When it hasn't worked

[LexFlex]

When switching to a different anti-psychotic, how could you tell that it was not working for you? Did you go back to your old anti-psychotic or try yet a different one?

[gizmo]

You can tell if an AAP isn't working for you if your symptoms that the med is supposed to treat (ie mania, depression) don't go away after a week or two.

As for what to do next, it's between you and your pdoc. In my experience, I have progressed from meds I've tried before to meds I've never tried. And when those didn't work, I went back to the old meds in combination with other medications. Often, a single medication doesn't treat all mental symptoms.

[Eden]

I switched to abilify recently, my psychosis came back, our first step was a higher dosage.

[g8orgirl]

It takes at least a couple of weeks for anti-psychotics to start working. I was put on Zyprexa briefly quite awhile ago and after about 8 weeks I had to switch back to Seroquel as the Zyprexa was not controlling my halluciantions and paranoia. I've been on almost all the atypical anti-psychotics amd even some of the older ones and have finally found a combo that seems to work quite well.

[apetasticaL]

how does someone know if the "good effects" [symptom removal etc] outweigh the side effects?

i get drowsiness, lethargy and akithisia [sp?] from my medication, yet it relieves many of my racing thoughts and manic behaviors, yet not all of my psychotic symptoms.

[Guest Recluse]

When switching to a different anti-psychotic, how could you tell that it was not working for you? Did you go back to your old anti-psychotic or try yet a different one?

I'm with the others on this. It takes a few weeks, although one of the benefits of AAPs is that they generally kick in faster than a lot of other medication.

For me, I could tell it wasn't working because I continued to have psychosis, hallucinations, hijacked emotions, and strange sensations. In my case, they sometimes even got worse, so a lot of different things can and will happen. Your mileage may vary in that regard, but just keep a little diary or a checklist when you start a new med. Every day before bed, go down your list and determine the level of severity of your symptoms or journal out how your day went in a few sentences.

That way, even in the throes of crazypants, you can look back and say 'this is the established pattern'.

Doing something like this makes it easier to make a judgement call about side effects vs. benefits.

As for whether or not to go back to an already established AAP, it really depends on your situation and doctor. For me, I didn't want to go back to an established one that 'sort of' worked, because that meant it would take even longer to find the one that really did work.

Often, a single medication doesn't treat all mental symptoms.

Gizmo is totally right (and since you're new, it bears saying that Gizmo is almost always right about everything and gives good advice). It might be that it takes more than one medication to really smooth things out. Be open to that possibility.

[LexFlex]

If a med takes two weeks to work, what do you do during the meantime? Suffer with your symptoms while waiting for it to work?

[Guest Vapourware]

You don't necessarily have to "suffer" through symptoms. What I've found helpful was getting a lot of therapy while waiting for the AP to kick in, because it gave me greater insight into why my thought processes were faulty. Therapy also helped in finding ways of alleviating the symptoms while waiting for the medication to work. Even the simple idea of being told that what I was perceiving wasn't true and that it was my mind playing tricks was very helpful for me.

[gizmo]

If a med takes two weeks to work, what do you do during the meantime? Suffer with your symptoms while waiting for it to work?

Other than benzos, there really aren't many medications that offer instantaneous results. Like vaporware said, you don't necessarily have to "suffer" but instead use other tools to get through the tough time. Therapy, occupying yourself with items ranging from watching movies to doing housework to spending time on the computer. There are more than a few people here on CB that have made it through tough times by camping out in the CB chat room.

[rowan77]

When your anti-psychotic doesn't work there is one simple step to take......Try another one!!

I was on Seroquel but it caused huge weight gain, went off it, was sleep deprived, became manic and was hospitalised and was started on Zyprexa which also caused weight gain and I refused to take it anymore so my pdoc put me on Abilify 15mg. But it didn't work, increased to 20mg, then 30mg...nothing....in fact I was worse as I had akathisia. So my pdoc restarted me on Seroquel and gradually my mood settled. So in my case I went back to the old reliable

[scatty]

Yes, you have to wait. If you have severe pychosis they may give you an injection in the ER, but that is rare I think.