Living with schizophrenia and atypical medication

Experiences of taking neuroleptic medication and impacts on symptoms, sense of self and agency: a systematic review and thematic synthesis of qualitative data

“…Across studies participants provided consistent descriptions of a distinctive state produced by neuroleptics This generally consisted of lethargy, cognitive difficulties, dampened emotions and reduced motivation, which was associated with a variety of physical effects and could lead to impaired functioning. Participants in many studies complained of feeling sedated and fatigued [4,7,8,18,19,22,[24][25][26] and highlighted the strength and unpleasantness of these effects using descriptions such as 'dopey,' [27] 'zonked,' [28] feeling like a 'cabbage' [29] or 'being hit by a truck' [30]. These effects were summarised in one study as 'crippling lethargy' [31].…”

“…These effects were summarised in one study as 'crippling lethargy' [31]. Associated with this were complaints of impaired cognitive function [23,29,[31][32][33][34][35][36][37][38][39], emotional blunting [31,37,38] and loss of motivation [23,26,29,30,32,[35][36][37]40], which were again described as profound and debilitating. Across studies, participants referred to feeling they had reduced clarity of thinking, intelligence, concentration and memory and felt 'slowed down' [31].…”

“…In some studies it was noted that the experience of taking neuroleptics had made some people depressed, anxious or suicidal [27,31,32,34,36,37]. Participants in ten studies explicitly compared the general state of physical, emotional and cognitive impairment that neuroleptics produced to being a 'zombie' [26,28,29,31,32,34,37,38,42,46]. 'Others described how the medication decreased the intensity, intrusiveness or emotional impact of psychotic symptoms or unwelcome thoughts' (pg 6) [37].…”

“…Data from several studies suggested that the symptom reduction achieved by neuroleptics appeared to improve people's ability to function or 'cope' [46] and enabled some to lead a 'fairly normal life' [23,27,29,34,39,46]. The authors of one study concluded that neuroleptics worked 'not by completely removing symptoms, but by calming the self and muffling the voices enough so that life was manageable and the person felt good.'…”

“…Participants from several studies expressed how they did not want to regard themselves as having 'schizophrenia' or a long-term condition and for these people, taking neuroleptic medication symbolised an unwanted and stigmatised identity as a chronic psychiatric patient [24,29,33,38,39,44,51,52]. They felt that needing to take medication made them 'lesser people' [39] and confirmed to others that they were 'weird' [24], 'mad' [44] or 'crazy' [38], especially because the effects of neuroleptics were sometimes very visible and described as making people 'look ill' [32] or 'like a patient [29]. Neurological effects [28,32,39,42,45,46] and weight gain [23,39,45] particularly contributed to this.…”