What Doctors Don't Tell YouMake sure that your symptoms have not been caused by other drugs. The Health Research Group, America’s drugs watchdog, says that anyone of any age who has recently become psychotic or delirious should review any medication he or she is taking with a health professional to make sure that the mental problem isn’t drug induced. This is particularly common with those over 60.
The following classes of drugs also can cause psychosis: antihistamines, analgesics, particularly those with narcotics like morphine, antibiotics, such as amphotericin B and acyclovir, anticonvulsants, like phenytoin, asthma drugs, the tricyclic antidepressants, barbiturates, drugs for high blood pressure like methyldopa, heart drugs with digitalis preparations or lidocaine, nasal decongestants, amphetamines, a variety of sedatives and tranquillizers, such as Valium and Halcion. Steroids, cimetidine and methylphenidate (Ritalin) can also cause what appears to be schizophrenia.Don’t take (or allow the administration of) antipsychotic drugs if you (or your loved ones) have not been properly diagnosed as schizophrenic. Antipsychotic drugs are notoriously overdiagnosed, particularly in older people, for anxiety, or as a sedative, particularly in nursing homes.
Antipsychotic drugs are extremely powerful, with many severe side effects. These include nerve problems like parkinsonism and tardive dyskinesia (involuntary movements of many body parts, a condition that can be irreversible); hip fractures and falls from sudden drops in blood pressure; anticholinergic effects (confusion, short term memory problems, and attention, disorientation, dry mouth, blurred vision, and worsening of glaucoma); lowering of blood pressure; weight gain; sedation; impotence; and bone marrow toxicity, to name a few.
If you are prescribed an antipsychotic drug, ask for the lowest possible dose of the drugs with the fewest serious side effects. Of the traditional antipsychotics, chlorpromazine (Thorazine) and thioridazine (Mellaril) are less likely to cause nerve disorders like parkinsonism, according to the HRG, compared with more potent compounds like haloperidol (Haldol). Nevertheless, Thorazine has a higher risk of causing hypotension, so if you already have low blood pressure, look to ones with a lower potential for dropping blood pressure.
Individual dosages are purely a matter of trial and error. Insist that your doctor launches you on the lowest possible dose for the shortest possible time. Older adults, who retain drugs longer in the body than do younger people, need to take one tenth to two fifths the dose given to young people, according to the HRG.
Make sure that you are being monitored carefully all during the time you are on these drugs and ask to adjust the dose or stop taking the drug at the first sign of uncomfortable side effects.
Once your condition has stabilized, particularly if you are on nutritional therapy, ask if the dosage can be gradually reduced.
Daniel Redwood DC
Tom Ferguson MD
