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Antipsychotics suppress brain activity and that's apparently why they work to alleviate symptoms of psychosis. Additionally, these drugs produce a whole gamut of side effects, some of which directly cause extreme physical suffering. If you have never taken antipsychotic medication, you have no concept of this. If you've taken antipsychotics, you likely have a good idea of what I'm talking about. 

Metabolic type side effects of Second-Generation Antipsychotics, such as Olanzapine, are often apparent to anyone observing--unusual and alarming weight gain. With the weight comes Type-2 Diabetes. The medication additionally makes it much harder to get up off the sofa and exercise. 

When taking Olanzapine and most other antipsychotics, it is much harder than you can imagine, to move your body. If someone tells you that you ought to go jogging for some exercise, good luck. A futile attempt at making the body try to do something it won't. 

I recall I was just out of the hospital, and employed as a janitor at eighteen, and was medicated with "Prolixin", a relatively older antipsychotic, following my first psychotic break. For the job, I had to use my body and make myself do tasks. To do this, I faced massive difficulty and massive suffering, as my body exceedingly[JB1] resisted being made to move. 

To be able to perform at the job, I became medication noncompliant. I was able to pull this stunt off for about a year before relapsing. I earned ten thousand dollars in that year, 1983, at my janitor job. And back then, ten thousand was a lot, especially for an eighteen-year-old. Since that time, whenever I've made a work attempt, it has been while medicated. I've had to maneuver around the depressing effects of the medication. This has been tough, and it has been problematic. I haven't earned as much at a job since that time. 

Antipsychotics cause depression. It is a very physical form of depression, produced by a lack of available neurotransmitters. It is harder to read. In my teens, I was an insatiable reader. Upon being medicated, it is hard for me to get through more than ten pages of a book, without taking a break. In my writing, I'm forced to take short shifts with numerous breaks from the work. My brain doesn't like sustained exertion. If I wanted to exercise, such as going for a long walk, symptoms such as paranoia and agoraphobia interfere, but so does the suppression of the mind and body, produced by antipsychotics. 

I haven't truly covered side-effects of antipsychotics; I haven't even quite scratched the surface. I've discussed a couple of the effects and how they impact work and health. Yet there are other side effects, called "Extrapyramidal" side effects, that include rigidity and involuntary movements. This class of side effects doesn't happen to everyone and doesn't always happen. Yet, if you have Tardive Dyskinesia, which is involuntary movements of the mouth, tongue, neck, head and/or upper body, it is disfiguring and makes you stand out like a freak. And it is devastatingly disabling. Tardive Dyskinesia is often irreversible and may get worse if antipsychotics are discontinued. In recent years there are some new treatments for it, following fifty or more years of human suffering, affecting perhaps millions of psychiatric patients. 

If you decide to comply with doctor's orders and take prescribed antipsychotics, you are making a substantial sacrifice. 

And what if you defy your doctor's orders or even court orders? --You are making a substantial sacrifice, a much bigger one. You are putting your mental health at risk, and because of that, you are risking life and limb, not only of yourself, but also of others. Psychosis is a very unforgiving symptom of psychiatric illness. It can cause you to lose your connection with reality. When that happens, you can't rely on your mind to prevent you from making devastating, in some cases life threatening mistakes. 

Recovery back to reality from a period of psychosis often takes months to years, and it is a considerable life setback. Your life circumstances will probably be affected. Your mind and body will not be as good as they were before you became psychotic. 

Recovering from psychosis might only happen because of other people forcing you to take medication. In the absence of that, you could remain psychotic until you die. The decision not to comply with doctor's orders to take antipsychotics is usually foolish, and it will usually bring bad things upon you and by consequence upon your loved ones.  

Jack Bragen is author of "Revising Behaviors That Don’t Work," and lives in Martinez. He can sometimes be reached for reasons other than mental health advice at jackbragen@yahoo.com.