Awakening on Antipsychotic Medication: A Call to Action

• Published in: Psychiatric rehabilitation journal 2024-12, Vol.47 (4), p.283-290
• Main Authors: Deegan, Patricia E., Stiles, Allison, Rufo, Missy, Zisman-Ilani, Yaara
• Format: Article
• Language: English
• Subjects: Adult; Antipsychotic Agents; Decision Making; Drug Therapy; Experiences (Events); Female; Goal Setting; Human; Humans; Male; Mental Disorders - drug therapy; Mental Disorders - rehabilitation; Middle Aged; Neuroleptic Drugs; Psychiatric Rehabilitation; Rehabilitation; Serious Mental Illness; Shared Decision Making; United States
• ISSN: 1095-158X; 1559-3126; 1559-3126
• DOI: 10.1037/prj0000608

Objective: Explore a lived experience perspective on using antipsychotic medicine and call to action for psychiatric rehabilitation practitioners to get involved in preparing people diagnosed with serious mental illness (SMI) to have a voice and choice in antipsychotic medication treatment. Methods: A first-person account of awakening on an antipsychotic medication for the first time is used to understand the lived experience and challenges of using it. Lessons learned are amplified through de-identified queries of the CommonGround database capturing concerns about antipsychotic medication of people diagnosed with SMI in public sector mental health clinics in the United States. Results: Lived experience of "me-on-medicine" included embodied and perceptual changes to self when taking antipsychotic medications. Discordance between the team's goal and personal goals for medication treatment interfered with recovery. Analysis of more than 100,000 concerns about antipsychotic medications expressed by 57,370 CommonGround users showed the most frequent concerns are that medication is perceived as unhelpful (21%), side effects (13%), impact on health (12%), and concerns about feeling unmotivated to use medication (8%). Among CommonGround users below age 30, low motivation to take antipsychotics was the third most prevalent concern. Among CommonGround users over age 30, concerns about the impact on health were the third most dominant. Conclusions and Implications for Practice: Psychiatric rehabilitation practitioners can support people diagnosed with SMI getting prepared to participate in decision making about antipsychotic medications with psychiatric care providers by identifying concerns and building skills and strategies to negotiate the new "me-on-medicine." Impact and Implications It can be challenging to use antipsychotic medications, especially if they are experienced as interfering with our goals or changing us in ways we do not like. Psychiatric rehabilitation practitioners can support people in becoming empowered self-advocates with their psychiatric care providers in order to get the treatment that is right for them.