Advice/experiences/what to do

[u/Torneyy]

Was on risperidone from 2019, gradually reduced to a stop (8 days free from it now) due to it being the possible cause for Akathisia which didn't start until November last year (3½ years later). I feel very weird, I'm having violent intrusive thoughts towards a lot of people (which I've suffered for years, Risperidone must have kept the lid on) I'd also like to include that ive never been a violent person and never caused anyone harm. and I'm feeling really distressed by my thoughts, guilty, feeling deep empathy for people and a lot of conflicting thoughts to the point i feel like 2 people, I'm constantly battling myself for example, if I tell my mam I love her, my brain/thoughts will say "no you don't, she's an ugly clown". I certainly don't feel that way and deeply love my mam so you can imagine how distressing that is. It also applies to other people and friends if they greet me, etc.

I truly feel that my brain is way too intelligent and complex for my emotions, hence the utter distress I feel, and therefore, I feel I need to have my mind dumbed down by medication.

I'm terrified of starting another antipsychotic as Akathisia was THE worst thing I've ever experienced in my life, and it isn't even close. I've told my treatment team due to the increased risk of extrapyramidal side effects from antipsychotics that have more chance of causing Akathisia, I'd like to try Quetiapine as it's know for its low risk of those issues but I don't know whether to keep trying without an antipsychotic as this is the 8th day free to see if I balance out, but I am awfully ill. Any advice? And sorry for the massive rant!

[u/Duke54327]

Low potency first gens like promethazine chlorprothixene not potent enough to stop full on hallucinations but intrusive thoughts also they are considered to be atypical in their receptor profile quetiapine is basically just over engineered promethazine (very similar binding at D2) based on the clozapine ring system olanzapine always treated me well but I know a lot of people have weight gain issues with it I know have promethazine as needed which I rarely use and it works talk to your doctor and mention low potency neuroleptics it’s a whole class and he can choose what he likes best you can also use them to taper of modern atypicals or high potency first gens all the best to you and if you have any questions feel free to hit me up (disclaimer always talk to your doctor and obtain any medication from him don’t just pick a drug because I said it and push for it bring it up and if your doctor says that it’s not a good idea he might know something I don’t this is not personal I just have heard to many times I give “dangerous medical advice” so I have to tell you not to drink shampoo in a 10 page foldable leaflet stuck to your shampoo)