Everything You Need To Know About Antipsychotics

Antipsychotics are a type of medication used to treat several mental health conditions. They are mainly used for Schizophrenia and Schizoaffective Disorder, though can also be used in cases of severe Depression, Bipolar Disorder and many other conditions.

There are two classes of Antipsychotics – both of which play a huge role in treating mental health conditions. Antipsychotics are also known as Neuroleptics, as well as Major tranquilisers.

While Antipsychotics cannot cure a mental health condition, they have helped many people control their symptoms in a positive way – to the extent where they significantly improve their quality of life.  

Information on Antipsychotics

Antipsychotics provide a range of benefits. While it can take several weeks for an antipsychotic to help symptoms like delusions, hallucinations or disturbed thoughts, other symptoms like anxiety, agitation and mania should improve very quickly.

After around 6 weeks of antipsychotic medication, the full benefit should be evident.

It is crucial that a patient takes their antipsychotic how and when a Doctor has advised. This involves taking the correct dose at the right time, and taking the medication on a consistent basis.

The lowest dose thought possible to improve symptoms will initially be prescribed, although this may raise over time. In many cases, a patient will need to take antipsychotics for life.

In some disorders, recovery is possible. Even in these instances, it is recommended that antipsychotics are continued to be taken for a few months, in order to lessen the chance of a relapse.

What conditions are Antipsychotics used for?

Antipsychotics can be used in treatment of a wide array of conditions, including, but not limited to:

• Psychotic Depression
• Delusional Disorder
• Brief Psychotic Disorder
• Shared Psychotic Disorder
• Bipolar I Disorder
• Schizophrenia
• Schizoaffective Disorder
• Some Personality Disorders

What are the different types of Antipsychotics?

There are over 20 antipsychotics licensed for use in the United Kingdom. However, there are a range of other antipsychotics, but not all are licensed for use in the United Kingdom.

There are two different categories of antipsychotics. Within these two types are a range of medicines.

• Typical Antipsychotics: Typical Antipsychotics are the oldest antipsychotics. They were mainly developed in the 1950s, with many continuing to be in widespread use in modern times. Unfortunately, this group of antipsychotics are associated with many side effects, including movement and muscular side effects. While they have been somewhat superseded by newer antipsychotics, this class continue to be in use.
  • Benperidol (Anquil)
  • Chlorpromazine (Largactil)
  • Droperidol (Inapsine)
  • Flupentixol (Depixol)
  • Haloperidol (Haldol)
  • Levomepromazine (Nozinan)
  • Loxapine (Adasuve)
  • Pericyazine (Neulactil)
  • Perphenazine (Fentazin)
  • Pimozide (Orap)
  • Prochlorperazine (Stemetil)
  • Promazine (Sparine)
  • Sulpiride (Sulpor)
  • Trifluoperazine (Stelazine)
  • Zuclopenthixol (Clopixol)

• Atypical Antipsychotics: Atypical Antipsychotics are the newest antipsychotics. They were mainly developed in the 1990s, and have been in clinical use ever since. This group of antipsychotics were seen as a major improvement on the first generation antipsychotics – due to less side effects. However, they do often cause weight gain, among other (albeit milder) side effects.
  • Amisulpride (Solian)
  • Aripiprazole (Abilify)
  • Asenapine (Sycrest)
  • Cariprazine (Reagila)
  • Lurasidone (Latuda)
  • Olanzapine (Zyprexa)
  • Paliperidone (Invega)
  • Quetiapine (Seroquel)
  • Risperidone (Risperdal)

How do Antipsychotics work?

It is believed that symptoms of psychotic disorders are caused by an excess amount of a chemical in the brain called dopamine. Dopamine is a neurotransmitter – something in the brain that is responsible for messages being passed around the brain.

Therefore, antipsychotics work mainly by blocking the D2 receptor – a subtype of the dopamine receptor. In theory, this limits the amount of dopamine that the brain produces.

Antipsychotics also affect other brain chemicals too – such as other neurotransmitters serotonin and norepinephrine. These neurotransmitters are linked to mood and emotion. This is why some antipsychotics can also be effective antidepressants. How the exact process works is unknown.

Side Effects of Antipsychotics

Side effects are very common with antipsychotics. While the exact side effects associated with each particular antipsychotic will differ from medication to medication, there are some constants. With any antipsychotic, a Patient Information Leaflet will be included in the box. This leaflet provides an exhaustive list of side effects.

Side effects from antipsychotics can cause discomfort. While some will only last a few days as the body adjusts to the medication, other side effects may be persistent, and last for as long as an individual takes their antipsychotic.  

Common side effects of antipsychotics include dizziness, constipation, blurred vision, dry mouth, drowsiness, nausea, irregular heartbeat, weight gain, vivid dreams, shaking, tremors, restlessness, sedation, enlarged breasts (men and women), unwanted movements (tardive dyskinesia), low sex drive and sexual dysfunction.

Serious side effects include suicidal thoughts, seizures, and a return of psychotic symptoms – known as Tardive psychosis. Neuroleptic Malignant Syndrome – a serious movement disorder characterised by high temperature, tremors, fever, difficulty in speaking and swallowing and changes in consciousness – is a serious condition that can prove fatal. It is a serious side effect.

An overdose should be avoided. If any of the side effects in this area appear, it is important to contact a Doctor or emergency department immediately. 

Cautions of Antipsychotics

It is important to thoroughly read the Patient Information Leaflet that comes with your medication. The leaflet will include specific cautions that should be taken into consideration when taking an antipsychotic.

General considerations when taking antipsychotics include:

• It is important to tell a Doctor or mental health professional about any other medication, substance or herbal remedy that is being taken, or has recently been taken, prior to taking an antipsychotic. Antipsychotics interact with several other medications – therefore making this very important.
• Avoiding alcohol in the first few days of treatment, to allow the body to get used to the medication. If consumed during treatment, drinking alcohol in moderation is important.
• Any antipsychotic can react unpredictably with illegal drugs; therefore it is advisable to not use recreational drugs when undergoing antipsychotic therapy.
• People taking antipsychotics can often have suicidal thoughts. Suicidal thoughts may be likely to occur at the start of antipsychotic treatment.
• Antipsychotics can potentially reduce the number of white blood cells. Anyone with any blood disorders should exert caution when taking antipsychotics. This will commonly involve regular blood tests.
• Antipsychotics shouldn’t routinely be taken during pregnancy or breastfeeding. It is important to discuss this with a Doctor.
• It is common for a patient to need to undergo a physical exam, blood test and possibly a heart test, prior to engaging in antipsychotic therapy. This will help a medical professional ascertain the overall health of the person. Overall health will need to be monitored throughout treatment.

Summary

Antipsychotics can seem like a scary prospect. However, they have proven very helpful to many people around the world. In fact, they have given some people relief from their symptoms.

It is important to always weigh up the positives and negatives of taking any psychiatric medication. For anyone that does opt to take an antipsychotic, hopefully it will be a worthwhile decision.

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