Antipsychotic Medications and DID/OSDD: What to Know
(Summary) If your prescriber has recommended an atypical antipsychotic and you have DID or OSDD, it’s important to understand how these medications can affect your system. Antipsychotics aren’t designed as a treatment for dissociation, and their impact on system communication is unpredictable. Some people find voices and switching reduced, while others notice dampened or even increased access to parts. Effects also vary by dose. This video explores what to expect and the key questions to ask your prescriber so you can make an informed decision.
Antipsychotics are often prescribed to people who report hearing voices. Newer, second-generation drugs in this class are called atypical antipsychotics.
Before I talk further about them, I want to be clear that I am NOT indicating that you shouldn’t be using antipsychotic medications. That is a discussion you need to have with your prescriber. If you are already taking an antipsychotic medication, it is very important that you DO NOT stop taking it cold turkey. The purpose of this particular video is for people who have DID or OSDD and have a prescriber who is recommending such a drug. I want you to be able to ask your prescriber questions so you can make a more informed decision before you start taking one of these drugs.
After saying these things, you probably expect that I will encourage you to resist atypical antipsychotics, but that’s not the case. What I want you to know is that the effect these drugs can have on you and your system is unpredictable. It can vary between drugs and dosages.
Antipsychotic medications may cut off communication between you and the rest of your system entirely, so that an Everyday Life Part experiences themselves as alone in the head and body. The prescriber may mistakenly believe that they have successfully treated the issue in such cases. Instead, when communication is cut off, the prescriber has prevented a system from progressing in its recovery. Sometimes, antipsychotics don’t completely cut off communication, but they dampen it. You might still hear others in the system, although they might sound quieter or further away, and you might even be able to communicate in bits, but it is usually less often than without the medication and usually takes more effort. This may be helpful to some people who are overwhelmed with voices and opinions and head noise, or it may be distressing to systems who were communicating fairly well before the medication and with medication now have to struggle. Alternately, some antipsychotics seem to have the opposite effect on some systems, leading to increased accessibility to others or ability to communicate with others in the system. In short: you won’t know how your system will respond to a medication until you try it. I’ve seen reports that the dose of the medication can be a factor in the results, which makes sense.
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