Posted by 49er on September 13, 2009, at 7:12:52
In reply to Re: Suggestions re: Someone Who Refuses Medications » 49er, posted by SLS on September 12, 2009, at 12:35:14
<<I don't think either one of us is crazy. I think we both want the same thing - healthy and happy people.>>
Well, you're not but people say I am:). In all seriousness, we do want the same thing.
<<I agree with you that the discontinuation of antipsychotics not be abrupt, but, rather, tapered. This is to help prevent the rebound psychosis that I alluded to in my previous post, and that speaks to your justified concerns. There are studies indicating that there is a supersensitivity of dopamine receptors that develops with chronic use of antipsychotics that facilitates this type of reaction. I don't know what the percentage is of people who react this way, but it seems to be a small minority.>>
How do you know it is a small minority since this is not going be studied usually in the medical community?
"Not unrelated to this phenomenon, is the medication break-through that occurs, despite continued neuroleptic treatment. This is also thought to occur in some cases as the result of the development of supersensitivity. However, it can be the result of an increase in psychosocial stressors. Unfortunately, there are a few people who become resistant to subsequent attempts at treatment with antipsychotics. Again, it is theorized that this is the result of the development of dopamine supersensitivities."
Actually, it sounds like your describing poopout which happens with quite a few psychotropic medications.
"It is the theory of an induction of dopamine receptor supersensitivity from chronic exposure to antipsychotics that becomes the thread that links withdrawal psychosis, medication breakthrough, and subsequent treatment resistance. However, these things are relatively uncommon."
Again, how do you know since the medical community still mostly minimizes withdrawal issues?
""The decision to treat or not treat becomes a balancing act between functionality and the risk of drug-related adverse events."
We definitely agree on this.
"I don't think it serves any further for the two of us to remark on the competency of a person in the midst of a psychotic or delusional schizophrenic episode. It is almost like we are talking about two different illnesses. People with more severe cases of schizophrenia can remain unreactive to questioning, let alone be relied upon to come to well deliberated decisions relating to the management of their welfare."What happens when they have periods of competency? Not all schizophrenics are going to be non reactive 100% of the time.
<<The type of person you describe is functional enough to at least comprehend the question. >>
Can you clarify? I am not sure what you're talking about.
<< I do not think that the people in the medical profession have conspired to produce protocols of treatment that they know are detrimental to the health of people with schizophrenia. As one would expect, there are consensuses arrived at through investigation and deliberation. Sometimes, they actually get it right.>>Please reread what I said as I have never made that claim. I think doctors get stuck in the we have done it this way forever type of thinking and we're not changing.
I gave you the example of my psychiatrist and pharmacist who questioned why I was tapering my meds slowly even though they admitted what I was doing was safe.
Also, the studies you think are the gold standard are not always the ultimate authority as they can be flawed for varios reasons.
49er
poster:49er
thread:915268
URL: http://www.dr-bob.org/babble/20090912/msgs/916840.html