Posts by fadedbear92

Bryan Reyes60 said:I’m not totally sure if this is the right spot for this—I didn't see a specific thread dedicated to Velafax, so I figured I'd just toss it in here!

I honestly feel like I owe it to you guys to share my experience with Velafax!
I really hope everyone currently using this—or even just thinking about picking it up—takes a second to read this!
I was on it for three years straight—running that higher dose, you know, the 2x75 mg split!

So, here’s the deal—the reason my doctor put me on this is because I’d been leaning way too hard on Xanax to deal with my social anxiety. It was getting to that point where I was worried about getting hooked, you know? So, they basically told me we need to pivot and introduce an antidepressant into the mix instead to keep things steady.🤷 Classic story—happens every single time!
And just like that—it actually started working! Honestly, I feel like a whole new person. These last two years have been absolutely incredible—just pure bliss. Things that used to totally wreck my mood or throw me for a loop? They don't even phase me anymore. It’s wild—I’ve got this newfound drive, this crazy energy, and just straight-up courage! It’s like my entire personality underwent a total makeover or something. Classic story, right? But man, I am loving it!🤷

So, I’m officially hitting my three-year mark on Venlafax—and man, things have definitely shifted lately! It’s like everything just feels... different. Not necessarily bad, just a total change in vibe from how things used to be when I first started.
Ugh, I’m seriously starting to feel this exhaustion hitting me—and it just keeps getting worse. It’s reached a point where these waves of fatigue and sleepiness during the day are so intense that I don't even have the energy to change out of my work clothes—I literally just "collapse" onto the bed in whatever I'm wearing and pass out!
And then—bam—the depression just hit me like a freight train, and man, it only kept getting heavier from there.
So, my doctor finally agreed that the meds had basically stopped working—and honestly, they were starting to do more harm than good—so we decided it was time to pull the plug. I didn't just quit cold turkey, though! Oh no, definitely not. I played it super safe and tapered off really, really slowly over the course of six whole months.

It’s been three months now—and man, those first two months were just brutal. I was basically stuck in bed the whole time, dealing with this absolute agony... just total, deep clinical depression that honestly hasn't let up yet.
Of course, I jumped straight to a second AD immediately—and honestly? Nothing worked. Then I even tried a third one—still nothing! It’s pretty obvious that once you've been hit by something that intense, everything else just feels like a total letdown.🙂
So, I’m officially on my third round of Wellbutrin today—man, what a ride! Honestly? I’m feeling just "okay" enough to actually get out of bed, which is a win, I guess. Not sure if it’s the meds finally kicking in or if I’m just finally moving past that whole Effexor phase, but hey, I’ll take it!

So, what I’m really trying to get at after everything that’s gone down is this:
I honestly feel so cheated—like, I was never actually depressed! It was always just massive social anxiety that felt like a total impostor. Public speaking jitters, turning bright red whenever eyes are on you... yeah, that stuff is rough. But honestly? It’s nothing compared to the crushing depression I’ve been dealing with. It’s this absolute nightmare that I can’t even put into words—just this heavy, constant weight I’ve been dragging around hour after hour, day after day, for months on end. Compared to social anxiety, the depression is just on a whole different level of intense.
Look, I’m totally not against antidepressants—honestly, I take them myself—but in my humble opinion, prescribing stuff like Paxil or other heavy-duty meds should really only be for the absolute toughest cases!!!
If I had any idea what he was actually going to do to me back then—seriously, if I’d seen it coming—there is absolutely no way I would have ever gone for him!!
Oh, and here’s the kicker—the whole reason they put me on V. was actually to help me taper off my old anti-anxiety meds. But then, get this, they went ahead and prescribed me a completely different anxiety med at the exact same time! Like, hello? What kind of logic is that even supposed to be??🤷

I know some people are gonna jump in and say that everyone reacts to ADHD differently—and hey, they aren't wrong! But for those who need a little reality check, here are a few facts to keep things in perspective:
So, I was catching up with this one friend of mine—we were totally comparing notes on everything—and it turns out she went through the exact same thing I did! We sat there analyzing every single detail, and honestly? It was like looking in a mirror—the whole timeline played out identically. Seriously wild!
So, on one of those old-school health forums, there was this one guy who basically made it a "public secret" to roast Velafax—he described it as just being some weird combo of half white and half yellow pills. Honestly, though, if you’ve been popping those things for years at a higher dose, you know exactly what I mean!
Look, seriously—just hop on YouTube and search for "Effexor withdrawal" or something similar to get up to speed. That’s basically just the doctor's way of saying Venlafaxine. It’s worth doing a little digging yourself so you actually know what's going on!
I can't even begin to describe how stoked I am about this! Honestly, my mind is just blown—it’s one of those things that makes you realize how much we actually take for granted sometimes. Just absolutely incredible! http://www.topix.com/forum/drug/effe...I2UR28DFD3N759

I know some people are gonna jump down my throat and say I was probably just genetically wired to spiral into depression, but honestly? I’ve actually done the homework on that—I really dug into it!
How many times have you guys scrolled past articles saying people only develop certain disorders—like bipolar or psychosis—right during or even after they start taking antidepressants? I feel like I’ve lost count! Seriously, I see it everywhere.

I’m honestly not even mad at my doctor. I get it—he’s helped tons of people out there and basically given them their lives back. I wouldn't trade him for anything, especially since so many other docs out there are way worse—like, they barely know what they're doing and just rush you through an appointment because of insurance paperwork. It's all "quick check-in, sign here, bye!" without actually listening. My guy actually answers my questions and doesn't try to force anything on me, which is huge. But let's be real for a second: most psychiatrists just don't know nearly enough about medication and they prescribe stuff way too easily. They basically just skim a manual and call it a day. Honestly? Sometimes patients end up knowing more than they do! We actually take the time to research because our lives are literally on the line, whereas for them, it's just another 9-to-5. At the end of the day, they can't truly wrap their heads around what we're actually going through.

At the end of the day, I just really wanted to ask you guys—is your situation actually bad enough that you're willing to gamble on those kinds of consequences?
And look, let's be real here: if it works, it *definitely* works. But—and this is a huge but—it doesn't last long at all.

It's awful! There are so many stories floating around about Effexor... I was on it for just one week, and I couldn't sleep for three weeks while trying to get off it—imagine, one week of use, and three weeks of hell!!! And some people are on it for years!!! The official prescribing info clearly states Effexor is meant for treating
SEVERE depression...

There's even a dedicated thread on this forum about Effexor...

They're even suggesting using Prozac to help taper off Effexor!

Using Prozac for withdrawal due to its longer half-life

Some websites claim that switching from venlafaxine to Prozac during the final stages of tapering allows for a reduction rate that prevents withdrawal symptoms. This is attributed to Prozac's long half-life (four days, plus eight days for its intermediate metabolite—check the note in Section 5). Because of this, the drug level in the system drops gradually, allowing the body to adjust as doses are removed. This decay rate was originally used as a model to determine how to step down venlafaxine levels. While switching to Prozac was considered, it would mean introducing a completely different medication and a new learning curve. Furthermore, the Prozac website notes that about 7% of patients can't metabolize the drug properly, which causes concentrations to spike dangerously. It was felt that this posed an unnecessary risk if the taper could be handled safely through other methods.

http://www.clinical-depression.co.uk...awal-symptoms/

http://en.wikipedia.org/wiki/Venlafa...ation_syndrome

Eric Jackson11 said:Leaking such highly sensitive information from internal sources is honestly just unnecessary and exhausting.
We’ve got certain people constantly hammering us with nineteen different theories about medications!!!! Ugh, it's draining.
Hey, someone tell rejo to please stop with all this constant copy-pasting... 🙂

Tapering off 0.25 mg of Xanax daily is basically no different than giving up your morning Nespresso—if anything, it's actually easier.

Well, just skip the reading material then... because let's be real, tapering off Xanax is definitely not a piece of cake...🙄

Charles Patel said:I don't give a damn about textbooks or academic papers. I can find all that junk in a library or online if I really wanted to. What I actually care about is real-world experience.

So, how do you actually get off Xanax, and what kind of hell am I looking at during the detox?

Dreading this stuff is an understatement. If I miss my dose by even a little bit, I'm done for—panic attacks, dizziness, feeling weak, nausea... it's brutal.

Right here is a tapering schedule for alprazolam (Xanax); check your daily dosage and the timeline for reduction. As you'll see, you could drop by 0.25 mg every week, though I'd suggest opting for the longer route—your body will adjust much more smoothly that way...

As for what to expect? If you go slow with small increments, the side effects won't be nearly as brutal... you might consider switching to Ativan if things get rough... personally, I was a heavy user for 15 years (I even hit 6-8 Xanax pills at 0.5 mg a day)... but my process was different from what I'd recommend to you...🙂

And here is a protocol developed by a doctor in London who uses a substitute medication to help bridge the gap while tapering off Xanax...

Good luck!!!

NOOTROPICS
Nootropics act as metabolic modulators within the central nervous system—essentially substances meant to boost mental performance and cognitive function. While scientists are still digging deep into exactly how they work and how effective they truly are, piracetam (Oikamid) is a classic example of this group.

DEMENTIA TREATMENTS
As Americans live longer than ever before, the prevalence of dementia is climbing fast, which makes finding effective treatments a massive priority for the medical community. Currently, researchers are pouring resources into developing better anti-dementia drugs. Here in the States, the standard FDA-approved options include
the acetylcholinesterase inhibitor donepezil (Aricept), the NMDA receptor antagonist memantine (Ebixa), and Ginkgo Biloba extract. These medications have earned their place in clinical practice by showing some success in slowing down
cognitive decline in patients living with dementia, all while maintaining a relatively manageable side effect profile.

MOOD STABILIZERS
In modern psychiatric practice, the go-to mood stabilizers are typically lithium, valproate, and carbamazepine. More recently, doctors have also started utilizing other anticonvulsants like lamotrigine, gabapentin, and topiramate.

When Mood Stabilizers Are Used

Currently, mood stabilizers (often used alongside antipsychotics) are indicated for managing mania. They are also vital for long-term maintenance and preventing both depression and mania in patients diagnosed with bipolar disorder. Beyond that, these stabilizers are frequently used to manage
impulsive behaviors in individuals who don't necessarily have bipolar disorder.

How Mood Stabilizers Work
The exact mechanism behind how mood stabilizers tackle bipolar disorder isn't entirely clear yet. What we do know is that lithium works through various receptors by interfering with cAMP production and boosting GABA metabolism.
It’s believed that valproate works, at least in part, by enhancing GABA function within the central nervous system. Similarly, it seems carbamazepine indirectly boosts central GABA receptor activity.

Side Effects of Mood Stabilizers
Lithium comes with a pretty long list of potential side effects: nausea, excessive thirst, frequent urination, hypothyroidism, tremors, acne flare-ups, weight gain, mild memory issues, and mental confusion. It’s worth noting that lithium has a narrow therapeutic window—meaning the line between a helpful dose and a toxic one is thin—which can lead to toxicity, especially if kidney function is compromised.
Valproate treatment can cause sedation, mild tremors, slight ataxia, digestive issues, and low platelet counts.

CONCLUSION
Over the last fifty years of modern
psychopharmacology, we’ve seen the discovery of an incredible array of psychiatric drugs.
Even though—just like in most other branches of medicine—we haven't found a "silver bullet" that addresses the root cause of every psychiatric condition, these existing medications are absolute game-changers. They significantly help patients manage their symptoms and, more importantly, drastically improve their quality of life.
Ultimately, we have to remember that mental health is complex; it involves biological, psychological, and social factors. Because of this, the most successful treatments combine biological medication, psychotherapy, and social support.
These three pillars overlap and reinforce one another in a holistic approach to care, with the emphasis shifting depending on the patient's specific needs and stage of illness. It's also crucial to realize that treating mental illness requires specialized training across the board. To get it right, you need a full team of professionals working together—including psychiatrists, primary care physicians, nurses, psychologists, social workers, and occupational therapists.

Learn more: Psychotropic Medications http://*************/t89383/#ixzz1mvclkGjX

Generic Drug Name
Starting Dose (mg/day)
Typical Dosage (mg/day)
TCA
amitriptyline (Amyzol)
clomipramine (Anafranil)
25-50
100-250
maprotiline (Ladiomil)
50
100-225
tianeptine (Coaxil)
12.5
25-37.5
SSRI
escitalopram (Lexapro)
10
10-40
fluoxetine (Fluval; WebMD; Prozac; Prozac dispersible)
5-20
20-80
fluvoxamine (Fevarin)
25-50
50-300
paroxetine (Seroxat)
10-20
20-60
sertraline (Zoloft)
25-50
50-200
MAOI (reversible MAO-A inhibitors)
moclobemide (Aurorix)
150
300-600
OTHER
reboxetine (Effexor)
8
8

Learn more here: Psychotropic Medications http://*************/t89383/#ixzz1mvcYQJxc

PSYCHOANALEPTICS
Psychoanaleptics are psychotropic drugs designed to lift the baseline mood, boost activity levels, and sharpen alertness. This category includes antidepressants, psychostimulants, ADHD medications, nootropics, and treatments for dementia. We won't be diving into ADHD meds here—that falls under pediatric psychopharmacology, which is a bit outside the scope of this specific overview.

ANTIDEPRESSANTS
Antidepressants work to alleviate depressive moods, while also helping with the physical sluggishness, fear, and anxiety often experienced by patients struggling with depression.

How Antidepressants Work
Tricyclic antidepressants (TCAs) enhance the effects of certain biogenic amines (like norepinephrine, serotonin, and dopamine) within the central nervous system. They do this by blocking presynaptic α2-adrenergic receptors, which prevents these neurotransmitters from being reabsorbed into the synaptic cleft, thereby allowing them to exert more influence on postsynaptic neurons. They also act as antagonists on muscarinic receptors—which, unfortunately, is responsible for many of the side effects associated with these drugs.
Serotonin inhibitors represent a newer class of antidepressants that specifically block just the reabsorption of serotonin from the synaptic cleft back into the presynaptic nerve ending. Because they don't block norepinephrine and dopamine like TCAs do, they generally cause fewer side effects. These serotonin inhibitors lack anticholinergic effects, have lower toxicity levels, and tend to stay active in the body longer.

Monoamine oxidase inhibitors (MAOIs) work by inhibiting the enzyme responsible for breaking down monoamine neurotransmitters. By stopping this breakdown, levels of norepinephrine, adrenaline, serotonin, dopamine, tyramine, and tryptamine increase in the tissues. The antidepressant effect is largely attributed to the resulting rise in norepinephrine and serotonin concentrations within the central nervous system.

Clinical Uses for Antidepressants

The primary indication for using antidepressants is major depressive disorder, though they are used for various other depressive states depending on the cause—such as depressive psychosis, the depressive phase of bipolar disorder, atypical depression, seasonal depression, recurrent depression, organic depression, neurotic depression, or reactive depression.
Antidepressants can also prove useful when treating dysthymia, panic disorder (with or without agoraphobia), obsessive-compulsive disorder (specifically with clomipramine and SSRIs), PTSD, premenstrual dysphoric disorder, and bulimia.

Common Side Effects of Antidepressants
With TCAs, the most frequent side effects stem from the autonomic nervous system due to their strong anticholinergic properties—think dry mouth, blurred vision, rapid heartbeat, constipation, and urinary retention. That said, people often develop a tolerance to these during treatment. A much more serious concern is heart strain caused by increased adrenergic neurotransmitters, which can lead to heart failure; therefore, extreme caution is necessary for anyone with cardiomyopathy. You might also see orthostatic hypotension paired with reflex tachycardia due to α-adrenergic receptor blockade.
Sedation is also quite common and can be particularly intense during the first few weeks of therapy. SSRIs tend to be much better tolerated than TCAs. Because serotonin inhibitors
don't trigger those anticholinergic effects, they have lower toxicity and longer-lasting impacts. However, drugs that ramp up serotonin levels can occasionally lead to akathisia or serotonin syndrome. Sexual dysfunction is another potential issue during antidepressant therapy,
most frequently linked to clomipramine and SSRIs.

PSYCHOSTIMULANTS
Psychostimulants are medications that excite the central nervous system, stripping away feelings of fatigue and drowsiness to boost alertness. This group includes drugs like dextroamphetamine (Dexedrine), methylphenidate (Ritalin), and pemoline (Revibol), though availability varies by region.

Learn more: Psychotropic Drugs http://*************/t89383/#ixzz1mvcN9tRk

Commonly prescribed Benzodiazepines in America (alphabetical order) and their characteristics

Drug
(Brand Name)
Approximate equivalent doses (mg)
Onset of action
Active metabolites
Average half-life (hours)
Duration of effect
Typical adult dosages (mg/day)
alprazolam
(Helix, Xanax, Xanax SR)
0.5
moderate
yes
12
short
0.5 - 6
bromazepam
(Lexapro, Ativan, Lexapro)
2.25
fast
yes
17
short
3 - 36
diazepam
(Ativan, Diazepam, Diazepam, Valium, Valium)
5
fast
yes
100
long
2 - 40
flurazepam
(Fluzepam)
5
fast
yes
100
long
15 - 30
clonazepam
(Rivotril)
0.25
fast
no
34
long
1.5 – 6
lorazepam
(Lorsilan)
1
moderate
no
15
short
2 - 6
medazepam
(Anxiolytic)
5
fast
yes
8
short
20 - 50
midazolam
(Dormicum)
1.25 – 1.7
fast
yes
2.5
short
7.5 - 15
nitrazepam
(Cerson)
5
fast
no
15
short
5 - 10
oxazepam
(Oxazepam, Carbamate 15)
15
slow
no
8
short
30 - 90

Benzodiazepine Overdose
Since Benzodiazepines fall among the most frequently prescribed
medications overall, their widespread availability contributes to them being a common choice in suicide attempts. Because they have a very wide therapeutic index (meaning there is a large gap between a helpful dose and a toxic one), they are generally considered safe drugs—essentially, they have low toxicity levels in cases of overdose. In fact, it is extremely rare for a patient to die from ingesting only Benzodiazepines. However, the danger spikes when they are combined with other substances, used by vulnerable populations (like children or the elderly), or taken by patients
with COPD.
When treating a Benzodiazepine overdose, doctors focus on supportive care to try and slow down absorption (such as gastric lavage, using activated charcoal, or administering laxatives) while closely monitoring vital signs. The antidote flumazenil (Anexate) is highly specific and works effectively in patients who have overdosed strictly on Benzodiazepines; it can even be used in comatose patients to help with differential diagnosis.

Learn more: Psychotropic Drugs http://*************/t89383/#ixzz1mvc9xH7P

ANXIOLYTICS, HYPNOTICS, AND SEDATIVES
We’re going to dedicate a good chunk of space to this group—mostly because these are the medications non-psychiatrists encounter most frequently in their daily practice.
Anxiolytics (tranquilizers or ataractics) are relatively newer psychotropic drugs designed to ease or eliminate anxiety and emotional tension without causing the heavy drowsiness typically associated with hypnotics. Nowadays, various Benzodiazepines and buspirone are commonly used as anxiolytics. Since buspirone isn't currently registered here in the States, we won't be diving into it specifically.

Hypnotics (sedatives) are drugs that induce sleep, though in much higher doses, they can lead to
anesthesia or even a coma. In smaller doses, they act as sedatives. This category includes both barbiturate and non-barbiturate agents.

Benzodiazepines
The first Benzodiazepine was patented way back in 1959—chlorodiazepoxide, which later became widely known by its brand name, Librium. Continuous research into related substances eventually led to the discovery of diazepam in 1963. It’s an anxiolytic that is 3 to 10 times more potent than its predecessor, offering a broader spectrum of action, including anticonvulsant and stronger muscle-relaxing effects. Research into benzodiazepine derivatives continues today, and there are about forty different drugs in this class available on the global market. The development of Benzodiazepines represents a massive leap forward in the pharmacological treatment of anxiety. These drugs have almost entirely replaced the barbiturates used previously, which had a much worse side-effect profile—specifically regarding high toxicity.

Mechanism of Action for Benzodiazepines
Benzodiazepines work by enhancing GABAergic activity. Gamma-aminobutyric acid (GABA) is one of the primary inhibitory neurotransmitters in the central nervous system, located in roughly 30-40% of all synapses, and functions through three specific receptors: GABAA, GABAB, and GABAC. The GABAA receptor, which is the target for Benzodiazepines, is essentially a complex chloride channel. Benzodiazepines increase how often this receptor channel stays open, though they don't change its conductivity or how long it stays open. Because the mechanism of action is identical across all Benzodiazepines in wide clinical use, the differences between them really just come down to their individual pharmacokinetics.

Clinical Indications for Benzodiazepines
Generally speaking, Benzodiazepines are well-tolerated, have relatively few side effects, and are highly effective at treating anxiety and related disorders. They also serve as effective hypnotics for managing sleep disorders. Additionally, Benzodiazepines work well as muscle relaxants or anticonvulsants, and are frequently used to manage alcohol withdrawal syndrome. They are even utilized as intravenous anesthetics.
Despite their wide range of uses, their primary indication remains anxiety disorders—specifically Generalized Anxiety Disorder and Panic Disorder. That said, patients dealing with OCD, social phobia, or PTSD can often benefit from these medications as well.
Other uses for Benzodiazepines include epilepsy, motor disorders, acute psychotic episodes, schizophrenia, catatonia, mania, depression or bipolar affective disorders, akathisia, agitated states, and more.
The specific pharmacokinetic properties of a particular Benzodiazepine will ultimately dictate its intended use.

Short-acting and intermediate-acting Benzodiazepines with rapid onset are typically used as hypnotics, whereas long-acting versions with slower absorption are used as anxiolytics. How fast they kick in depends on their lipophilicity. Diazepam is among the most lipophilic Benzodiazepines, meaning it crosses the blood-brain barrier incredibly fast, leading to a very rapid onset. However, because it redistributes into fat tissue so quickly, its effects wear off fast too. On the other end of the spectrum, you have Lorazepam, which is significantly less lipophilic; therefore, it has a slower onset but a longer-lasting effect.

Advantages of Benzodiazepine Anxiolytics
The main perk of Benzodiazepine Anxiolytics is just how fast they kick in—you can really feel the difference after the very first dose. Plus, they’re relatively non-toxic and much safer than other drugs with similar effects. Even if someone takes too much, it rarely leads to a fatal outcome. Now, alcohol does slightly boost the effects of Benzodiazepines, so while non-drinkers aren't strictly forbidden from having a small drink while on this therapy, they definitely need to be warned that any alcohol will hit them much harder.
When treating Generalized Anxiety Disorder, we see plenty of Benzodiazepines being used successfully today (think Diazepam, Lorazepam, Oxazepam, and others), and honestly, studies comparing them for this specific issue haven't been able to single out one as being more effective than the rest.
Low-potency Benzodiazepines, like Oxazepam, work best for constant, ongoing anxiety—things like Generalized Anxiety Disorder or acute stress. On the flip other hand, when you're dealing with episodic anxiety like Panic Disorder, high-potency options like Alprazolam, Clonazepam, or Lorazepam tend to be more effective. Oxazepam is actually quite easy on the system due to its specific pharmacokinetics, making it a great choice for managing continuous anxiety in older adults or patients with liver issues.

Side Effects of Benzodiazepine Anxiolytics
Because the body builds up a tolerance to the anti-anxiety effects, it’s usually recommended to limit treatment to a maximum of four consecutive weeks. Of course, in real-world clinical practice, hitting that mark can be incredibly tough.
The most common side effect is unwanted daytime drowsiness. Patients should be warned about this, though in most cases, it can be managed or dialed back by adjusting the dosage titration and picking the right medication.

Probably the biggest fear people have about using Benzodiazepines is the risk of becoming addicted during long-term use. For those who do develop a dependency (which happens in up to 35% of patients using them for longer than four weeks), withdrawal syndrome occurs
if they stop suddenly or drop their dose too drastically. It's also worth noting that dependency can develop in a fetus or newborn if the mother takes Benzodiazepines during pregnancy.
Sometimes, Benzodiazepines can trigger what we call a paradoxical effect—mostly in children or the elderly—where instead of calming down, they experience increased anxiety, agitation, irritability, or even hostility. We've also seen cases of depression, including suicidal behavior, or even euphoria during chronic use.
Because they act as both sedatives and muscle relaxants, they can lead to falls and subsequent injuries, like hip fractures, especially in older patients. They can also cause memory impairment in the elderly.
While it's less common than with other psychiatric drugs, anxiolytics can also cause sexual side effects. For instance, erectile dysfunction is sometimes linked to Clonazepam, low libido to Diazepam, and sexual disinhibition to Flunitrazepam.

Advantages of Benzodiazepine Hypnotics
Benzodiazepines are among the most frequently prescribed, and arguably the best, hypnotics available.
Choosing the right hypnotic from this group depends entirely on the type of insomnia the patient has; the half-life—basically how long the sedative effect lasts—is the most critical factor here.
So, for patients who struggle to fall asleep, we'd use a Benzodiazepine with a rapid onset and short duration (like Triazolam). For those who have trouble staying asleep, a medium-acting hypnotic (like Temazepam) works better, and for those who wake up too early in the morning, a drug that lasts 7-8 hours (like Nitrazepam or Flurazepam) is the way to go.

Side Effects of Benzodiazepine Hypnotics
Despite being highly effective at first, many patients develop a tolerance quite quickly—actually faster than they do for the anti-anxiety effects. You might also run into "rebound insomnia," which can happen during treatment or when tapering off the Benzodiazepines.
Impairment of psychomotor skills and memory during the day—usually after taking slow-eliminating Benzodiazepines—is particularly noticeable in the older population.

Dependency can kick in surprisingly fast—we're talking just a few weeks of consistent use—and if you suddenly stop, withdrawal symptoms can hit within days. Also, a quick heads-up for anyone dealing with COPD: you really need to steer clear of Benzodiazepines because they can depress your breathing.

Benzodiazepine Misuse
Just like a lot of other medications out there, Benzodiazepines often get used off-label—meaning people misuse them alone or mixed with other psychoactive substances. They’re actually pretty cheap on the street and go by all sorts of slang names (for instance, people might call things "libbies" for chlordiazepoxide—derived from Librium—or "Vitamin V" for diazepam, which obviously comes from the famous brand name Valium).
People tend to take sedatives, hypnotics, and anxiolytics orally, either sporadically to chase a specific temporary buzz or continuously to maintain a steady, mostly mild state of intoxication. Generally, younger folks are more prone to occasional misuse, while middle-aged individuals are more likely to use them regularly—often picking them up from their family doctor (or a few different ones) under the guise of needing help with insomnia or anxiety.

Learn more: Psychotropic Drugs http://*************/t89383/#ixzz1mvbxnjuR

Here is the breakdown I promised, as follows:

Drug
generic (brand) name
Daily therapeutic dose (mg)
Sedative effect
Hypotensive effect
Anticholinergic
EPS
Other side effects

First-generation Antipsychotics
(dopamine antagonists)
fluphenazine (Perazine)
2-60
++
+
+
+++
haloperidol (Haldol)
5-30
+
+
+
+++
chlorpromazine (Largactil)
200-800
+++
+++
++
++
levomepromazine (Nozinan)
200-400
+++
+++
+++
++
perazine (Phenothiazines)
100-800
+++
+++
+++
++
promazine (Phenothiazines)
75-800
+++
+++
++
++
thioridazine (Melleril)
150-800
+++
+++
+++
++
pigmentary retinopathy
cardiac side effects
Second-generation Antipsychotics
(serotonin-dopamine antagonists)
aripiprazole (Abilify)*
15-30
+
+
+
+
clozapine (Zyprexa)
150-600
+++
+++
+++
+
agranulocytosis
quetiapine (Seroquel)
150-800
+++
++
++
+
olanzapine (Zyprexa)
10-20
++
+
++
+
risperidone (Risperdal, Risset)
1-6
+
++
+
+
sulpiride (Sulpiride, Eglonyl forte)
800-1600
+++
+++
+++
+
ziprasidone (Geodon)
40-180
+
+
+
+

*Not yet approved in the US

Find out more: Psychopharmaceuticals http://*************/t89383/#ixzz1mvbgwJp5

Benzodiazepine derivatives
alprazolam – Helix, Xanax, Xanax SR
bromazepam – Lexapro, Ativan, Lexapro
diazepam – Ativan, Diazepam, Diazepam, Valium, Valium
lorazepam – Lorazepam
medazepam – Anxiolytic
oxazepam – Oxazepam, Carbamate

N 05 B C
Carbamates
meprobamate – Meprobamate

N 05 B Anxiolytics

N 05 A A
Phenothiazines
with dimethylaminopropyl group
levomepromazine – Nozinan
promazine – Phenothiazines

N 05 A B
Phenothiazines piperazine group
fluphenazine – Lyogen, Perazine
perazine – Taxilan

N 05 A C
Phenothiazines with piperidine structure
thioridazine – Melleril

N 05 A D
Butyrophenone derivatives
haloperidol – Haldol

N 05 A E
Indole derivatives
ziprasidone – Zeldox
N 05 A H

Diazepines, oxazepines, and thiazepines
clozapine – Zyprexa
olanzapine – Zyprexa
quetiapine – Seroquel

N 05 A N
Benzamides
sulpiride – Eglonyl, Sulpiride

N 05 A L
Lithium
lithium carbonate – Lithium Carbonate

N 05 A X
Other antipsychotics
risperidone – Risperdal, Risset

N 05 A Antipsychotics

N 05 PSYCHOTROPICS
Table 1 b. Classification of psychopharmaceuticals registered in the US according to the ATC system
N 03 A A
Barbiturates
methylphenobarbital – Phemiton
phenobarbital – Phenobarbital
primidone – Primidone
N 03 A B
Hydantoin derivatives
phenytoin – Diphenhydramine
N 03 A D
Succinimide derivatives
ethosuximide – Asamid
N 03 A E
Benzodiazepine derivatives
clonazepam – Rivotril
N 03 A F
Carboxamide derivatives
carbamazepine – Tegretol
N 03 A G
Fatty acid derivatives
sodium valproate – Depakote, Depakote
valproate – Diprozin
N 03 A X
Other antiepileptics
lamotrigine – Lamictal
topiramate – Topamax
gabapentin – Neurontin

Table 1. Classification of psychopharmaceuticals registered in the US according to the ATC system
N 03 ANTIEPILEPTICS
N 05 C D
flurazepam – Fluzepam
midazolam – Dormicum
nitrazepam – Cerson
N 05 C F
Drugs related to benzodiazepines
zolpidem – Sanval
N 05 C M
Other hypnotics and sedatives
valerian (tincture) – Persen
N 05 C Hypnotics and sedatives
Table 1c. Classification of psychopharmaceuticals registered in the US according to the ATC system

N 05 PSYCHOANALYPTICS

N 056 A Antidepressants
N 06 A A
Non-selective monoamine reuptake inhibitors
amitriptyline – Amyzol
clomipramine – Anafranil
maprotiline – Ladiomil

N 06 A B
Selective serotonin reuptake inhibitors (SSRIs)
fluvoxamine – Fevarin
fluoxetine – Fluval, WebMD, Prozac, Prozac dispersible
sertraline – Zoloft
paroxetine – Zoloft, Lexapro
escitalopram – Lexapro

N 06 A G
Monoamine oxidase type A inhibitors
moclobemide – Aurorix

N 06 A X
Other antidepressants
tianeptine – Coaxil
reboxetine – Effexor
venlafaxine – Effexor, Effexor XR
hypericin – Favora

N 06 B X
Other psychostimulants and nootropics
piracetam – Oikamid

N 06 D
Anti-dementia drugs
donepezil – Aricept

N 06 D X
Other anti-dementia drugs
ginkgo biloba – Favora Ginkgo

N 06 B Psychostimulants, ADHD medications, and nootropics

Learn more: Psychopharmaceuticals http://*************/t89383/#ixzz1mvbGaNUc

Psychotropic Drugs
According to the definition established by the World Health Organization (WHO) back in 1976, psychotropic drugs are medications that influence mental functions, behavior, and how a patient perceives their reality.

The modern definition—which you can find online today via the "Medical Dictionary" on the WebMD site—isn't significantly different. It essentially states that psychotropic drugs are chemical substances that, when administered in specific doses, act in particular ways on mental life and psychological behavior.
Psychotropic drugs, or psychotropic medications, fall under what we call biological therapy for mental disorders. They can be categorized in several different ways. Here, I’ll start with the 2004 classification developed by the WHO, known as the Anatomical Therapeutic Chemical (ATC) classification system.

Under the ATC system, all medications
are sorted into 14 groups based on the primary anatomical site where the drug exerts its main effect (Level I), and then further divided into four lower levels:
Level I: Main anatomical group
Level II: Main therapeutic group
Level III: Therapeutic subgroup
Level IV: Chemical-therapeutic subgroup
Level V: INN (International Nonproprietary Name)—the generic
name of the drug

In Level I, under the N (NERVOUS SYSTEM) designation, you'll find the following Level II groups:
N 01 Anesthetics
N 02 Analgesics
N 03 Antiepileptics
N 04 Antiparkinsonians
N 05 Psycholeptics
N 06 Psychoanaleptics
N 07 Others
I won't be getting into anesthetics or analgesics in this write-up.

All antiepileptics registered here in the US are listed in Table 1a under the N03 designation. Furthermore, all psycholeptics registered in the US are found in Table 1b under the N 05 designation, subdivided into Antipsychotics, Anxiolytics, and Hypnotics/Sedatives. Table 1c, under the N 06 designation, lists all psychoanaleptics registered in the US, which are split into antidepressants, psychostimulants, ADHD medications, nootropics, and dementia treatments.
It's worth mentioning here—since people trip up on this all the time—that a drug's generic name should be written in lowercase, while the brand name gets a capital letter; after all, the brand is a proper noun.
Even though this classification is quite modern, it’s bound to spark some debate among clinicians because, technically speaking, it isn't entirely accurate.
You see, nowadays, a huge number of psychotropic drugs are used for multiple therapeutic indications, and the categories listed here only represent what the drug was originally proven effective for. For instance, many antiepileptics are now successfully used to treat bipolar disorder, certain antidepressants are the first choice for panic disorder or PTSD, and anxiolytics are effective in treating catatonia, etc.

ANTIEPILEPTICS
I'm not going to cover antiepileptics in this section, though I will circle back to their use as mood stabilizers later on.

PSYCHOLEPTICS
Psycholeptics are drugs that lower mental tone—basically, they reduce psychological activity. As shown in Table 1b, they are divided into Antipsychotics, Anxiolytics, and Hypnotics/Sedatives.

ANTIPSYCHOTICS
Terminology
The first antipsychotics discovered (up until the arrival of clozapine) were called "classic" antipsychotics or neuroleptics—essentially typical or conventional antipsychotics, or "major tranquilizers."
The reason why antipsychotics were called neuroleptics for so long stems from a scientific misconception: the idea that a patient *had* to experience what is called "neuroleptic syndrome" (from the Greek *neuron* meaning nerve plus *lepsis* meaning seizure or grip, implying a kind of stiffness) to achieve an antipsychotic effect. Even though it was quickly realized that neuroleptic syndrome isn't actually the mechanism behind the drug's action—but rather an unwanted, iatrogenic side effect—the name for the group proved incredibly hard to shake.
When clozapine was discovered in 1958, it generally didn't cause extrapyramidal symptoms in patients, yet it had a much more pronounced antipsychotic effect. Because doctors weren't ready to abandon the dogma that you couldn't have efficacy without neuroleptic syndrome, it was dubbed an "atypical neuroleptic." The following year led to the discovery of numerous other antipsychotics that also didn't trigger major extrapyramidal side effects (like Sulpiride, Risperdal, Zyprexa, Seroquel, and many others still in research phases), all of which were labeled atypical antipsychotics. Eventually, once it became absurd to have more "atypical" drugs than "typical" ones, the terminology shifted toward more accurate terms: today, instead of "atypical antipsychotics," we use "new antipsychotics" or, even better, "second-generation antipsychotics."

How Antipsychotics Actually Work
Back when chlorpromazine was first discovered, nobody really understood how its antipsychotic effects worked—it was all a mystery. It wasn't until just a few years later (around 1957) that researchers figured out it actually blocks postsynaptic dopamine receptors. In a way, this discovery—*ex iuvantibus*, as they say—actually helped pinpoint one of the core issues behind schizophrenia: basically, an overactive central dopaminergic system. This led to what we now call the dopamine theory of schizophrenia. Then, in 1958, clozapine entered the scene as a serotonin-dopamine antagonist. It turns out serotonin plays a huge role in those "negative" symptoms (the ones involving deficit), which really strengthened the whole serotonin-dopamine theory of the disorder.

What Antipsychotics Are Used For
Generally speaking, Antipsychotics are great at treating "positive" psychotic symptoms—things like hallucinations, bizarre behavior, or delusions—regardless of the specific diagnosis. Now, second-generation Antipsychotics are also effective at helping with "negative" symptoms, such as lack of motivation, social withdrawal, flat affect, or akinesia. You’ll also occasionally see them used for certain non-psychotic behavioral issues, including organic psychosyndromes, Alzheimer's dementia, intellectual disabilities, delirium, Tourette's syndrome, PTSD, and even transient
psychotic symptoms in patients dealing with personality disorders.

Common Side Effects of Antipsychotics
The thing is, Antipsychotics—especially the first-generation ones—often come with significant side effects. These can be a real dealbreaker for patients, often leading them to stop treatment altogether, which unfortunately leads to relapses. Low-potency Antipsychotics tend to cause the most noticeable anticholinergic effects (think dry mouth, constipation, urinary retention, or blurred vision), and they are frequently linked to extrapyramidal side effects like tremors, akathisia, dyskinesia, or tardive dyskinesia. Using low-potency options or clozapine can also lower a patient's seizure threshold and might cause orthostatic hypotension. Then there's agranulocytosis, which is most commonly tied to clozapine; because this can be fatal, patients absolutely have to be monitored through regular blood count safety programs to watch for potential neutropenia. Also, Thioridazine and Ziprasidone can significantly prolong the QT interval, so you have to be careful, especially with anyone dealing with cardiomyopathy. As for the second-generation drugs—specifically Zyprexa and clozapine—they often lead to weight gain and dyslipidemia, and can even be linked to new-onset diabetes mellitus. I always recommend regular check-ups for lipids, glucose, and body weight for everyone on newer Antipsychotics.

Robin Gonzalez3 said:Man, I just went and dropped all my new pills at once... damn...

http://yoursmiles.org/ksmile/monster/k3003.png

Good grief—you seriously should NEVER do that. Just remember this for next time so you don't ruin your own progress! It’s the same deal when you start any new medication regimen: you can take just a quarter of a pill for maybe a week, then slowly ramp it up over another week until you finally hit the prescribed dosage.
Seriously!

Robin Gonzalez3 said:Yeah, I really can't right now... I've got my follow-up appointment in less than two weeks... but I'm gonna reach out to my primary care doctor this Monday and see what they say...

Honestly, talking to your doctor is probably better than anything else—just try to stay calm about the medication. It sounds like you weren't quite ready to taper off yet, or maybe those withdrawal symptoms are just hitting you incredibly hard. Just curious, how did your psychiatrist tell you to scale back the Alice? You didn't just jump straight from the old dose to a new one without a gradual taper, did you? That would be wild.
You should probably drop the dose by a quarter pill for 3 or 4 days, then another quarter for the next 3 or 4 days, and just keep going until you're finished...

Robin Gonzalez3 said:Man, I just downed half of Alice's drink and I'm actually feeling better now—guess those were just some dehydration symptoms kicking in...

Well, alright then—can you reach out to a psychiatrist, and if so, when?

Robin Gonzalez3 said:fadedbear92, I think things have finally settled down a bit... even though my heart is still doing those weird little skips and my head feels totally out of it... xD—like, everything is just spinning around, you know?

Look, you really should call 911—you can't mess around when it comes to your heart...

Robin Gonzalez3 said:Hey everyone, it’s me again... honestly, I feel terrible—about to throw up right now. I think it might be from those Elizabeth pills I’ve been taking for two years; they just changed my prescription, and I’m thinking about stopping this current treatment altogether because it’s making me feel awful. I can't tell if it's the lingering effects of the Elizabeth or these new meds... but I need to go vomit, then maybe take some more Elizabeth... my heart is skipping beats, I'm sweating, and I feel nauseous... I've gotta go retch... please help, what should I do? :S

How are you feeling now that you've thrown up? Has your body calmed down at all?

Robin Gonzalez3 said:haha, thanks for the heads up🙂 I mean, yeah, I know it's on the milder side, but when you throw Haldol, Depakote Chrono, and Sanval into the mix on top of it? Man, that whole combo just has me feeling super foggy xD

Psychomotor agitation during mania, dementia, intellectual disabilities, acute and chronic schizophrenia, and alcoholism.
Muttering and hallucinations in acute and chronic schizophrenia, paranoia, and acute confusional states.
Choreiform movements. Senile irritability and aggression.

Depakene Chrono

Is that being used as a mood stabilizer? It's normally an anti-epileptic, right?

And Sanval—all of this just leaves me feeling kind of confused xD

[/I]

Good grief, who wouldn't be feeling http://photos6.socializr.com/67/32/17/673217628m.jpg

Robin Gonzalez3 said:Hey, so my psychiatrist just put me on Priscilla extended-release 25 mg... and now I’m kind of tripping over this "extended-release" thing. Like, am I supposed to suck on it or what? Anyway—oops—just swallowed it already. xD

They're just pills, haha—I take mine to help me sleep...

Well, now I’ve actually learned something new about why they call them that: "...medication tablets coated in an appropriate color using sugar or chocolate... derived from the French term *dragée*..."

http://www.mayoclinic.org/index.php?show=search

hollowviper40 said:That looks like a hell of a lot of pills.
On a side note, moving away from the Prozac talk and everything we’ve been discussing—whenever I spend too much time scrolling through this thread, I can't help but picture my friend's living room. He had this grandmother of his, well over 90 years old, basically a living mummy who just sat in the corner of the couch staring at the TV all day. If he tried to nudge her or even just acted out because he was being an idiot, she wouldn't even blink. She’d just stare him down with this cold, totally uninterested look and hit him with a single word: "Damn."

one very perceptive old lady, I must say...😂

I didn't actually expect anything dramatic to happen—it just got me thinking about the general state of mental health in our workforce... I honestly don't know when (maybe in another 100 years?) society will finally realize how vital a healthy psyche is, or even just a treated one. It always seems to get pushed to the sidelines. We live in this "instant, fast-paced, faster-than-ever" kind of society where if you aren't mentally sound, you're basically discarded because you aren't "useful" or efficient enough. Only the human machines seem to survive here... though, okay, maybe I’m getting a bit too deep into this... and I suppose that's the tone of the novel, too.
"...Writing about the heatwave in the summer of 2003, when 10,000 elderly people died in France, Michel Houellebecq suggests that this mass death—leaving seniors to perish without family support or medical care—was actually an indicator of how highly developed French society had become. He argues that youth is a fetish, while the elderly are viewed merely as economic and aesthetic burdens. The plot revolves around a religious sect promising eternal life by collecting DNA from its members to be stored for future cloning..." *The Possibility of an Island* / Michel Houellebecq... anyway, I'm totally going off-topic...😁