#MHJ 8. Meds Check-Ins

(Note to self: I should’ve written more blogposts so it’s not like my blog is only used for me ranting about my #MHJ.)

Early December of last year, I started this #MHJ series and wrote about how in October-November 2021 I suffered from depressive episode(s). I’ve written about the first visits to my psychiatrist (which I’m still seeing on a monthly basis), the experiences of getting through BPJS bureaucracies, and my diagnoses of ADHD and Bipolar Disorder. To let me function better in life and –essentially– make my brain not working against myself, I’ve been taking multiple pills daily to help me control the disorders. The thing is, 3 out of 5 of my former and current prescribed pills are classified as psychotropics here in Indonesia. This is a check-in post for this topic.

From healthline.com, a psychotropic is defined as any drug that affects behavior, mood, thoughts, or perception. Permenkes Nomor 2 Tahun 2021 tentang Penetapan dan Perubahan Penggolongan Psikotropika classifies legally-available psychotropics into 4 groups (Golongan I, II, III, and IV), as a local adaptation of the Convention on Psychotropic Substances treaty. These groupings are based on the substances’ medicinal uses, how addictive they are, and their potential for abuse.

Psychotropics are heavily regulated, in which possession and/ or conveyance of them without proper authorization are seen as criminal offences that could result in fines and jail time. You’ve seen some celebrities got in trouble for that, namely Lucinta Luna (Riklona/ Klonazepam — Golongan IV), Roy Kiyoshi (Diazepam & Dumolid/ Nitrazepam — both Golongan IV), Daniel Mardhany from Deadsquad band (Prohiper/ Methylphenidate — Golongan II), and Almh. Vanessa Angel (Xanax/ Alprazolam — Golongan IV) (though this one is a little bit tricky because she took them under doctor’s surveillance, but the problem was that the official prescription was still on her hands).

Undang-Undang Republik Indonesia Nomor 5 Tahun 1997 Tentang Psikotropika
Pasal 62
Barangsiapa secara tanpa hak, memiliki, menyimpan dan/atau membawa psikotropika dipidana dengan pidana penjara paling lama 5 (lima) tahun dan pidana denda paling banyak Rp. 100.000.000,00 (seratus juta rupiah).

I am currently on prescription for 2 psychotropics. One is methylphenidate (Golongan II) for my ADHD and one is alprazolam (Golongan IV) for… I’m not sure, actually. The third med I no longer take is clobazam (Golongan IV). I will break down my experiences of taking each of these meds to help my disorders.

A. Methylphenidate 10mg

From MedlinePlus.gov:

"Methylphenidate is used as part of a treatment program to control symptoms of attention deficit hyperactivity disorder (ADHD; more difficulty focusing, controlling actions, and remaining still or quiet than other people who are the same age) in adults and children. … Methylphenidate is in a class of medications called central nervous system (CNS) stimulants. It works by changing the amounts of certain natural substances in the brain. " 

I love methylphenidate especially because HOW FREAKING HARD IT IS TO OBTAIN, LIKE, HOLY GHOST!!! that makes me feel pretty exclusive lol. AFAIK, in my city, only certain psychiatrists and 3 establishments (2 pharmacies + 1 psychiatric hospital) that have the legal authority to prescribe/ dispense this med, and the administration processes behind it are complex. Each pharmacy could only work with 1 psychiatrist and will not take prescription from any other doctor. Also, they require the original prescription and the patient’s ID card copy for their monthly report to the central government.

Aside of its logistical nightmare, I feel that this med definitely helps me. The two effects most noticeable are I get less fidgety and it shortens my time-blindness. My brain also gets less easily distracted; at least until the med wears off (it lasts for 4-6 hours) and then it’s back to the usual Noisy FM up there. So, I’m still looking for ways to prolong the effect and keep the momentum going for the rest of the day when I’m on it.

Decrease in appetite is present, too, but it doesn’t really affect me as I don’t eat much anyway. The problems that methylphenidate don’t solve (yet?) are my inability to focus on boring tasks and my bad sleeping habit. I often still go to bed at 1:30am. Maybe that’s why my doctor also prescribes me depressant in the form of alprazolam.

B. Alprazolam 1 mg

Ah, the classic Xanax. From MedlinePlus.gov:

"Alprazolam is used to treat anxiety disorders and panic disorder (sudden, unexpected attacks of extreme fear and worry about these attacks). Alprazolam is in a class of medications called benzodiazepines. It works by decreasing abnormal excitement in the brain."

Almost funny story: The first time I get prescribed alprazolam, my doctor mistakenly wrote it as ‘take it in the morning’ pill. The next appointment –which was a month after that–, I told him I would always get very sleepy at around 1 PM and oftentimes naps were unavoidable because of it. He realized the mistake and explained how it has always been supposed to be an evening pill. So, yeah, this med had made me took daily naps for one full month once.

Anyway, from what I read, Alprazolam is not commonly used to treat bipolar disorder. My doctor only said that it would/ should improve my sleep quality. Whether that’s true or not, I’m still feeling the benefit of taking it alongside Depakote. I become less chaotic and panicky in general. Plus it intensifies my nihilistic view –which I’m not sure whether it’s a positive or negative effect, let’s be honest here. In short, I’d give this med a thumbs up.

Another story: I have a friend who used to take drugs for recreational purposes, and when I mentioned that I practically have a stash of generic Xanax with me, he looked surprised slash enthusiastic (Him: “Ooh, can I have one?” Me: “Of course not! I need it to function.”). I still can’t comprehend why it appeals to him so much and wondering how different the effects are on him. Because for me with my condition, I would never categorize it as fun, moreover recreational.

C. Clobazam 10 mg

From MedlinePlus.gov:

Clobazam is in a class of medications called benzodiazepines. It works by decreasing abnormal electrical activity in the brain.

My short review: Nope. Didn’t feel any effect with this one at all, positive nor negative.

I want to end this post with a reassurance or maybe a reminder for people who are currently considering getting help for their mental health, or have just getting started, or maybe at the same spot with me which is right in the middle of it:

Getting help for your mental health is like reading an adventure book with many chapters in it; and some of it could be very long. You may get detoured from your main quest. There would be many unpredictable parts.

But you,

you have to keep reading,

to get

to the happy ending.

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