I think the evidence that antipsychotics, including atypical antipsychotics, can cause cognitive impairment is pretty compelling. Is taking antipsychotics worse, or better, than leaving psychosis untreated?
Can you split the difference by taking lower dosages or getting off meds sooner? “Procedural learning in schizophrenia can reflect the pharmacologic properties of the antipsychotic treatments.” Cognitive and behavioral neurology 17.1 (2004): 32-40.
Monkeys develop working memory deficits after 1-4 months of haloperidol administration (P = 0.0000004) and recover when given a D1 agonist. If you give a rhesus monkey haloperidol, it performs worse on a working-memory task (in which, if you can remember which window had a flashing light earlier, you get a treat when you stick your face in), and the higher the dose, the worse the accuracy. Haloperidol, olanzapine, risperidol, quetiapine, and clozapine all worsened marmosets’ performance at an object-retrieval task relative to baseline.
Evaluation for the underlying cause can lead to extensive laboratory screening, on average more than 20 laboratory tests.
Despite thorough evaluation, 80% of patients with chronic urticaria have no identifiable cause of hives, commonly called chronic idiopathic urticaria.
In many cases, the pathogenesis of mast cell activation is incompletely understood and still requires further elucidation.
Three metabolic consequences occur with mast cell activation: degranulation (immediate release of mediators including histamine, serotonin, tumor necrosis factor [TNF]-α, proteases, and proteoglycans); cytokine and chemokine synthesis (leading to late-phase inflammation); and leukotriene and prostaglandin synthesis.
Depending on the stimulus, mast cell activation can involve any or all three of the metabolic processes in the production and persistence of hives.
Mast cell stimulation leading to acute and chronic urticaria can be caused by Ig E-mediated reaction, autoimmunity, direct mast cell activation, arachidonic acid metabolism, infections, physical urticarias, and systemic diseases (Box 1). And one of the consequences of this is that you may lose the ability to notice that you have lost anything. The present was simply given; I wasn’t frustrated when it refused to honor my theories. But with antipsychotics it isn’t the normal sort of drug-induced dumbness – feeling tired, or distracted, or mentally sluggish, say. It’s like your capacity for abstract thought is reduced. I did not draw correlations between present and past events, didn’t formulate ideas about the workings of things.Urticaria, also known as hives, is defined as raised, erythematous skin lesions that are pruritic and evanescent.They typically last less than 24 hours without leaving residual marks or bruising. Acute urticaria is defined as outbreaks of urticarial lesions that do not persist beyond 6 weeks.Chronic urticaria is defined as the recurrence of hives on a near daily basis for more than 6 weeks.