Factors Influencing Medication Effects & Side Effects

I see so many posts about meds working and not working or causing nasty sfx, etc., that I thought it might help to run down the following info about the influencing factors I know of from both education and observation that are most commonly observed:

  1. Co-morbid abuse of or addiction to alcohol or street drugs. Far and away the most often-seen correlative.

  2. Lack of appropriate, functional support from family members, other intimates and the health-care providers.

  3. Inconsistent use of prescribed medications. The anti-Ps, anti-As and anti-Ds all have half-lifes. If they’re not taken on schedule, or suddenly discontinued, one may experience withdrawal and rebound effects.

  4. Over-medication. A very common problem, especially if the prescriber is not a more sophisticated, board-certified psychopharmacologist (regardless of whether he or she is an MD, and DO, an NP or a PA). I have seen a lot of pts do better on lower dose levels, but NOT everyone, by a long shot.

  5. Stress. Too little as well as too much. Some stress is useful; too much is not. If the autonomic nervous system is regularly in “fight or flight” (let alone “freeze, freak, flop or fry”), the meds may not only not be able to get the job done but make things worse (as with negative symptom pts).

  6. The principle anti-P is no longer effective owing to neuroplastic changes the med itself – or many other other factors – may have induced.

  7. Poly-pharmacy. A lot of sz pts (especially those with negative symptoms) are on "cocktails* used to try to balance the neurostimulant vs. neurodepressive effects of other meds, as well as mood levelers and minor tranqs. What may have worked well together before may not work well now.

  8. Abuse of PRN-used minor tranquilzers, especially benzodiazepines like Ativan lorazepam, Klonopin clonazepam, Valium diazepam and Xanax alprazolam.

  9. Over-dosing or overly long-term use of other anti-anxiety agents like BuSpar buspirone, Inderal propanolol or Catapres clonidine.

  10. Diet. Unfortunately, a lot of sz pts are drinking way too little water, drinking way too much coffee or other caffeinated beverages, eating junk food, eating way too much bread, eating way too much sugar, etc., etc., etc.

I think it’s a really good idea for pts – or those living with them – to keep a record of what the pt is taking (including street drugs), and how he or she is doing.


Number 1) Very guilty of that 6 years ago. It was amazing how much punch Seroquel had when I got out of detox and rehab.

  1. that was pretty much the only thing on your list that worked out well for me. I’m very lucky for the family I have.

  2. Guilty of on again… off again meds… or skipping or forgetting.

  3. I think I was on too much Seroquel at one point because when it got cut by more then half… I felt like my whole existence was waking up.

  4. took classes for stress management and anger management… that has helped me keep an eye on my red flags.

  5. I’m afraid of that one… when I was younger, I always did wonder if I just “out grew” my meds. I hope this combo will work for a while more… that trial and error part gets to me.

  6. Again… hope this combo of Latuda/ Seroquel will hold a while longer

  7. Guilty of that and had to work to keep an eye on it… trying to use other methods to stress control and anxiety control. Just learning meditation and mindfulness. Have a long way to go.

  8. Some how I missed that one… :relieved:

  9. very guilty of bad diet and too much sugar and far far too much coffee… So I have managed to stop smoking… cut down on the bread, drink more water and this is the hard one… cut back on the coffee.

Thank you for posting this.


Thank you for posting this writing!

I do well.


Yeah, good list.

Fortunately, 1) this doesn’t happen a lot, and 2) it is very well understood by sz specialists. There are so many alternatives now that some combo – if not just a one-to-one switch – will get the job done about 95% of the time… IF the pt is dealing well enough with the other nine issues listed in the original post.

If one wanted to know pretty much everything about meds, interactions and sfx, and have about $70 US to blow, one can get this: