u/CreativeTangerine114

Someone else wrote this. It describes my experience taking the dopamine and serotonin blocking antipsychotics well.

"The experience was not merely unpleasant sedation or a collection of manageable “side effects.” It felt like a pharmacologically imposed dismantling of my mind. My thoughts became slower and less substantial; my emotions, motivation, curiosity, pleasure, spontaneity and ability to connect with other people were profoundly suppressed. Tasks that once came naturally required enormous effort, while much of my inner life seemed inaccessible.

The most terrifying part was remaining conscious enough to recognise what I had lost. I could remember being mentally alive, but I could no longer reach that version of myself. It was like being trapped behind thick glass: awake, but cut off from my emotions, intelligence, personality and capacity to participate fully in life. My body continued to exist, but the faculties that made existence meaningful felt chemically restrained.

“Lobotomy-like” is the closest description I have—not necessarily as a claim that the drug literally performed a surgical lobotomy, but because the resulting emotional flattening, cognitive impairment, passivity and loss of initiative resembled what people associate with one. The symptoms also felt brain-injury-like: impaired concentration, memory, planning, speech, motivation and emotional responsiveness. Whether or not those effects constitute permanent physical damage, the lived experience was one of being neurologically incapacitated.

Calling this simply “tiredness,” “low mood” or “reduced motivation” does not capture its severity. It was an enforced alteration of consciousness and personality—an experience of watching myself disappear while being unable to stop it. That loss of mental autonomy was frightening, disabling and traumatic."

Might be helpful if anyone is trying to describe how terrible being on antipsychotics are.

A pivotal 26-week trial compared aripiprazole with olanzapine in 317 previously treated adults. Fourteen per cent taking aripiprazole gained at least 7% of their body weight, compared with 37% taking olanzapine. Among participants who remained in treatment, average weight changed by −1.37 kg with aripiprazole and +4.23 kg with olanzapine. Aripiprazole was clearly better than olanzapine, but 14% gaining at least 7% is not weight neutrality. (McQuade et al.)

The participants were not drug-naïve. Some may already have gained weight on earlier drugs, while others may have lost weight because a more obesogenic drug was removed. The trial mainly answered what happens when previously treated patients switch to aripiprazole rather than olanzapine.

In a later study of 188 drug-naïve first-episode patients, average one-year weight gain was 9.2 kg with aripiprazole and 10.5 kg with risperidone. Treatment changes limit how much can be attributed to uninterrupted aripiprazole, but the finding directly contradicts simple neutrality. A wider meta-analysis likewise found weight gain with every antipsychotic in drug-naïve groups; aripiprazole looked neutral or weight-reducing mainly in switching studies. (First-episode study; meta-analysis)

The honest claim is: aripiprazole causes less weight gain on average than olanzapine or clozapine, but it can still cause substantial gain. Calling it “weight neutral” is misleading, especially when used to dismiss a patient’s experience.

Someone else wrote this. It describes my experience well.

"The experience was not merely unpleasant sedation or a collection of manageable “side effects.” It felt like a pharmacologically imposed dismantling of my mind. My thoughts became slower and less substantial; my emotions, motivation, curiosity, pleasure, spontaneity and ability to connect with other people were profoundly suppressed. Tasks that once came naturally required enormous effort, while much of my inner life seemed inaccessible.

The most terrifying part was remaining conscious enough to recognise what I had lost. I could remember being mentally alive, but I could no longer reach that version of myself. It was like being trapped behind thick glass: awake, but cut off from my emotions, intelligence, personality and capacity to participate fully in life. My body continued to exist, but the faculties that made existence meaningful felt chemically restrained.

“Lobotomy-like” is the closest description I have—not necessarily as a claim that the drug literally performed a surgical lobotomy, but because the resulting emotional flattening, cognitive impairment, passivity and loss of initiative resembled what people associate with one. The symptoms also felt brain-injury-like: impaired concentration, memory, planning, speech, motivation and emotional responsiveness. Whether or not those effects constitute permanent physical damage, the lived experience was one of being neurologically incapacitated.

Calling this simply “tiredness,” “low mood” or “reduced motivation” does not capture its severity. It was an enforced alteration of consciousness and personality—an experience of watching myself disappear while being unable to stop it. That loss of mental autonomy was frightening, disabling and traumatic."

Might be helpful if anyone is trying to describe how terrible being on antipsychotics are.

hey. I've had multiple episodes of psychosis. I did keto for a year and i got all the benefits and had no issues. I stopped the diet and relapsed eventually into psychosis after another year (so I had two years off meds). I stopped the diet due to a life event and found it challenging to go back onto it.

I found out the hard way that keto is something I may need to do for life if I use it to manage my mental health issues. It works. It does what I wish the medication would do for me. But as I said I found it hard to sustain.

Is there anyone else in a similar situation? Did others on this subreddit experience psychosis and manage their condition using keto?

Also how do you guys manage to sustain the diet long term? Has anyone else stopped it and struggled to restart it at times?

Thanks

Hey all.

I've had 6 episodes of psychosis over the past 9 years. Each episode has been quite life ruining and has had consequences to my life. I'm determined to put an end to them and take some medication.

I get delusional when in psychosis and on meds my delusions are non existent. I don't hallucinate or hear voices.

After the first episode I took 5mg aripiprazole for a year and it worked completely fine as a maintenance dose. I was even smoking cannabis while taking the 5mg which is a trigger for my psychosis and it kept me well protected. I then stopped the medication and realized how much better I felt off it, and proceeded to try hard to come off meds but failed a number of times and relapsed. The point is 5mg is lower than the 10,15 or 20mgs normally prescribed as maintenance doses.

I no longer smoke weed or do any drugs and don't even drink alcohol anymore.

My main issue with the meds is that they completely demotivate me and make me feel like I'm living a completely different life. I can't get anything done and everything is a complete drag. This is because of the dopamine and serotonin blocking that the meds do.

I did some research into aripiprazole and found out that at 1mg 60-70% of dopamine is blocked, 2mg 70-80%, 5mg 86% and at 15mg 90-94% and at 20mg 92-96% depending on the individual person. This data was provided by chatGPT from PET imaging studies done on aripiprazole dopamine occupancy at various doses.

I'm just wondering if anyone got their maintenance dose lower and managed to stay protected against psychosis? I'm thinking of doing a very slow taper over 2 years to try to get to 2mg or 1mg aripiprazole which still has a very large effect on the brain but might allow me to function a bit better. 5mg worked for me before so I have that as a baseline. I'm optimistic that 2mg or 1mg may in fact be more sustainable.

How did you guys try to find a maintenance dose? My plan is to get to 5mg and stay there for 6months to stabilize, then try to slowly taper to 2mg over a few months and stay there for 6months to stabilize again. If I'm functional and well I'll just keep taking 2mg. If I'm still not functional but not symptomatic I might then taper down to 1mg and try that. This is what I'm thinking now.

Has anyone managed to lower their maintenance dose? Did anyone use dopamine occupancy to find a suitable dose? Has anyone taken 2mg or 1mg aripiprazole and stayed well against psychosis?

I just want to hear people's experiences since I don't fully trust the science behind psychiatry and have been told some pretty inaccurate things by the doctors over the years. They seem to be in denial about how disabling the drugs they prescribe really are.