Do psychotropic meds contribute to poor decision making sometimes?

Nurses General Nursing

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Specializes in ER.

A close friend and I were visiting recently. Her husband has been on more than one anti anxiety medication since his son was killed by a drunk driver over 10 years ago.

He is a big hearted guy, although obstinate. She's worried about his latest venture, getting into even more debt by buying a property in the mountains a pretty long ways from their home. If all goes well it would be a good investment I suppose, but he is seriously overextending himself at a time when he should be securing himself for retirement.

My friend and I are both nurses and we were talking about whether anti-anxiety medications can dull common sense. Anxiety is actually a natural emotional response to protect us from risk and harm, just like pain is.

I think we all realize that we are in overmedicated society. We live in a world of sensory overload and a lot of stress. I believe that we are often masking our understandable reactions to this. The medical system just gets people on meds and keeps them on them. It's convenient, so people can keep living their hectic, fast paced lives, while drug companies make a nice profit.

Thoughts?

Specializes in Maternal - Child Health.

I don't know the answer to the question you posed, but my thought is that if he is exhibiting anxiety severe enough to require regular medication, perhaps this is not a good time to be making a major life decision. Might your friend be able to persuade her husband to see a couples therapist to work thru an apparent difference in their comfort with this financial decision?

Specializes in adult psych, LTC/SNF, child psych.

Without more specifics, it's hard to make a generalization to your posed problem. Anxiety medications alter neurochemistry but I don't believe they alter thinking in such a way to "dull common sense". Most anxiety (and psychotropic) meds have warnings to not drive, drink or make important decisions while taking those medications (until you know how this medication will effect you), so it's *possible* but I think you're thinking too much. I imagine that your friend's husband has anxiety issues, which can lead to cognitive distortions and trouble with making appropriate decisions.

People on anti-anxiety medications still experience anxiety, just like everyone else. It's just not paralyzing, crippling, impending sense of doom anxiety like the kind you get when you're having a panic attack. You're misinformed if you think that anxiety is overmedicated, that all anxiety medications are addictive and that prescribers are just getting people "hooked" on them.

Specializes in ICU, LTACH, Internal Medicine.

I am absolutely, positively, 110% believe in it. In fact, as my life circle includes many people who are high-ranked academicians and therefore prone to prolonged attacks of intence self-doubt, hesitation, anxious waiting for results of experiments, constant and deep concerns about problems no one in the whole world is able even to scratch, much less to solve, etc. I heard it more than once. It is a common opinion among science community that professional researchers shouldn't touch anxiolitics like Xanax because they dull down their natural instincts of doubting everything and make them prone to making openly stupid ideas, and should avoid antidepressants if it at all possible because they kill creative drive which is the one and only thing these guys are in fact living for. This is a world where one careless conclusion can wipe out a reputation which generally takes more than a quarter of the century to make, so people working in professional science prefer to go through their torments of creativity cold turkey instead of risking what they value above everything else.

Oh, the life of a wife of a scientist, and mother of another budding one. And, in addition to all that, a nurse :)

Specializes in adult psych, LTC/SNF, child psych.
I am absolutely, positively, 110% believe in it. In fact, as my life circle includes many people who are high-ranked academicians and therefore prone to prolonged attacks of intence self-doubt, hesitation, anxious waiting for results of experiments, constant and deep concerns about problems no one in the whole world is able even to scratch, much less to solve, etc. I heard it more than once. It is a common opinion among science community that professional researchers shouldn't touch anxiolitics like Xanax because they dull down their natural instincts of doubting everything and make them prone to making openly stupid ideas, and should avoid antidepressants if it at all possible because they kill creative drive which is the one and only thing these guys are in fact living for. This is a world where one careless conclusion can wipe out a reputation which generally takes more than a quarter of the century to make, so people working in professional science prefer to go through their torments of creativity cold turkey instead of risking what they value above everything else.

Oh, the life of a wife of a scientist, and mother of another budding one. And, in addition to all that, a nurse :)

I would love to argue with you, but you've got an interesting perspective there. I have anxiety myself and have taken prescription anxiolytics before. *I* don't think they effected me like that but YMMV.

Specializes in ICU, LTACH, Internal Medicine.
I would love to argue with you, but you've got an interesting perspective there. I have anxiety myself and have taken prescription anxiolytics before. *I* don't think they effected me like that but YMMV.

In addition to above:

I live with severe allergies and therefore have to be more careful than most people around me in terms of what I touch, what I eat, where I am, etc. I do not have clinical level of anxiety per se but I have to pay attention to things ALL. THE. TIME. When I have to take meds which dull this kind of "hyperalertness", I became a bit sloppy, to the extent that my family noticed it. I never took anxiolytics per se, but Benadryl works the same for some reason.

I remeber very clearly how once I was almost directly exposed to my worst allergen by a careless kitchen aide while in hospital. I got 1 mg or so of Versed before that to facilitate extubation but apparently was alert enough to follow all commands and breath completely on my own. In any other time, I would immediately ask to get that thing out of where it can touch my skin or something which I can touch later on. There, I just so clearly remember that huge cookie sitting right near and me thinking along the lines "oh, please... oh, I JUST DO NOT CARE, I will call someone... later on I will..."

The nurse who entered right after that almost fainted when she saw it all, and I was thinking why all that fuss ever happens when I was STAT wheeled from the room and continued to swim in bliss while the room was violently washed and decontaminated.

Irregardless of the reason he may be making inappropriate financial decisions. Maybe she could find a neutral financial advisor who would discuss their financial situation, maybe someone at their bank? Or she just needs to tell him no, we're not doing that. I know easier said than done!

Specializes in orthopedic/trauma, Informatics, diabetes.

What I have heard the most complaints about is the apathy people start demonstrating when starting anti-depressants. They aren't anxious or paranoid anymore, but they seem to lose the ability feel love, or joy they way they used to.

I have anxiety issues and I know the unmedicated me makes much worse decisions than the medicated me.

Sometimes it is hard to tell what can be attributed to medication or just a personality quirk

Specializes in Family Nurse Practitioner.
I would love to argue with you, but you've got an interesting perspective there. I have anxiety myself and have taken prescription anxiolytics before. *I* don't think they effected me like that but YMMV.

I had money on this after reading your initial response. :)

Anxiety absolutely can be crippling and often requires pharmacologic treatment however my opinion of benzodiazepines, if that is in fact what the man in OP is taking, is they absolutely can disinhibit, confuse and should rarely be used long term and almost never in geriatrics.

There is data out there indicating this class of medications in possible increased rates of dementia, falls, delirium and life threatening withdrawal symptoms with abrupt discontinuation. My biggest issue in addition to the above is that they work so well for ameliorating anxiety in a majority of cases, in my personal experience, many people have no impetus to do the necessary, often painful and slow work in therapy which will actually result in functional improvement instead continuing to pop a pill whenever uncomfortable feelings arise. Just my two cents and since none of yous paid even two cents take it for what its worth.

Specializes in Critical Care.

It depends on what exactly he's taking for his anxiety. Long term use of benzodiazepines is associated with cognitive decline and disability, although it's completely possible that he would make financial decisions that not everyone in the world would agree with, just like everybody else does.

Specializes in ER.

Ten years of antianxiety meds, after the death of his son, tells me he has issues that needs to be dealt with. I imagine his general life issues cause some trouble with decision making, more than the meds hes been on for ten years. I feel bad for him. His coping skills are well entrenched now, and hard to change.

It's possible he's going through a manic episode. Maybe he's being treated for the wrong mental illness. Let's not blame poor financial decisions on pills.

If it was my loved one, I would have them reevaluated and ensure it's just anxiety and he's not going into manic episodes.

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