where this might lead. How do you know if something is essential? I really don't want to be psychotic... Unfortuately, I won't be able to contact my psychiatrist again till January, so no chance of working out an alternative.

amye I've been on antidepressants before. SSRIs don't sit well with me - they allow me to function, but worsen various depressive symptoms and led to chronic self-harm, suicide ideation and alcohol abuse. Not so good. She didn't officially diagnose me, but she does think I am exhibiting possible psychosis. I see her pretty regularly, so she does know my situation pretty well. I'm already in therapy for my ED and am being referred to PTSD therapy as well. I just don't think my symptoms are psychotic, I think it's more likely to be depersonalisation disorder. And I really don't want to take such a hard-hitting drug without really needing it, especially due to the side effects. Aparently sleepiness and weight gain affect basically everyone on the drug. I know I still need to gain weight, and I was hoping she would say it might pass with further recovery, but she told me that it is expected that I would feel more emotionally stable than when I was in the depths of ED by now, but really I feel less stable. This worried her as well. Olanzapine most certainly doesn't feel right at the moment, but obviously I worried what might happen if I don't take it as well as if I do. Does this still sound like she made a bad call to you or does it make sense with a little more info? I will try to get a second opinion though. Thank you for your reply though.

 

Hi Scruncy, I do not have time to reply properly now but I am in a very very similar situation to yourself and have also been prescribed Olanzapine but am yet to take it due to the same concernsas youself. I will reply properly tommorrow but just wanted you to know you are not alone xxx

Here's a link that explains how to see another doctor on the NHS:

http://www.nhs.uk/chq/Pages/910.aspx?Category ID=68&SubCategoryID=156

I have taken olanzapine (and several other anti-psychotics, for a neuromotor disorder) and really hated it. I've had periods where I felt depersonalized, like I was watching myself in a film.. and olanzapine only made it worse. I felt completely numb and blank while I was on it. It was extremely hard to concentrate.. I knew things were really bad when I tried to count out change in a grocery store and couldn't. I had to hold out my hand and let the cashier pick out the coins.

However, everyone is different, and just because I reacted this way to it doesn't mean you would. It seems to help a lot of people with schizophrenia and bipolar disorder.

I would recommend talking with your GP again, since it's likely faster than getting a second opinion. If your GP isn't willing to prescribe something else (in the absence of your psychiatrist), ask for a new referral/second opinion. I personally believe there are better possibilities to start with and that anti-psychotics should never be a first choice in treatment, but I'm not a doctor. 

I looked up the recommended treatment for depersonalization, and I've taken several of them which had far fewer side effects than anti-psychotics. One of them (lamotrigine) cleared up my head a lot, without any noticeable bad side effects besides being thirsty all the time.

#6  
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Original Post by scrunchy10:

amye I've been on antidepressants before. SSRIs don't sit well with me - they allow me to function, but worsen various depressive symptoms and led to chronic self-harm, suicide ideation and alcohol abuse. Not so good. She didn't officially diagnose me, but she does think I am exhibiting possible psychosis. I see her pretty regularly, so she does know my situation pretty well. I'm already in therapy for my ED and am being referred to PTSD therapy as well. I just don't think my symptoms are psychotic, I think it's more likely to be depersonalisation disorder. And I really don't want to take such a hard-hitting drug without really needing it, especially due to the side effects. Aparently sleepiness and weight gain affect basically everyone on the drug. I know I still need to gain weight, and I was hoping she would say it might pass with further recovery, but she told me that it is expected that I would feel more emotionally stable than when I was in the depths of ED by now, but really I feel less stable. This worried her as well. Olanzapine most certainly doesn't feel right at the moment, but obviously I worried what might happen if I don't take it as well as if I do. Does this still sound like she made a bad call to you or does it make sense with a little more info? I will try to get a second opinion though. Thank you for your reply though.

 

That makes more sense now, given your doctor knows a lot about your situation and what has worked/hasn't worked in the past. I think it's great that you're seeking PTSD therapy; PTSD can definitely be linked to feelings of depersonalization. However, it still strikes me as odd that she prescribed olanzapine... like tristessa said, a mood-stabilizer like Lamictal would perhaps be a better "first choice", something to try out. I've been on Lamictal and it has a better side effect profile, but unfortunately I didn't give it enough time to work properly. Maybe you could ask your doctor about that (also, getting a second opinion wouldn't hurt). 

I'm experiencing depersonalization/derealization right now, and I have in the past. It's quite frightening... I have PTSD as well (and haven't had the proper treatment for it in therapy)... I know that in DBT (dialectical behavioral therapy) they have a specific treatment plan for people with PTSD, and though I haven't personally done it I think it's definitely worth a shot and hopefully will lessen your depersonalization.

Also, I'm not sure if this will apply to your situation, but in my experience being at a low weight (not extremely low, but at a weight your body is not yet comfortable at) intensified my feelings of depersonalization and "psychotic" symptoms. Maybe gaining a bit more would take the edge off a bit.

#7  
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Hi Scrunchy,

In your position I would also feel very ambivalent about taking the medication.

However, would you be willing to take it for a trial period, say one month or two months. If you do experience distressing side effects then stop taking it and tell your psychiatrist in January how it went. However if you take it and you feel better, more in the present and more stable, then this could really aid the psychiatrist/doctor in figuring out a diagnosis.

Good luck either way.

Love Suzi xx

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