Antipsychotics

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Overview: Antipsychotics are a type of medication used to treat several mental health conditions. They are used mainly for Schizophrenia, though can also help in some cases of Depression, Bipolar Disorder and Post-traumatic stress disorder. Antipsychotics in low doses can also be used to help treat Dementia. There are two classes of Antipsychotics, as will be discussed. Antipsychotics are also referred to as both Neuroleptics and Major tranquilisers.

 

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How do they work?: Antipsychotics cannot help cure mental health conditions, but they are usually effective in reducing and controlling some of the symptoms associated with these conditions. These symptoms can include delusions and hallucinations, disturbed thoughts, agitation, mania and violence. The medication works by blocking the action of dopamine. It is believed psychotic episodes are caused by the brain producing too much of the chemical dopamine. The medication also regulates levels of other chemicals that are responsible for regulating mood – such as noradrenaline and serotonin.

 

How effective are they?: Research on the efficacy of Antipsychotics is generally positive. Antipsychotics are believed to work strongly on areas like hallucinations and delusions, but not so well on improving thought processes, apathy or social interaction. Therefore, using Antipsychotics alongside some form of Psychotherapy is recommended. Some Antipsychotics are believed to be particularly useful in helping treat Bipolar disorder when mood stabilisers have failed to work.

 

Treatment Course: Antipsychotics generally come in tablet form, though some can be injected or taken as a liquid if required. Once prescribed, the lowest dose that will result in improvement will be prescribed. Long-term use of Antipsychotics is generally recommended – especially with severe conditions like Schizophrenia and Bipolar disorder. Anxiety should reduce within hours of administration, though it can take a few weeks for hallucinations or delusions to be controlled. If after around a month has passed without success, it is worth talking to your GP or mental health specialist regarding switching Antipsychotics. It is highly likely you will experience some side effects early in the treatment. It is crucial however that you continue to take the tablets. Some Antipsychotics can only be prescribed by a mental health specialist, not a GP. Prior to being prescribed an Antipsychotic. a patient should undergo a blood test and physical examination.

 

Types of Antipsychotics: Antipsychotics tend to fall into one of two categories, as seen below. There are 24 antipsychotics licensed in the United Kingdoms.

 

 

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Side Effects

We recommend consulting the individual page for each Antipsychotic for information on side effects – as they differ from tablet to tablet. Furthermore, the leaflet that comes with each pack of tablets contains enhanced information on side effects. Side effects with Antipsychotics are generally difficult to manage – but the positives should outweigh the negatives. You will often see a GP during the first month of treatment to see how you are reacting.

 

The most common side effects are sedation, headaches, dizziness, anxiety, restlessness, weight gain, blurred vision, constipation.

 

The serious side effect of Tardive dyskinesia can also take place. This is where an individual will commit involuntary movements, usually in your face, legs or arms. This can be irreversible. On average 20% of patients taking atypical antipsychotics will develop the disorder, while the rate is at 30% for those on the older antipsychotics.

 

As antipsychotics interact with brain chemicals such as dopamine, the medication can affect movement. These effects are more likely when using older antipsychotics. Shaking, restlessness and spasms can all take place.

 

Sedation, seizures, suicidal feelings and weight gain are also common side effects that should be monitored closely.

 

Antipsychotics can also reduce white blood cells, potentially cause heart problems, and can result in a minor increase in the likelihood of developing Diabetes.

 

You certainly shouldn’t withdraw suddenly from antipsychotics – instead you should gradually reduce your dose.

 

If you suddenly withdraw from antipsychotics, you risk developing the severe disorder Neuroleptic Malignant Syndrome – which can be fatal. Men and people over 40 are most likely to develop the syndrome.

 

 

Cautions

As with any medication, you must be careful when taking Antipsychotics. Your GP or mental health professional should make you aware of any types of medicine or foods that you should avoid. Some frequently used medications, even over-the-counter ones shouldn’t be used with Antipsychotics. It is worth looking at the individual page of each Antipsychotic to see cautions, but an overview is provided here.

 

You shouldn’t take Antipsychotics if you have Phaeochromocytoma (a type of tumour that cases a high blood pressure) or are in a coma.

 

Antipsychotics should never be taken in conjunction with Tricyclic Antidepressants. You shouldn’t combine a first generation Antipsychotic with a second generation Antipsychotic. You should also avoid Benzodiazepines too, and any sleeping pills. Don’t take the antidepressant Trazodone together with Antipsychotics. You should also avoid Lithium – the mood stabiliser.

 

Alcohol: Alcohol acts as a sedative, therefore it is recommended that anyone taking an Antipsychotic stays away from drinking alcohol.

 

Pregnancy and Breastfeeding: Antipsychotics generally aren’t recommended for pregnant women. Taking Antipsychotics while breastfeeding also isn’t recommended. Antipsychotics have been linked to birth defects, problems for infants and other side effects.

 

Young People: Antipsychotics are often prescribed to people from 13 years and over, though it is recommended to wait until 18 to take them. Therapy should be offered as a first line of treatment for 13-18 year olds.

 

Illicit Drugs: The use of illegal or recreational drugs isn’t recommended, as they can react unpredictably with Antipsychotics.

 

As always, ensure you read the information leaflet.

 

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