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Antipsychotic medications explained Psychosis is a condition caused by any one of a number of illnesses (for example, schizophrenia or bipolar mood disorder), which affect the brain and cause the person to lose contact with reality. During a psychotic episode, the person may experience delusions, hallucinations and thought disturbances. Antipsychotic medications work to minimise these symptoms. How antipsychotic medications work Medical research has shown that symptoms of psychosis are associated with changes in brain chemistry. Antipsychotic medications help to restore the brain's natural chemical balance, thereby reducing or getting rid of the psychotic symptoms. It can take some days or even weeks before the medication starts to work. Antipsychotic medications help control symptoms Although antipsychotic medications cannot cure mental illnesses for good, they are effective in eliminating or reducing psychotic symptoms such as delusions, hallucinations and thought disorders. After the psychotic episode has passed Maintenance doses of an antipsychotic medication are also important to minimise the risk of further psychotic episodes. If a person suddenly stops taking antipsychotic medication against their doctor's advice, it can lead to a return of psychotic symptoms. Common side effects Common side effects of antipsychotic medications include: - Drowsiness
- Weight gain
- Loss of periods in women
- A drop in blood pressure when standing up (this can cause dizziness)
- Stiffness or trembling in muscles.
It is important to remember that the same medication can affect different people in different ways. Not everyone will have the same unwanted effects. Side effects should be discussed with the doctor Side effects are worrying, despite the fact that they show the medication is working. Side effects should be discussed immediately with the treating doctor. They can be minimised by changing the dose, changing the medication prescribed, prescribing another form of medication, or simply changing the time of day the medication is taken. Tardive dyskinesia Tardive dyskinesia refers to involuntary movements that appear in a minority of people who have been taking an antipsychotic medication for a long time. These movements usually involve the mouth and the tongue, although other parts of body may also develop movements. Tardive dyskinesia may be masked by the antipsychotic medication, and may only appear when medication is discontinued or the dose is reduced. Tardive dyskinesia does not respond to antiparkinsonian medication. The best way to avoid it is to use the lowest dose of antipsychotic medication possible. The new generation of antipsychotic medications In recent years, a new generation of antipsychotic medications has become available. They have fewer side effects and are as effective as (or more effective than) the older antipsychotic medications. The new medications are: Clozapine - may be prescribed for people with schizophrenia, whose symptoms are not sufficiently helped by other antipsychotic medications.
Olanzapine - may be prescribed for people with schizophrenia and related psychoses.
Quetiapine - may be prescribed for people with schizophrenia.
Risperidone - may be prescribed for people with schizophrenia and related psychoses.
Amisulpride - may be prescribed for people with schizophrenia. There is also some evidence that these medications are more effective against the 'negative' symptoms of psychosis, such as social withdrawal, loss of drive and lack of emotional expression. How long before these medications start to work? People prescribed amilsulpride, olanzapine, quetiapine or risperidone may see some benefits within six weeks. If the drug is not working, the doctor may consider adjusting the dose or replacing it with a different medication. About one third of people taking clozapine will see some benefit within six weeks. For others, it may take up to 12 months to see benefits. People taking clozapine need regular blood tests About three per cent of people who use clozapine experience a fall in white blood cell numbers. White blood cells are needed to fight infection. People taking clozapine need regular blood tests to determine if this effect is occurring. If it is, the drug is immediately stopped. Clozapine can also cause: - Sleepiness
- Weight gain
- Low blood pressure
- A fast or irregular heart beat.
- At high doses, clozapine can cause epileptic seizures. If this happens, the doctor may prescribe anti-epileptic medication or lower the clozapine dose.
Other side effects Other possible side effects may include: - Amisulpride - dizziness, drowsiness, a dry mouth, increased appetite, constipation, weight gain or fluid retention.
- Olanzapine - blurred vision, weight gain and increased appetite, sleepiness, low blood pressure, dizziness, dry mouth and constipation.
- Quetiapine - sleepiness, dizziness, dry mouth and constipation. Headaches can occur but are usually not a major concern.
- Risperidone - sexual dysfunction, loss of periods in women, upset stomach, dizziness and a fast heartbeat. Some weight gain is possible.
Some of these effects may decrease over time, while others may be helped by the doctor reducing the dose. A careful diet and regular exercise can help overcome any problems with weight gain. Things to remember Antipsychotic medications don't cure mental illnesses but can reduce, or even eliminate, symptoms. The new generation of antipsychotic medications has fewer side effects.
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