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How To Lessen the Suicide Risk from Meds.

 

 

Please note that this article is still a work in progress.  I still need to do a lot more research on it, and the drug companies are just now making the data available.  I didn't have access to my computer or books for almost a month and I'm still catching up with unpacking, paying bills, selling my house and all that crap.  But this is a huge issue that is on everyone's mind right now, so I had better deal with what I do know and get it out there.

Once the decision has been made to take meds, there are some steps that can be taken to lessen the chances of suicide caused by the meds themselves.

  1. In-patient hospitalization when starting a course of medication if there is a real risk of suicide to start with.

    Hospitalization isn't all that bad.  No, really, it's not.  Read all about my recent experience.  (Eventually that will be a complete article on its own.  For now it's just a recent blog entry and isn't yet finished.)

    Remember folks, One Flew Over The Cuckoo's Nest was written over 40 years ago.  Things have changed a lot.  It ain't perfect, but it's not as scary as you might think.  My stay in the lock ward was much more like being on a cruise ship than being in some kind of torture camp.  And I was involuntarily committed under a 5150 order!

    Here's the deal - one of the main factors in drug-related suicide is that when someone is nearly catatonic in a well of infinite hurt waiting for the sweet release of death, they're just too damned depressed to actually do anything about it!  And when an antidepressant works just a little bit it gives them enough energy and clarity of thought to accomplish the one thing on their mind.  In a psychiatric hospital killing yourself is a much more difficult thing to do.
  2. Of course hospitalization isn't always an option for one reason or another.  My one week sojourn would have cost me $16,000 if I didn't have Medicare.

    So that's where you rely on your network of family / friends / whomever as well as a minimum of twice-weekly visits with your doctor and therapist.  And if you're talking to other counselors, then you'll be doing more than twice-weekly sessions, because the semi-pros don't count in this case, as extraordinarily helpful as they can be.

    In other words, if you can't be watched 24/7 in a hospital, then you have to be watched by as many competent, in-the-flesh humans as possible as often as possible.  Pets, angels, stuffed animals, internet buddies and fellow nut jobs don't count.

  3. Med compliance.  I cannot stress the importance of med compliance.  Taking your pills as directed.  Every day.  The same time of day every day.  Get a pill organizer.

    One of the biggest problems, especially with kids, is med compliance.  If a dose is skipped it's possible to feel like shit the next day.  This is really the case with many of the SSRIs, and notoriously Paxil (paroxetine).  And Paxil is especially problematic in that skipping doses can cause it to become less effective.  You can see where this is going, right?

    Skip a dose - feel like shit - take the drug and don't feel as well as before - skip a dose - feel like shit - take the drug and still don't feel right...

    This is one of the reasons why Prozac (fluoxetine) is the only  modern antidepressant approved for use with kids.  Its 9.3 day half-life makes med compliance less of an issue.

 

 

  1. If you have any sort of suicidal thoughts, call your doctor and/or therapist immediately!  If your doctor isn't available, call 1-800-SUICIDE (1-800-784-2433) or any of the local suicide hotlines you can find at SuicideHotlines.com.  Outside of the US find hotline numbers at Suicide Helplines.org  If all else fails, there's always 911 or whatever the emergency number is where you live.

  2. Expectations are generally set way too high.  This is part of the quick fix mentality that everyone has.

    Doctors, patients, patients' families and HMO / insurance company accountants want the meds, and only the meds, to fix the problems right now.

    If the problem isn't fixed right now who gets blamed?  The crazy person, that's who.  That sort of guilt and stress contributes to suicidal ideation. And if they do kill themselves, the drug companies and the medications are suddenly at fault.  Certainly not all the people who wanted everyone to get well right away.  Oh no, they're never to blame.

    Everyone needs to take a deep breath and get some perspective.  The numbers I've seen for bipolar disorder are that it takes an average of two years, from initial crisis and diagnosis to some form of reasonable stability.  I'll try to find some verification for that, but from what I've seen in support group land and in my own experiences that's a pretty good number.  It seems to map well to other severe disorders.

    Two years people.

    Two years before you can go back to doing whatever it was that you were doing before you flipped out.  Or at least something close to what you were doing.

    Two years of therapy, eating right, exercising, participating in a support group.

    Two years of being on the right meds.  OK, some of you need not be on the meds for that long, but there's still going to be a period of being on meds that's longer than a month, that's for damned sure.

    See, this is presuming you're on the right meds in the first place.  It's a complex process of figuring out what you need, based on your symptoms, your history and various physical markers.  at The Amen Clinic Mouse and I had three-hour long evaluations on top of the brain scans.

    Now do you expect to get the right meds the first time after a 30-minute visit to an HMO doctor?  Maybe you will, maybe you won't.  It won't be entirely the doctor's fault if you don't.  It's hard to get accurate information from someone in the midst of a psychological or neurological crisis.

    I'm amazed that doctors and nurse practitioners get it right as often as they do.  Or close enough anyway.  But that just goes to show you yet another way that they are vastly smarter than I am, or most other people with these websites, when it comes to making you better.  Translating PI sheets into English and giving you tips on how to live your life when your nuts is a hell of a lot easier than actually trying to heal you.

    So relax and have some patience, patient.  As I wrote in the introduction to this site a severe crisis, regardless of the disorder, is the psychic equivalent of a broken leg.  The injury is real, if invisible without the aid of a fancy brain scan.  It's not your fault that you're not better tomorrow or next week.

    Forget about work, school or similar commitments.

     



    Your only priorities are:


    • Getting well.

    • Caring for yourself (get all the help you can with this).

    • Caring for any children, pets and other dependents (again, get all the help you can)

       

    That's it.

    Apply for disability.

    Take a leave of absence, a sabbatical, whatever.

    Fuck anybody who tells you to "Get over it" or "Cowboy up" or similar nonsense.  And not in the good way.

    Two years may seem like forever, but compared to the rest of your life, it's not that long.


  3. Learn about how long it takes for a particular med to work, and what the side effects are like.  As in point 5 some people lose all hope when taking an SSRI and nothing happens after a week.  Yet most SSRIs take 2-4 weeks to kick in.

    Other people fall into despair over the cognitive impairments (i.e. me feel stooopid) from anticonvulsants (a.k.a. mood stabilizers).  OK, feeling stupid really sucks.  I will be addressing what you can do to counter this side effect.  But, really, it takes about a year for your brain to adjust to those powerful, but really wacky meds.  Epileptic seizures and bipolar flip-outs do serious damage to your brain, but the anticonvulsants can actually reverse said damage.  No, really, they can.  While your brain is being fixed it's going to act a little slower than before.

    Then there's always the question of finding the right med.  That takes time, too.  I'm working on articles to help speed up that process.  Until then it's often trial'n'error.

    Use this site to learn all you can about the meds.  Knowledge is power.  If you feel empowered about your healing, if you feel more in control about it then things won't seem so bleak and hopeless.

 

 

 

The Overlords of the 12 Zernox Galaxies have compelled me through messages in the Sunday Chronicle to beg you for your support.  Unfortunately I need money again, so if you can:

Visit the Support Page for how you can help if you don't have any money laying around.   This includes reviewing Crazy Meds for Amazon.com and/or

rating this site for Psych Central:

There's also our Mental Mall to snag some free software or a purchase some books. 

Better yet, if you run a business and want to advertise on Crazy Meds, see our page on ad rates and policies.  I'm all about fiscal transparency, so follow the money for full disclosure of my finances.

 

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Take care, and keep taking your crazy meds!

If you still have unanswered questions about this or other medications, including which one is, or combination of meds are the best for you, your best bet is to ask on Crazy Meds Talk.  Better yet, if you want to let the world know how they worked out for you and want to help out others in their quest for the correct meds, join the party.
If you 
want to discuss your issues, I suggest checking out one of the various support groups online.  
Otherwise, if you're letting me know about how much you like or hate the site, or  need to let me know about medication effects in private, then just drop a note to jerod23 at gmail dot com  Honestly, I usually don't have a lot of time to answer e-mail these days.  The snide autoresponse message that may or may not hit your mailbox is going to tell you the same thing.
Another problem is that you may not get a response even if I wanted to send you one.  You see, so many dickweeds with malicious intents and too much time on their hands have appropriated the crazymeds.org domain name to use for their spam, viruses and the like.  Subsequently some lazy-ass e-mail protection software authors just go by the domain name, and not the IP address.  So I've been blacklisted because of the actions of others.  Or the software just doesn't like the domain name because of the "crazy" and/or "meds."  Or your question about a particular medication will set off spam flags.  So the e-mail just wouldn't go through regardless.  Sorry.

 

 

 

Hey, did you find this page all by itself through Google or some other search engine? Great! But to really appreciate the entire site, you need to start here.

 

 

Dead tree references:

 

 

Healing Anxiety & Depression Daniel G. Amen, M.D.,  and Lisa C. Routh, M.D. © 2003.  Published by G.P. Putnam's Sons.  Mouse and I are both patients at one of Dr. Amen's clinics.

 

 

 

Instant Psychopharmacology 2nd Edition Ronald J. Diamond M.D. © 2002. Published by W.W. Norton

 

 

Essential Psychopharmacology Stephen M. Stahl, M.D., Ph. D. © 2000.   Published by  Cambridge University Press

 

A Primer of Drug Action Robert M. Julien, M.D., Ph. D. © 2001.  We use the Ninth Edition.  Sometimes that comes up on an Amazon search, usually it doesn't.  Published by  Worth Publishers

 

 

Physicians' Desk Reference Editions 53 & 56 Maria Deutsch & Anu Gupta, Drug Information Specialists, et al. ©  1999, 2002. Published by Medical Economics Company.

 

The Complete Guide to Psychiatric Drugs Edward Drummond, M.D. © 2000. Published by John Wiley & Sons, Inc.

 

 

 

Mosby's 2004 Drug Guide David Nissen PharmD, Editor.© 2004.  An imprint of Elsevier.  The edition we're using isn't listed on Amazon.

 

 

End of books used for this article.

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Hey, did you find this page all by itself through Google or some other search engine? Great! But to really appreciate the entire site, you need to start here.

 

 

 

 

Created Wednesday, September 29, 2004

Last updated Saturday, May 15, 2010

 

Copyright © 2003 - 2007 Jerod Poore. All rights reserved.

 

Almost all of the material on this site is copyright © 2002, 2003, 2004, 2005, 2006 and 2007 Jerod Poore. Except, of course, the PI sheets, those are the property of the drug companies who developed the drugs the sheets are about.  And any documents that are written by other people which may be posted to this site will remain the property of the original authors.  You cannot reproduce this page or any other material on this site outside of the boundaries of fair use copying without the express permission of the copyright holder.  That's usually me, so just ask first.  That means if want to print out a few pages to take to your doctor, therapist, counselor, support group, non-understanding family members or something like that - then that's OK to just do.  Go for it!  Please.  As long as you include this copyright notice and the following disclaimer, I'm cool with it.

All rights reserved. No warranty is expressed or implied in this information. Consult one or more doctors and pharmacists before taking, or changing how you take any neurological and/or psychiatric medication. Your mileage may vary. What happened to us won't necessarily happen to you. Nobody on this site is a doctor, therapist, or a pharmacist. We don't portray them either here or on TV. Only doctors can diagnose and treat an illness. Some doctors tend to get pissed off by patients who know too much about medications, so tread lightly when and where appropriate. Diagnosing yourself from a website is like defending yourself in court, you suddenly have a fool for a doctor. Don't be a cyberchondriac, thinking you have every disease you see a website about, or that you'll get every side effect from every medication. Self-prescribing is just as dangerous.  All information on this site has been obtained through personal experience, the experiences of my friends, the experiences of people reported on online support groups, and from sources that are referenced throughout the site.  Know your sources!  As such the information presented here is not a substitute for real medical advice from your real doctor, just a compliment to it.  No neurologists, psychiatrists, therapists or pharmacists were harmed in the production of this website. All brand names of the drugs listed in this site are the trademarks of the companies listed after them in the pages about the drugs, even though those companies may or may not have been acquired by other companies who may or may not be listed in this site by the time you read this. Always read the PI sheet that comes with your medications and never ever throw them away.  If you didn't get a PI sheet, demand one.  Loudly.  Crazy Meds is not responsible for the content of sites we provide links to.  We like them, or they're paid advertisements, or they're something you should read to make an informed decision about a particular med.  Sometimes they're more than one of those things.  But what's on those sites is their business, not ours.  Very little information about visitors to this site is collected or saved. And from time to time I do look at search terms used to find it in an effort to make the information I present more relevant. Use only as directed. Void where prohibited.

 

"Everything is true, nothing is permitted." - Jerod Poore