Medication and Reduced IQ

April 4, 2009

The Maudsley Bipolar Disorder Project: the effect of medication, family history, and duration of illness on IQ and memory in bipolar I disorder.

This article presents evidence that psych meds make us sicker.

“Patients on treatment with antipsychotic drugs had a lower current full scale IQ, lower general memory scores, and lower working memory scores. A family history of affective disorders was associated with a higher full scale IQ, but not with either general or working memory measures. Duration of illness was negatively associated with general memory scores, but had no effect on either IQ or working memory measures.”

Remission in Bipolar Disorder

November 3, 2006

If someone figures out how to “cure” genetics, let me know. You can’t exactly pick up a bottle of Grecian Formula for Brain at the local pharmacy.

Remission is another thing altogether. That simply means that you are having an extended symptom-free period. Given that the DSM-IV bipolar criteria only require that the patient have ONE episode of mania or hypomania, some folks may remain in remission for the rest of their lives even without meds.

Science *is* empiricism. I would like to suggest that a large percentage doctors are not particularly careful in their application of the science of medicine. If they were scientific, they’d test and retest the bipolar patient’s continued need for meds instead of following the bizarre rule of thumb that once you’re on meds you need them forever. The killer is that as long as the illness is masked by drugs, it is impossible to practice “evidence-based medicine” as they disparagingly call it.

None of us on meds is being treated in an scientific manner. It isn’t scientifically valid to say that bipolar disorder causes cognitive deficits if a large percentage of the patients in the study were on meds. Antipsychotics have been *proven* to reduce the IQ by affecting the short-term memory. They aren’t the only drug to cause cognitive deficits. Lithium makes you feel as if your brain is wrapped in cotton wool.

I don’t believe that it is scientifically valid to say that bipolars must be on meds for life. If the patient stops the meds and experiences a return of symptoms… well, you’ve rewired the brain. The drugs themselves create a continued need for themselves by reconfiguring the brain’s neurons to need higher levels of serotonin in the synapses. The symptoms are bound to return, and much worse than before the drug did its damage.

Another thing about remission is that so many things besides bipolar disorder cause mood swings. Bipolar disorder has periods of remission. Things like the personality disorders, schizophrenia, schizoaffective disorder, PTSD and any of a hundred organic illness all cause mood swings. But they don’t necessarily have periods of remission, and in many cases remission just doesn’t occur.

Here – this is my particular manifestation of bipolar disorder. Three-year cycles. They come no matter what, but fortunately the meds attentuate the episodes. On the other hand, until I was on meds the cycles didn’t seriously impact my salary.

I think that it’s important, if a bipolar isn’t having remissions, to figure out why. Ultra-rapid cycling could be caused by an antidepressant, particularly in women. Newly-diagnosed bipolars often experience a great deal of fear or anxiety that might be better treated with therapy than with additional meds. Antipsychotics may ruin the patient’s ability to effectively manage the illness by dumbing them down. Sometimes it isn’t the illness, it is the meds that make bipolars disabled.

Are your drugs masking periods of remission?

Sometimes I get tired of the reverse stigma that I get for taking fewer meds so that I can continue to have a life. Isn’t that the purpose of treatment? If not, what is?

Most bipolars have the so-called milder varieties of the illness, and many of them are unfairly overmedicated and isolated from society for no good reason. It is unbearably sad to see that happening. So if I can tolerate psychosis instead of trying to medicate away every little nuance of mood or emotion, does that make me somehow inferior? I don’t f*cking think so. It isn’t pathological until it has a negative effect on my life.