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The Most Dangerous Psychiatric Drugs: Highest Risk Medications

If you’re taking a psychiatric drug, you probably hope that you’re taking the one with the lowest overall risk.  Sure you want the drug to be therapeutic and alleviate your symptoms, but you also don’t want to take a drug with a rapid tolerance onset, debilitating side effects, and crazy withdrawal symptoms.  Many dangerous psychiatric drugs are insidious in that they provide symptomatic relief, but end up resulting in disabling long-term effects; in some cases these effects are permanent.

Some of the most extreme dangers associated with psychiatric drugs include: drug-induced psychosis, tardive dyskinesia, brain volume loss, and dementia.  Unfortunately, many patients taking these drugs are not well-informed of the long-term effects.  In fact, some general practitioners remain unaware of the latest research suggesting that certain drugs may be risky long-term treatments from a holistic health perspective.

As an example, medicating a patient with a benzodiazepine may be helpful for reducing anxiety, but daily treatment may result in rapid tolerance onset.  Eventually the patient will develop tolerance to the highest dose, and will likely experience side effects from ingestion of such a large dose.  The individual may then need to discontinue the medication, experience debilitating protracted withdrawal symptoms and may even end up with early-onset dementia several years later – all as a result of one psychiatric drug that they thought was helpful.

Criteria to Determine the Most Dangerous Psychiatric Drugs

When attempting to distinguish the most dangerous psychiatric drugs from the less dangerous (lower risk) ones, it is important to have some criteria.  Since most psychiatrists do not prescribe drugs based on “danger” and have no scale to determine potential dangers, it may be smart to do your own research.  If I were to devise a rating scale, it would incorporate the following aspects of a drug: abuse potential, long-term effects, side effects, tolerance onset, and withdrawal.

Abuse potential / addiction / dependence

Dangerous or high-risk psychiatric drugs tend to be those with a high potential for abuse, addiction, and dependence.  While not everyone will abuse them, the fact that there is potential for abuse alone should be considered problematic.  Should someone with an addictive personality get prescribed any agents with a high abuse potential, chances are that they may get abused.

When drugs are abused or taken in excess, this could lead to impaired cognitive function, adverse reactions, and in some cases even death.  Prescription drugs with high potential for abuse are commonly referenced as “controlled-substances.”  The lower the number of the “schedule” such as “Schedule II” controlled-substance, the greater the potential for misuse and abuse.

Long-term effects

We live in an immediate-gratification oriented culture, where everyone is focused on getting immediate, fast-track results with no consideration of the future.  The problem with an immediate-gratification treatment strategy is that you may get immediate relief from debilitating psychiatric symptoms, but long-term effects aren’t considered.  This is best evidenced with drugs like barbiturates and benzodiazepines; they provide potent immediate relief, but may cause neurodegeneration when taken over a long-term.

When taking any drug, you should always calculate the likelihood of long-term effects or prognosis associated with a particular treatment.  In some cases (depending on your condition) you may be forced to take a gamble on potential long-term effects (e.g. using antipsychotics for schizophrenia).  That said, you should still make sure you’re working with your psychiatrist to minimize potential of these effects.

Side effects / adverse reactions

Many people review side effect profiles of drugs, but are so desperate for symptom relief that they’re willing to put up with some side effects.  Several of the most common side effects associated with dangerous psychiatric drugs include: impaired cognitive function, drowsiness, weight gain, and sexual dysfunction.  While the side effects may be bearable for awhile, frustration associated with weight gain or impaired cognition may continue to mount over time.

Imagine if you’re taking a drug that’s making you feel less depressed, but one of the side effects is drowsiness and cognitive impairment.  This may lead to you making more errors at work and could get you fired from a good job.  In other cases, people may find that their romantic partners even become dissatisfied with them due to sexual dysfunction and/or severe weight gain associated with treatment.

Tolerance onset

Whenever considering any psychiatric drug, tolerance onset should always be assessed.  Even if you start with a low dose on an “as-needed” basis, certain drugs are associated with a rapid-tolerance onset.  These are generally “Schedule IV” controlled-substances like psychostimulants and benzodiazepines.

The problem with a rapid-tolerance onset is that a person must keep taking greater doses to achieve the same initial therapeutic effect.  Before the individual realizes it, they’ve hit the maximum daily dose or are taking supratherapeutic doses just to get symptomatic relief.  At these high doses, side effects and adverse reactions often occur and discontinuation from the drug creates a neurophysiological fiasco.

Withdrawal symptoms

Many psychiatric drugs are associated with severe withdrawal symptoms, but certain drugs are tougher to discontinue than others.  Safer drugs tend to be less potent, and withdrawal symptoms subside more quickly after discontinuation.  Certain drugs are dangerous to the point that if you discontinue too quickly (e.g. cold turkey), you could end up experiencing seizures or even dying.

For this reason, it is important to consider the severity of withdrawal in advance.  Most psychiatric drugs require a gradual titration to reduce the intensity of discontinuation symptoms.  However, some drugs take much longer than others to titrate “off” of.  Someone on high doses of benzodiazepines may take years before they successfully taper off of a high dose and an additional year before they recover.

The Most Dangerous Psychiatric Drugs

Based on the aforementioned criteria, below is a list of the most dangerous psychiatric drugs.  Keep in mind that this is not a hierarchical list, meaning that what’s listed first isn’t necessarily more dangerous than the next item on the list.  Also understand that some individuals may need to take certain drugs due to lack of other options for their particular illness.

1. Antipsychotics

Antipsychotics are commonly referenced as “neuroleptics” or “major tranquilizers.”  There are two types of antipsychotics, namely: “typical” (older antipsychotics) and “atypical” (newer antipsychotics).  These drugs function primarily as dopamine receptor antagonists, meaning they bind to the dopamine receptor to prevent excess stimulation from dopamine misfiring.

  • Abuse potential: These drugs have an extremely low potential for abuse. Most people that take them wish they had another option.  These are easily among the most unpleasant psychiatric medications to ingest.
  • Long-term effects: The long-term effects associated with antipsychotic usage (especially at high doses) are downright scary. Over a long-term most people gain hundreds of pounds in weight, and there’s a chance they may develop Type 2 diabetes, and tardive dyskinesia (a permanent uncontrollable twitch).  Plus there is substantial evidence to suggest that these cause brain volume loss (both white and grey matter).
  • Side effects: If you want to gain weight quickly, antipsychotics are the fastest track method. These drugs increase appetite significantly to the point that you’ll be raiding your fridge in the middle of the night.  The medications also severely impair cognitive function and coordination as a result of anticholinergic-induced drowsiness.
  • Tolerance onset: The tolerance onset associated with these medications is relatively slow. Most users can tolerate the same dosage for a long-term before requiring an upward titration.
  • Withdrawal: Discontinuing antipsychotics is certainly no picnic. Withdrawal symptoms are just as severe (if not more severe) than any psychiatric medication.  Various discontinuation symptoms include: insomnia, fatigue, agitation, anxiety, depression, and even psychosis. (Read: Can withdrawal from antipsychotics cause psychosis?).

Despite the heavy marketing of these drugs as antidepressant augmentation strategies, they really should be limited to being used by individuals with psychotic symptoms.  Even if they provide relief, they will cause you to lose brain volume.  The side effects are no fun, plus you could end up with permanent Type 2 diabetes, tardive dyskinesia, and even memory impairment as a result of the anticholinergic effects.

What’s horrible is that these drugs are being doled out like candy to people with relatively benign conditions like insomnia. (Read: Seroquel for insomnia).  They are approved for schizophrenia and the treatment of bipolar disorder.  That said, even people with bipolar disorder can likely find a safer medication that works than antipsychotics.

If you’re looking out for long-term brain health and overall physical health, this is a class of medication to avoid like the plague – unless you have schizophrenia and no other choice.  Those diagnosed with depression, anxiety, and insomnia should seriously consider other options.

2. Benzodiazepines

Benzodiazepines are arguably the single most effective class of medications for alleviating anxiety.  If you’re overly anxious or stressed, you can take a benzodiazepine and literally get immediate relief.  They are very fast-acting drugs, but are associated with some serious problems.  In fact, there is evidence that benzodiazepines cause dementia and possibly permanent memory impairment.

  • Abuse potential: Benzodiazepines have a high potential for abuse, and are thus regarded as a “Schedule II” controlled-substance. Many people end up becoming addicted to their effects and take more than necessary to “get high” or even just to feel calm.  They are regarded as one of the most addictive drugs, sporting a 1.83 addiction rating.
  • Long-term effects: The most dangerous long-term effect associated with benzodiazepine usage is that of cognitive impairment. This impairment was considered “moderate” to “large” and appears across all measures of cognitive function, including memory.  The GABAergic effects may also promote neurodegeneration.
  • Side effects: Some neuroscientists have argued that while a person takes benzodiazepines, they are unable to learn new information. It is well-documented that they impair cognition, but they may blunt learning abilities as well.  Various side effects include drowsiness, cognitive impairment, confusion, and disorientation.  This is certainly not a favorable side effect profile for those with cognitively demanding jobs, nor those operating heavy machinery.
  • Tolerance onset: Those taking benzodiazepines tend to notice rapid-tolerance onset. You may start out at a very low dose, but notice that within a month it’s ineffective.  The next step is increasing the dose, which after another month, that’s no longer effective.  Before you know it, you’re tolerant to the highest dose and side effects are unbearable.
  • Withdrawal: Going through benzodiazepine withdrawal is as severe as any, and can be fatal if high doses are discontinued “cold turkey.” Those that have developed tolerance to high doses usually require an extended tapering period, sometimes lasting well-over 1 year.  Even after the tapering is done, a person will likely still experience post acute withdrawal syndrome (protracted symptoms) characterized by debilitating anxiety, hypersensitivity, etc. – months (or years) after the medication has been stopped.

The dangers associated with benzodiazepines can be minimized by taking extremely low doses on an “as-needed” basis.  However, those with addictive personalities may not be able to resist taking more than their prescribed dosage.  Not only do these drugs impair all measures of cognitive function, they inhibit learning ability and may speed up neurodegeneration.

Those taking benzodiazepines may find them effective for anxiety or insomnia, but the long-term effects outweigh the immediate relief for most people.  If you aren’t sure what to take besides a benzodiazepine, you may want to consider a safer option like Clonidine for anxiety.  I’d also recommend reading the following: “Hierarchy of Anxiety Treatments” and “Xanax Alternatives.”

3. Sleeping Pills (“Z-Drugs”)

The nonbenzodiazepine hypnotics a.k.a. “Z-drugs” (sleeping pills) are commonly prescribed, yet most consumers remain uneducated of the risks associated with treatment.  Sure they’ll help bypass tough cases of insomnia for a good night’s sleep, but the long-term effects as well as side effects are alarming.  According to a 2012 study, people taking sleeping pills increase their risk of early mortality and cancer.

  • Abuse potential: The abuse potential for Z-drugs is considered to be relatively low as “Schedule IV” controlled-substances.  That said, many people find the effects of these drugs similar to benzodiazepines; both drugs influence GABAergic activity.  Due to the effect on GABA, sleeping pills have a higher potential for abuse than often perceived.
  • Long-term effects: The risks associated with long-term usage of sleeping pills are considered similar to those associated with benzos.  You may find that your memory has declined as well as your cognitive performance. Another problematic long-term outcome is an increased likelihood of early mortality and cancer – as evidenced by a 2012 study published in the British Medical Journal.
  • Side effects: These drugs carry risk of some serious side effects including: depression, impaired cognitive function, amnesia, and sometimes hallucinations. The side effects alone should steer most people away from these drugs.  Plus they may increase your level of sedation after sleep, making it more likely that your motor skills will be impaired; your likelihood of getting into a car accident increases with Z-drugs.
  • Tolerance onset: While the tolerance onset may not be quite as quick with Z-drugs as it is with benzodiazepines, tolerance is quickly established. This means that you’ll constantly need to increase the dosage of your sleeping pill in order to get relief from your insomnia. Continuously increasing the dosage simultaneously increases risk of debilitating side effects.
  • Withdrawal: It is considered challenging to cope with the symptoms associated with sleeping pill discontinuation. If you want some evidence, just read what you’ll experience during Ambien withdrawal.  Many people taking the drug are unable to discontinue due to the array of withdrawal symptoms that arise.

If you have insomnia, you should consider sleeping pills a last resort.  While they may be slightly safer than benzodiazepines, they have a relatively similar mechanism of action – acting on the neurotransmission of GABA.  Taking sleeping pills for a long-term is thought to impair cognitive performance and may lead to early onset dementia.

Individuals that consider sleeping pills a necessity may want to reevaluate their lifestyle as well as other habits.  Insomnia can generally be corrected by making some habit changes and working with a sleep expert.  Tolerance is quickly established on sleeping pills and withdrawal symptoms aren’t pleasant – just a couple more reasons you may want to avoid them.

4. Psychostimulants

Psychostimulants are drugs that function by increasing activity in the brain and nervous system.  They stimulate activity, usually via reuptake inhibition of dopamine and/or norepinephrine.  Increasing concentrations of stimulatory neurotransmitters leads to improved cognitive function, increases in physical energy, and relief from symptoms of ADHD (attention-deficit/hyperactivity disorder).  Despite the efficacy of psychostimulants, there are potential dangers to consider before taking one.

  • Abuse potential: There is significant potential for abuse associated with psychostimulants. These drugs increase concentrations of dopamine, a neurotransmitter associated with feelings of pleasure, reward, and euphoria.  Individuals may like the initial dopaminergic “high” derived from these drugs, which may lead to drug abuse and ultimately “stimulant psychosis.”
  • Long-term effects: The long-term effects associated with psychostimulants are a bit difficult to analyze. Most professionals believe that when taken at therapeutic doses by individuals with legitimate ADHD, they may actually have beneficial long-term effects.  Other researchers think that long-term usage may deplete dopamine stores and downregulate dopamine receptors.  Evidence remains conflicting regarding long-term effects: one study reported nothing significant, a second reported slight benefit, and a third reported modest harm.
  • Side effects: The side effects associated with psychostimulants are generally favorable. Not only does cognitive performance improve, but a person has more physical energy as a result of these drugs.  Unfavorable side effects include: hypertension, dizziness, headaches, anxiety, and insomnia.  That said, many people find that these drugs increase libido, improve mood, and contribute to weight loss; all of which are considered favorable.
  • Tolerance onset: Tolerance is rapidly established on psychostimulants, which is why many people need to constantly increase their dosage for therapeutic effect. A person may quickly build up tolerance to a low dose, and find that they need to continuously increase their dosage to achieve the same initial therapeutic effect.  In a relatively short timeframe, a person will have likely doubled their dosage.  The problem is that when a person reaches high doses, the side effects may become severe and ultimately lead to discontinuation.
  • Withdrawal: It is extremely difficult for most people to deal with the symptoms that arise upon discontinuation from psychostimulant drugs. Many people have reported that following Adderall withdrawal, they experienced extreme fatigue, sleepiness, weight gain, and impaired cognitive function.  Think of the withdrawal period from psychostimulants as being mostly the polar opposite of being on the drugs.

Compared to antipsychotics and benzodiazepines, the psychostimulant drugs aren’t considered nearly as dangerous.  They don’t appear to significantly impair cognitive function over the long-term.  That said, people who abuse these drugs may end up developing physical health problems as well as problems with cognitive function such as low dopamine and downregulated receptors.

For individuals who use psychostimulants responsibly and/or on an intermittent (“as needed”) bases will likely minimize many of the potential risks associated with long-term use.  Additionally, some evidence suggests that if you have legitimate ADHD, the long-term effects could actually be beneficial.  It should also be noted that there are many effective “Adderall Alternatives” that you may want to consider prior to using a psychostimulant.

5. Mood Stabilizers (Anti-Manic Medications)

Various anti-manic medications include: depakote, lamictal, lithium, and tegretol.  These medications are generally safe for most people with bipolar disorder over the long-term, assuming patients are carefully monitored.  That said, these drugs may be more dangerous than antidepressants due to the fact that they can cause liver damage and thyroid dysfunction.

  • Abuse potential: Mood stabilizers have a low potential for abuse. They are commonly prescribed for bipolar disorder to help reduce manic symptoms.  They will not produce an intoxicating high – all they do is “stabilize” a person’s mood.
  • Long-term effects: The long-term effects associated with mood stabilizers may be subject to both individual variation and the specific medication taken.  Potential long-term concerns include liver problems, pancreatitis, and thyroid abnormalities. In some cases a person may experience cognitive impairment as well – depending on the drug taken.
  • Side effects: The side effects associated with mood stabilizers are generally subject to individual variation. Some side effects may include: hair loss, weight changes, depression, thirst, or itching.  Some people may not be able to cope with hair loss and may feel as if the drugs are toxic to their body.
  • Tolerance: Most people find that they don’t develop tolerance to mood stabilizers. Many people are able to stay on the same dosage for years with sustained efficacy.  Even if an increase in dosage is required to boost efficacy of the medication, tolerance onset is gradual.
  • Withdrawal: Those discontinuing mood stabilizers like Lithium may end up dealing with discontinuation symptoms. (Read: Lithium withdrawal). The withdrawal may be more severe with certain medications than others, and subject to individual variation.  That said, the withdrawal from mood stabilizers is considered mild compared to most other psychiatric drugs.

Those with bipolar disorder benefit from taking mood stabilizers because they balance a person’s mood, preventing manic highs and depressive lows.  These drugs are considerably safer than antipsychotics when used over a long-term from a holistic health perspective.  They have a considerably milder withdrawal period as well.

Using a mood stabilizer could be justified among those with treatment-resistant depression, particularly Lithium – which has a favorable track record as an adjunct.  That said, these drugs should generally be taken only by those with conditions that warrant their usage (e.g. bipolar disorder).

What about antidepressants, are they dangerous?

Most people know that antidepressants are associated with unwanted side effects and difficult withdrawal symptoms.  That said, most newer antidepressants are considered relatively safe, even when taken over the long-term.  By comparison to antipsychotics and benzodiazepines, taking an antidepressant won’t impede your cognitive function and memory; certain antidepressants may even improve your ability to focus.

  • Abuse potential: Most antidepressant medications have no significant abuse potential. This means they cannot be taken for a pleasurable, intoxicating effect.  People aren’t buying Prozac on the streets to get high, whereas they may buy benzodiazepines and/or psychostimulants.
  • Long-term effects: A majority of antidepressant medications are considered safe when taken over the long-term. There is evidence that some medications may cause health conditions over a long-term such as: tinnitus, chronic fatigue, and idiopathic pulmonary hypertension.  However, the effects of antidepressants (assuming they aren’t anticholinergic) over the long-term are of modest concern.
  • Side effects: Most antidepressant side effects are generally of moderate concern. They are not considered harmful, but may be problematic from a holistic perspective.  Weight gain and sexual dysfunction happen to be among the two most common side effects.  Should a person experience one or both of these side effects, they may end up becoming more depressed as a result.
  • Tolerance: It is well known that antidepressants stop working as a result of tolerance. Fortunately the tolerance is relatively slow in that it usually takes at least 6 months before an individual needs to increase their dosage to achieve the same therapeutic effect.  Some people are able to remain on the same dose for years without tolerance, so there is some evidence that tolerance is subject to individual variation.
  • Withdrawal: The absolute worst aspect of antidepressant treatment is the discontinuation period. For years it was speculated that there were no significant withdrawal symptoms associated with stopping antidepressants.  Now it is well-known that people experience things like: brain zaps, dizziness, headaches, increased depression, anxiety, and even suicidal thoughts when they stop their medication.  Unfortunately, many of these symptoms can persist for months after the drug has been fully cleared from the body.

It should be noted that antidepressants are far safer than antipsychotics and tend to improve long-term outcomes for individuals with major depression.  Based on the type of antidepressant and mechanisms of action, some drugs are safer than others.  The SSRIs, SNRIs, and various atypicals are considered safe.  The certain tricyclics may be geneotoxic and/or anticholinergic – potentially causing detriment to long-term health.

Various MAOIs are also known to have a dangerous interaction with tyramine, meaning if you eat too many foods with tyramine while taking an MAOI, you could end up in the hospital.  Most psychiatrists explain this, but it is a risk that should be considered if you aren’t disciplined enough to monitor your dietary intake.

Which of these psychiatric drug classes is the most dangerous?

The argument could be made that antipsychotics and benzodiazepines are both the most dangerous.  Though they have different mechanisms of action, they are both risky long-term treatments.  Benzodiazepines have a greater potential for abuse and may disrupt cognitive function more significantly than antipsychotics depending on the dosage administered.

Despite the fact that your brain may function slightly better on an antipsychotic than a benzodiazepine, the physical side effects associated with antipsychotics are worse than those associated with benzodiazepines.  You may be unable to stop eating, and become clinically obese – leading to a cascade of other health problems including hypertension and Type 2 diabetes as a result.

This leads you to end up on even more pills just because you’ve been taking an antipsychotic.  Many of the physical health effects also influence the health of your brain; it’s a symbiotic relationship.  The withdrawal is perhaps more dangerous from benzodiazepines, but discontinuation of antipsychotics may be equally as debilitating.

Individuals taking benzodiazepines intermittently at very low doses likely won’t experience the same dangers as someone taking an extended-release version every day.  The frequency of administration and the respective dosing of each drugs dictates the harm potential, but both drug classes should be avoided unless all practical options have been pursued without therapeutic benefit.

Conducting a risk-benefit analysis: Do benefits outweigh risks?

If you are taking any of the drugs listed above, it is important to consider whether the risks outweigh the benefits you’re getting from the drug.  If you’re getting great symptomatic relief from a “risky” psychiatric drug, you may be willing to endure any potential dangers associated with treatment.  On the other hand, if you’re not getting any relief and are experiencing debilitating side effects – you may want to consider switching to a different medication.

It may be a tougher situation for someone who finds an antipsychotic working well to treat their depression, but is gaining significant weight and is concerned about long-term brain volume loss.  Assuming they’ve explored all other options and they feel as if nothing else will work, the usage of an antipsychotic may be justified.  Similarly, someone with refractory anxiety may decide that the short-term boost in quality of life from benzodiazepines is worth the risk of dementia.

What can be done to minimize risks of these drugs?

To minimize the risk associated with the most dangerous psychiatric drugs, it is recommended to only take them when necessary (e.g. benzodiazepines on an “as-needed” basis).  In addition to reducing the frequency of usage, you should also be taking the minimal effective dose.  In other words, you should slowly titrate your dosage up from the lowest possible dose until you get therapeutic benefit.

  • Take a low (yet effective) dose: If you need to take one of these drugs, it is recommended to take the minimal amount that provides symptomatic relief. By taking the minimal dosage, you decrease your risk for side effects and long-term effects.
  • Reduce frequency: Certain drugs like benzodiazepines and sleeping pills can be taken on an “as-needed” basis rather than daily. With these drugs, you should be taking them only when absolutely necessary; reduce your frequency of usage as much as possible.

If you are taking more than the minimally effective amount, you’ll develop quicker tolerance to the drug and the exogenous chemicals will make more significant changes to your physiology.  The combination of quicker tolerance and greater physiological change equals an increased risk of adverse effects, severe side effects, and/or debilitating long-term effects.

Considering individual variation vs. potential dangers

Understand that not everyone taking psychiatric medications associated with dangers will experience them.  Many people take medications such as benzodiazepines for a long-term and end up with no cognitive impairment and/or end up fully restoring their cognitive function.  Others may take mood stabilizers for decades with no adverse reactions as evidenced by their consistent blood tests.

That said, many people do end up experiencing adverse reactions (e.g. tardive dyskinesia from antipsychotics) and wish they had known of these potential dangers prior to taking their medication.  Understand that the potential dangers shouldn’t scare you away from taking a drug if you need it, but they maybe should scare you away if there are safer options.  In other words, “off-label” use of these drugs shouldn’t be considered until all other options have been explored.

To get a better idea of whether you’re more prone to these adverse reactions, you may want to consider getting some genetic testing (e.g. GeneSight). Genetic tests will help you determine how likely you are to respond to a certain drug and tolerate it with minimal side effects.  The more knowledge you have regarding how you’re likely to react, the better.

The Catch-22: Necessity of Drugs vs. Potential Dangers

If you have schizophrenia, you’ll probably need to take an antipsychotic to alleviate your symptoms.  If you struggle with incessant delusions and are hearing voices, the most effective treatment is likely to be an antipsychotic that acts as a dopamine receptor antagonist.  This helps reduce dopaminergic activity and provides symptomatic relief.  Unfortunately, most natural remedies for schizophrenia are not nearly as effective as pharmaceutical options.

The major catch-22 is that despite getting symptomatic relief, a person may gain a significant amount of weight, experience high blood pressure, and even develop permanent Type 2 diabetes – all because of their medication.  This means that you’re left to choose between: symptomatic relief and medication-induced adverse effects.

For some individuals, the adverse effects are a serious concern.  Despite the fact that illnesses like schizophrenia are severely debilitating, so are conditions like Type 2 diabetes, obesity, and brain volume loss associated with the medication.  In regards to schizophrenia, most evidence suggests that long-term health outcomes are superior among those adhering to treatment compared to those who discontinue.

The goal for most people with severe mental illness should be to get it under control, which will increase their ability to function in society and improve their quality of life.  At a certain point, medication adjustments may be warranted as a result of side effects and adverse reactions.  That said, when faced with a Catch-22, it is usually better to err on the side of symptom control.

Determining whether you could be using a safer drug…

Always work with your psychiatrist to determine whether there is a safer treatment option than the drug you’re currently taking (for whatever condition you have).  Many people fail to investigate the array of low risk treatment options that exist.  If you are concerned about the drug that you’re currently taking, do a bit of research and read up on the safest psychiatric drugs.

If you have an up-to-date psychiatrist, chances are that he or she will know the safest possible options for your condition; even if they are considered “off-label.”  Explain that you are concerned about the long-term effects and/or side effects of your current treatment and determine the other possible options.  While some people may be limited in their treatment options, others may find a drug with considerably lower risk compared to their current medication.

What do you think is the most dangerous class of psychiatric drugs?

If you have an opinion regarding the most dangerous class of psychiatric drugs, feel free to share it in the comments section below.  Mention whether you’ve endured any of the side effects, adverse reactions, discontinuation symptoms, or long-term effects discussed in the article.  If you think a particular drug is more dangerous than others in its classification, provide some reasons explaining why in the comments section.

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14 thoughts on “The Most Dangerous Psychiatric Drugs: Highest Risk Medications”

  1. This site is useful but this article is 100% wrong on SSRIs. They are very dangerous. They cause neurotoxicity, dementia, suicide, Serotonin Syndrome death and more.

    I have diagnosed neurotoxicity from them and in a wheelchair. Whoever is feeding the media BS that they are safe isn’t looking at the thousands in Facebook support groups from them.

  2. The worst side effect in my opinion with the antipsychotics is not weight gain or diabetes, but insomnia.

    If you come off of the medications your blood work will likely correct itself. Insomnia may not correct itself even afterwards if you are taking a high dosage sedative.

  3. I have a Mother who has Bi-Polar 2 disorder, the one categorized as the worst one. She began taking lithium at age 49 and nineteen years later was hospitalized for lithium toxicity. She also had been on other drugs. At age 72, she looks far worse than she should.

    She has developed balance problems, she has fallen and hit her head, she has high blood pressure! That is not even in my family because my family has some great genetic traits with low BP. She has always preferred medications to cope with her inability to sleep plus issues with “feelings of grandeur”.

    This has caused me to question many things. I do blame her doctor for prescribing the pills. Would you go this route based on these facts? People think drugs are easy to switch around, but then it is very hard. She was offered a rehab but claimed people will not treat her, for all kinds of excuses.

    So alas, these drugs can very well be addicting. If I had a magic wand, I would have helped her find a way to live more honestly, deal with her diet, deal with a lot of issues with her health and make sure she did not get started with psychiatrists.

    Oh and I will add this particular one is so obsessed with keeping her, he has stated her drug hangover symptoms are imagined and there are NO side effects. So it’s a tie between her not wanting to get better help, and this manipulative doctor that has changed the course of her entire existence.

    I will share with you something doctors will not. Many times, mould allergies and problems with good bacteria in the body cause neurological problems and interrupt our natural feel-good chemical processes in our bodies. This is one of the actual underlying reasons for many patients to have problems with their mood.

    I do not aim to be an expert I only aim to state how people need to look at the big picture of why people might feel desperate and think a drug is going to cure or help them when I have seen the opposite first hand. Good Luck.

  4. I was on benzos for two and a half months, 0.5mg twice every day. They helped me tremendously with my anxiety and I had no problem getting off them. I know a ton of people who have taken them long-term and had no problem getting off of them.

    There is the potential for abuse but these are much less problematic meds than they are made out to be unless you’re on a very high dose for a long time.

    It sounds like whoever wrote this article has a bewilderingly preferential perspective of SSRIs, which is interesting given they have caused more suicide than any other psychiatric medication and are notorious for their extremely adverse side effects. Who’s paying you, seriously?

  5. SSRIs are “relatively safe”? How can a med that has suicide or Serotonin Toxicity listed as a symptom be considered safe? The research is flawed. They cause permanent brain damage.

    Neurotoxicity, hyponatremia (permanent condition caused by both SSRIs and brain injury), dementia, suicide, etc.

    • SSRIs are considered “safe” because they typically don’t cause death in case of overdose (not the case for tricyclics and MAOIs) – serotonin syndrome can happen but it’s pretty rare.

      SSRIs are pretty well tolerated with other types of drugs–again not the case with the other two classes. This is according to my doctor when I asked about switching to a tricyclic when SSRIs became ineffective.

  6. Seroquel XR prescribed by Psychiatrist after a 20 minute interview. Lithium added by mental health Certified Nurse Practitioner. Zoloft added by same mental health Certified Nurse Practitioner. No drug or diagnosis information provided at all.

    Left on cocktail for 5 years. Off of cocktail now for 5 years. Worst 10 years of my life. Emotional and physical dysregulation off the charts. (I was taking care of my terminally ill child when “they” gave me these to help).

    Was NEVER like this before the medications. NO ONE BELIEVES ME! Lobotomy in a pill cocktail. Cannot wait until this is fully recognized as an iatrogenic condition induced by psychiatrists, mental health providers, and medical practitioners. May become an anti-neuroleptic advocate.

  7. Is kissing someone that is taking antipsychotics dangerous? I found almost zero info about it. Can saliva and other bodily fluids contain enough traces of antipsychotics as to mess with the brain/body of someone that never had to take these meds but is exchanging bodily fluids with that person? Since some of these side effects are permanent and include psychosis itself, why does no one talk about it?

  8. My psychiatrist has me on no less than meds including 3 benzos. Some were increased in June and slowly I have felt side effects such as dizziness, incoordination, blurry vision, confusion (to the point where I won’t even drive in my small town where I have lived for 14 years because I got lost 3 times)., memory loss, continuous migraines, total loss of appetite and nausea. I have lost 40 lbs. since June.

    I started to research the meds I was on about 2 months ago and didn’t like what I read so I asked my psychiatrist to reduce some, but he in fact wanted to increase one and add another and said if I wasn’t feeling well to drop my vitamins. So, I went to my GP and she was shocked at what I am on and wants me off them ASAP. The only problem is I cannot get into see another psychiatrist until March!

    I feel like I will melt into a puddle on the floor. This is a scary scenario for me. I feel betrayed by my psychiatrist whom I have been seeing for over 12 years.

  9. I am on sizodon 0.5mg (risperidone) for last 12 years due to drug abuse-related psychosis. First I was on risdone 1mg for 6 years and then titrated to 0.5mg. My left eye twitches involuntarily most of the time and I can’t remember smallest details… like where I have kept my reading glasses or when I brushed my teeth. My cognitive performance deteriorated so much that I have been jobless for more than a decade and my erectile dysfunction has created differences between me and my wife of 10 years. Moreover, my child has been born with a low IQ. Also I suffer from extreme weight gain, high lipids and have a mad look on my face. It is the worst drug of mankind.

  10. I was on every class of psychiatric drugs for 15 years. As more drugs and the dosages increased I became more confused. The psychiatrist ignored how debilitated I became and the horrific physical side effects I was enduring. By chance I had a consult with a neurologist who said I had the worst drug-induced Akathisia he had ever seen. I had no idea what Akathisia was.

    When I told my psychiatrist about this (with a letter from neurologist) the psychiatrist looked dumbfounded. How could I have gone to a so-called physician all these years who never really looked at me? I’d also been in the ICU with Seroquel induced acute pancreatitis. All this happen within 10 weeks and it was my wake-up call to taper off all the psychiatric drugs.

    I found out later my psychiatric diagnosis was bogus because other psychiatrists said there was nothing wrong with me. How could I be told I was psychotic when I was on heavily prescribed psychiatric drugs and when I went off of them I was told I was normal? The most dangerous psychiatric drugs? It has to be the neuroleptics hands down.

    There’s no way these drugs should ever be prescribed and if they are the the side effects (damage) should be explained in detail to wherever they’re prescribed to and that person’s family and friends. If my psychiatrist thinks his client is this mentally ill then he should bring in as many of this persons support system to discuss options. How can a prescribing psychiatrist give drugs to someone who doesn’t understand about informed consent?

  11. I have adult ADD and was deeply depressed from being in a failed marriage and a religious cult. Over a period of 18 years I was prescribed SSDIs, and was subsequently diagnosed with bipolar disorder, wrongly, as it turns out. I was put on high levels of Lithium, mood stabilizers, and anti-psychotics. I eventually developed drug induced Parkinsonism and went on disability.

    I was also on high levels of L-dopa and Caridopa for the Parkinsonism. After finally divorcing, I met a woman whom I had known 32 years previously, and she had me re-evaluated. My neurologist recognized the DIP, and my psychiatrist said was misdiagnosed, so together they titrated me off all drugs, and within 8 months all symptoms disappeared.

    I underwent another brain scan after this and the Parkinsonism was gone. We married, and I began working again part time, although I’m trying to explain a 3 year absence to potential employers, which is a challenge. To be succinct, I was fed drugs like candy and consented, because, after all, the doctors surely had to be experts.

    I have my life back after 27 years of a failed marriage and 18 years of misdiagnosis. To say I’m grateful is a bit of an understatement. I’ll never trust a drug from a doctor again. This is a 100% true story. Oh yes, I left the cult too when I divorced. Forgot to mention that.

  12. I met yesterday for the third time with my wife’s RN who writes the prescriptions for her bi-polar. She was taking very high doses with very adverse reactions until 6 weeks ago. If I had not gone with her to her appointment, I am sure that dosages would have been increased. Two weeks ago she was again given seroquel which she can not tolerate.

    I went with her to her appointment yesterday and when I mentioned having discussed her medications with three different pharmacists I was told not to ever come back. The pharmacists all thought that dosages and combinations were dangerous. Is this a common occurrence in the psychiatric field? Thank you.


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