Medication Information for Family Members

There have been medications available to help people living with a mental illness or psychiatric diagnosis for many years. Some people who have been prescribed medications have found a good fit for medications to take, and felt better fairly quickly. (It can take six to eight weeks for some medications to work well). For others finding a medication or medications that worked has been a much harder journey. It may take or have taken several different medications to get someone feeling well enough to get a better start on their personal recovery journeys.

Newer medications came along and helped improve the quality of life of people who have a serious and persistent mental illness. Many people felt that their ability to think and reason improved when they were placed on newer medications. Others felt that the side effects were less problematic, and that is what made them feel better. Many of the newer medications are perceived to have the advantage of working differently, on different neurotransmitters, etc.

Medication fact sheets can be found on the NAMI website. Pharmacies distribute information with prescriptions, and even more information can be found on the various pharma websites. There is a huge book called the Physicians Desk Reference Guide (PDR) that has pictures of the pills that are available (name brands). The PDR also lists medication side effects. The medication side effects are not listed all together in one place. They are listed under studies associated with those side effects.

Knowledge about medication side effects is very important. Much of the testing done on psychiatric medications was done on white males. It is proven that many medications will affect people of color differently. Some are proven to affect the sexes differently. When you are searching for a side effects (say to find out whether or not a particular problem or behavior is a side effect), and you are using the PDR to try to find information, check for the side effects under other studies. One example of this is Depakote, which was used for many other purposes before it was used as a mood stabilizer. Many side effects may be listed under a number of studies, and the side effects have become more apparent because the medications have been used for so much longer.  

Medications, while an important component to many people's recovery journeys, are in some ways a two-edged sword. Psychotropic medications are extremely powerful. They can help you feel better mentally, while making you feel worse physically. Or they may affect some individuals very little physically.

One thing that we do know is that when you stop taking a medication, the side effects will often stop first. There may be a “halo period” when the side effects are nonexistent, but the effect on mental processes is still working well. For example:

If I stop taking a powerful medication that causes my muscles to tighten and my stomach to bloat up until I feel like a Macy's Thanksgiving Day float, a day or two later I may be able to move much better, and I no longer have an uncomfortable bloat. I may still benefit from primary effects of medication, to help me think more clearly. For a few days I might want to stay off my medication; because I feel really good, maybe even better than I do when I am on the medication. However, when the half life of the medication wears off my thinking may go downhill.

It takes people a while to learn that things happen this way. Some people want to remain on a medication for the rest of their lives because it helps them feel better. Some people want to know that that they are getting better, but they hate the side effects of the medication. They may willingly agree to go on and off of a specific medication again and again. Some people may not know why they are prescribed a medication, only to have it discontinued later, and later prescribed again. It can help to ask a psychiatrist questions about the medications prescribed, and any proposed changes. Some people may feel a general illness creeping up on them, and not realize that this may somehow be related to the medication. As medication levels build up in your system, side effects may also build up. You may not notice these changes unless you are keeping a medication log or journal.

To help a person figure out if a medication may be causing a problem, ask them specific questions.

How is your breathing? Are your muscles tight? Is your stomach upset? Are you able to move well? Do you feel like getting out and doing things? (if they did before taking the medications, this is important.) Is your stomach upset all the time or just when you take your meds? Do you lose your balance more now? Are you gaining or losing weight? Are you able to sleep well at night? Do your legs feel like they are moving continually? Or any other questions that might help define what the problem is.

Each person's situation is different, so the questions asked need to be relevant to each person’s given situation.  

One reason people with a serious mental illness give for not wanting to take medications is that it makes them sick. It can be hard to have any illness, and take the medications that are prescribed. Many people have leftover antibiotics in their medicine cabinets because they didn't finish taking them or didn't remember to finish taking them when they started feeling better. A person with a mental illness/psychiatric diagnosis is no different. When life starts happening and routines change, medications may unintentionally be forgotten.

Many families state that they feel frustrated when a family member with a serious and persistent mental illness does not or will not take their medications. There are a myriad of reasons as to why this may happen. Keeping an open line of communication is crucial for the family unit to work through what is happening.

When some people stop taking a psychotropic mediation there is chance that the medication may not return to the same therapeutic level that it was at prior. This happens both when people arbitrarily stop taking a psychotropic medication, and when they can't afford a medication (say for 2 weeks out of 12 weeks). It is something that people with a mental illness/psychiatric diagnosis need to know to make an informed choice about whether or not to stop taking a medication.

The following quote is from the NAMI Hearts and Minds Online Education Course available on the NAMI website

People who live with mental illness are often at higher risk for heart illness and much of that risk is preventable: knowledge is power. People who live with mental illness are more likely to have classic heart risk factors such as cigarette smoking, obesity, diabetes, elevated cholesterol and hypertension (high blood pressure)—all of which can be made worse by some antipsychotic medications.

Take all complaints and thoughts about physical illness seriously. Help your family member get things checked out. Advocate for and with them by asking questions and expecting answers from psychiatrists, physicians and other medical professionals. People with a mental illness are losing their lives prematurely due to things like pneumonia, diabetes and heart disease.