Several things motivated me to experience the effects of antipsychotic medication. Clearly my professional life has introduced me to many people who take them regularly, and I have seen their effects in members of my close family. And, of course, I also write about mental health issues, and that means touching on the issue of medication. I don’t think anecdotes are valid alternatives to systematic data collection, but I do think personal experience can be helpful – at least for me - in balancing and contextualising the available literature.
There are two rather interesting videos available online (here and here) that show examples of so-called extrapyramidal side-effects of anti-psychotic drugs (dystonia, parkinsonism, akathisia and tardive dyskinesia). I have to confess that they slightly frightened me (especially the first video at 6 minutes in), but they brought home the unenviable choices some people have to make… and especially the idea that the adverse effects of the drugs can sometimes be as bad as the problems they are intended to treat.
Immediately after I posted my intention to take chlorpromazine on social media, there was a flurry of comments from friends and followers.
Some merely referred to the idea as a ‘stunt’, with a variety of slightly off-the-wall analogies. But aside from the usual trivialities of social media, I saw three themes in the comments I’ve received over the past 36 hours.
First, some professionals (psychologists and psychiatrists), people who themselves use services and others sent rather nice messages praising my decision and suggesting that mental health professionals may well benefit from personal experience of the medication prescribed for their clients.
The second theme was not explicitly critical, but suggested this was a seriously unwise move. This is an interesting set of comments… it implies that these are dangerous drugs… very dangerous drugs.
I happen to believe they are… but they are also taken by hundreds of thousands of people daily. If the medication is so dangerous that it’s unwise to take them, does that have an implication for the very many people who are prescribed them… ?
And this leads on to the third theme of comments; something I’ve heard many times before. That is, if (on the one hand) a person isn’t suffering from a particular illness, the drugs will lead to nasty adverse effects but (implicitly on the other hand) the drugs would be much less unpleasant if someone is ill.
This speaks to the idea that the drugs ‘normalise’ or ‘correct’ chemical ‘imbalances’. And, therefore (the argument goes) it’s both unwise for me to take them – my dopamine levels are (it’s argued) normal, so the drugs will depress them dangerously. It’s also (the argument continues) irrelevant, because my dopamine levels will be depressed to an abnormal state, whereas someone who’s “ill” and who therefore has abnormally high dopamine levels will merely have their dopamine depressed to a normal level… which will be relatively benign for them (I know of one psychiatrist who believed that “the madness soaks up the drugs”). The argument is, then, that my experience tells us nothing about ‘real patients’.
My view is… this medication is contentious, but also extremely common. Very frequently, people have no choice about taking it. Sometimes this is because of pressure from mental health staff who see their role as persuading people to take these drugs. In many cases people are compelled to take them by force of law. The Mental Health Act allows medication by force if necessary, as thousands of people experience every year. I frequently write about mental health services, and where possible, I think it’s good to have personal experience of things about which you comment.
My understanding is that there’s precious little evidence to support the ‘chemical imbalance’ model – so I don’t accept the idea these drugs will ‘normalise’ the imbalances of “ill” people, but dangerously depress my neurochemistry. Instead, I think the drugs will have the effects that drugs have… and I, like everybody else, will experience them. I guess, on Monday, I’ll find out.