When I was first put on antipsychotics I thought it wouldn’t be a big deal, but now I know that there was a lot I didn’t realize about taking them.
On the same day I was diagnosed with bipolar disorder I was put onto an antipsychotic. That was over three years ago. Now I take two different antipsychotics along with mood stabilizers and antidepressants. When I was first put on antipsychotics I thought it wouldn’t be a big deal, that I would just take a pill or two and that I would get better. Several hospitalizations and different antipsychotics later I now know this was pretty naïve and that there was a lot I didn’t realize about taking antipsychotic medication.
I write about sedation a lot as it is a very common side effect of atypical antipsychotics, and for me, it is the worst. I didn’t realize how debilitating sedation is until I experienced it and at times it feels as if I am swapping one set of problems (my psychotic manic highs) for another (sedation).
When people hear the word ‘sedation’ they think of drowsiness, but sedation is far from drowsiness. Drowsiness is nothing compared to the fatigue antipsychotics cause. Drowsiness is when you feel slightly or even moderately tired. Sedation is when no matter how hard you try, you can’t keep your eyes open. I have had to kiss my early mornings goodbye and waking up between 10am and 11am has become the norm on days off. And mornings are the worst. My body may appear awake, but the grogginess still has my mind locked away until the afternoon.
What I didn’t realize about taking antipsychotics is that to be able to have a productive day, you need a https://www.bphope.com/bipolar-buzz/9-steps-to-take-for-better-sleep/strict bedtime, and this bedtimes impacts on your social life. If I don’t take my antipsychotics by a certain time I will sleep the day away. My entire routine has become centered around taking my antipsychotics.
#2 Weight gain and hunger
I am lucky because I haven’t gained weight since starting my antipsychotics. However, I do watch what I eat and exercise nearly everyday (a feat considering the sedation). Though my weight hasn’t changed, the side effect of weight gain still haunts me and is usually on my mind.
What I do experience is insatiable hunger after taking my antipsychotics. Nothing can make me full because I turn into a bottomless pit. I have learnt to take my antipsychotics right before bed (hence why I sleep late – another trade-off) so I don’t binge in the evening, but I still occasionally get up and eat during the night.
#3 Dry mouth
As a nurse I was aware that a common side effect of antipsychotics is a dry mouth but I didn’t think it would be that bad. That is until I experienced it myself. The worst part of this side effect is that it’s constant. I have had a dry mouth for over three years and water, gum or mints don’t bring relief. It constantly feels like I have run a marathon in the desert without one sip of water. Again, mornings are the worst because it feels like I have eaten a sand dune overnight. And the dry mouth can very quickly turn into a sore throat.
What I didn’t realize about constantly having a dry mouth was the amount of water you need to consume to be able to talk properly because along with the sand, it also feels like you have glue in your mouth. A follow-on from drinking lots of water is that I also feel bloated all of the time and I need to go to the toilet all of the time.
#4 The taste of medication
One of the antipsychotics I take is a wafer and it tastes disgusting. I can’t even describe the taste. The first time I took it I thought I was having an allergic reaction because my tongue went numb and my mouth tingled (it wasn’t, it’s normal for that to happen when taking this medication), and in the first year of taking it I nearly vomited every night because of the taste. The seconds it takes for it to dissolve feels like minutes and the taste stays in my mouth for the rest of the night.
What I didn’t realize about taking antipsychotics was the indirect side effect of irritability. At times these direct side effects make you really grumpy. Everyone gets irritable when they’re tired, so why wouldn’t the sedation caused by antipsychotics make you irritable? I feel most grumpy in the mornings when my brain is still asleep and my throat is burning. That’s the time people should stay away because I am literally unable to socialize properly and this annoys me. Additionally, not only am I trying to deal with the side effects of antipsychotics, but other medications, which at times also contributes to irritability.
#6 The effectiveness
So far I’ve painted an unpleasant picture and sometimes I do ask myself if I have made the right choice between taking antipsychotics and being frequently unwell. But antipsychotics have been very effective in controlling my mania and psychosis. I marvel at how these two medications stop me from cycling in and out of mania, which I am sure is what would be happening to me if I didn’t take them. It is because of antipsychotics and a combination of other medication that I can function and enjoy life. Sometimes you have to choose the lesser of two evils and for now, the lesser evil is antipsychotics.
Sally lives in Victoria, Australia. She was diagnosed with bipolar disorder two years ago when she was 22, however she has been dealing with extreme moods since she was 14. When she experienced her first episode of depression, she was too embarrassed to get help even though she knew that something was wrong. Throughout high school she battled depression after depression, each one getting worse. At university she continued to have depressive episodes and when she wasn’t depressed she was extremely happy, incredibly driven and unusually energetic. Everyone thought this was her normal mood, herself included and so the elevated times went unnoticed.
The turning point was in her final year of university when she was referred to the university counsellor. She was diagnosed with depression but after many failed treatments she saw a psychiatrist who diagnosed her with type II bipolar disorder. However that quickly turned into a diagnosis of type I bipolar disorder after a psychotic manic episode.
She is currently completing her honours degree in nursing and works as a nurse in the emergency department. She blogs for The International Bipolar Foundation and has written for several publications. She also volunteers for a mental health organization where she delivers presentations about mood disorders to high school students. Although relatively new to this world, she is passionate about mental health promotion and thoroughly enjoys writing about mental health.
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