Thursday, November 26, 2009

Medications and power

When Ian and I met with Dr. Stern earlier this month we urged her to take Chris off Serdolect and not to substitute another antipsychotic. For once, even Ian was on my side about the Serdolect after we realized that it can lead to sudden cardiac arrest. Somehow, Dr. X at the psychiatric hospital had "forgotten" to tell us about this particular side effect, probably because he had finally managed to get me to shut up about his adding a second medication on top of the Abilify. It was only after Chris went for an ECG that it dawned on me why he was having one in the first place. I didn't bother researching Serdolect's particular drawback because all antipsychotics have side effects (at least this one wasn't clozapine) and I am sick and tired of continually being on the offensive with the doctors and being on the opposite side of Ian.

I feel that with the subsequent interventions that Chris has undertaken since leaving the hospital in May (Tomatis Therapy and Sound Therapy) he has a better grip on reality and will be in stronger position than before to get off these stupid medications once and for all. He also has to be in a stronger position to make his own case with Dr. Stern. I really hate having a psychiatrist involved in what I consider our "family business," meaning Chris, Ian and I coming up with our own agreed strategy. If there were no prescription medications involved, we would only be needing Dr. Stern to act as a counselor. Prescription medications means a psychiatrist has to be involved. The psychiatrist then has gained enormous power over the decision making of the patient and family. I forgot to add that there is a second psychiatrist involved who I haven't met - the whom who prescribes the medications. This is an arrangement that we agreed upon with Dr. Stern so that she can meet with Chris without medications being the main topic of discussion. Where there is a psychiatrist, there is medication, however, because Dr. Stern needs to confer with the second psychiatrist about them.

If I think too much about this and actively intervene, I'll be headed for another round of sleepless nights. My new strategy is to trust Dr. Stern to do the right thing with Chris's fully informed consent. Dr. Stern has been remarkably open to listening to us in the past and has professed a desire to see Chris off the medications "at some point." The point where that "some point" is located is of course up to debate.

6 comments:

  1. Clearly, you appear not to be a proponent of medication for the treatment of schizophrenia (a label I abhor. Schizophrenia does not exist. It is a convenient classification that was conjured up by a psychiatrist and which means nothing. I suggest schizophrenia cannot be cured because schizophrenia does not exist.) Why then do you keep bringing Chris to a psychiatrist who medicates him?

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  2. Schizophrenia is a psychiatric label for weird behavior. When the behavior gets too weird, chances are you will wind in in a mental hospital, as Chris did when he was 19. You then get put on meds. We weaned Chris off medications over a year ago, over a period of a year. He was fine for nine months, and then got weird again. We tried everything we knew to keep him out of the hospital because we knew he would be put back on meds. That's unfortunately, what happens. So, before he became a danger to himself or others (it was getting close) we had to put him back in the hospital, where of course, he was put back on medications. When you are released you need a psychiatrist. I haven't found one where we live who will agree to work from day one to take him off them, so, that is why Chris is on meds. His psychiatrist says she believes in working to get him off them, so I feel that I have found someone who is reasonable. There is also my husband to consider, who does believe in meds. It would be nice if I could operate unilaterally, but few of us who want to stay married have this luxury. I wouldn't even refer to schizophrenia in my blog were it not for the fact that I want other people who are looking for help for the diagnosis they have just been handed to find it. So, in that regard, the term schizophrenia is more meaningful than "collection of weird symptoms."

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  3. The obvious question then, based on your reply, is why does Chris get weird? What causes the weirdness? Is it fear? If so, what is he afraid of? We all get weird at times don't we?

    If the psychiatrist believes that Chris can get off medication why does she put him on it?

    Why do you have to have a psychiatrist after you get discharged from a hospital? Is there a law regarding this?

    You must believe the psychiatrist has the right answer if you keep bringing him there for medication. Or, is it that you are afraid of weird behaviour? How can you be sure he would become a danger to himself or someone else?

    Can you describe his weird behaviour? I really don't understand what weird is in the context you are using it.

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  4. Why does Chris get weird is exactly why I am writing a blog about holistic recovery from schizophrenia. That's the central question that everybody must answer if they don't want to rely on medications for the rest of their life. My July blogs covered some of this territory. My June blogs dealt with some of the interventions that we used to get Chris off meds the first time. I am not necessarily against psychiatrists, and their are some good ones, but it takes work to find them. I don't know where you live, but where I live the hospital would not release Chris unless they were assured he would be seeing a psychiatrist. It is probably a prudent use of the public good - to make sure that people who end up their in an emergency situation taking up hospital beds don't use it as a revolving door.

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  5. Actually, I've asked myself, too, why you would bring Chris to one of these pill-pushers, while I also suspected that you might have valid reasons for doing so. Now I see,that, indeed, you have.

    I'd like to say to anonymous that it seems easy enough, in theory, to keep people out of the system. You just don't drag them along to a psychiatrist's office, or the ER, and everything's just fine. Or is it? Unfortunately, we don't have Soteria houses all over the planet, and looking back at my own "weirdness", I have enormous respect for the courage and staying power both my friends and especially my therapist, taking a huge professional risk by not committing me, showed. It certainly is far from as easy as it immediately might seem to keep up with someone who's in an extreme state of mind. In my early twenties I once spent an evening and a night with someone who was acutely "psychotic". Was I exhausted?? One thing is for sure: I wouldn't have been able to do that 24/7 for days, maybe weeks on end. You need a team to do that. Or you simply have to resort to drugs, if you don't want to be overcome by exhaustion. Which is in nobody's interest that you are.

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  6. I, too, would love a therapeutic setting where Chris can go just to heal without meds, but where do these places exist? Relatives need a break, too. (Read: Christmas was hell). Luckily, Chris is becoming amazingly well, so another slide may not happen. The psychiatrist respected our wishes not to put Chris back on meds, and the weirdness went on for another six months until I decided that to the hospital he goes.

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