Atypical Antipsychotics – often known as second-generation antipsychotics – are a class of antipsychotics.
Atypical antipsychotics can be used to treat a range of mental health conditions – including Schizophrenia, Schizoaffective Disorder and other psychotic disorders.
The class of Atypical antipsychotics are the most-prescribed type of antipsychotic in the United Kingdom, having largely replaced typical antipsychotics. Atypical antipsychotics have less side effects and are generally safer – although both adverse effects and risks are still present.
Information on Atypical Antipsychotics
Atypical Antipsychotics provide a range of benefits. It can take several weeks for an antipsychotic to help symptoms like delusions, hallucinations or disturbed thoughts. However, other symptoms like anxiety, agitation and mania should improve very quickly. After around 6 weeks of taking the medicine, its full effects should be felt.
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.
Sometimes, recovery from psychotic conditions is possible. But even when recovery has been achieved, 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 Atypical Antipsychotics used for?
Typical antipsychotics can be used to help treat a vast array of conditions, such as, but not limited to:
- Psychotic Depression
- Delusional Disorder
- Brief Psychotic Disorder
- Shared Psychotic Disorder
- Bipolar I Disorder
- Schizoaffective Disorder
- Some Personality Disorders
What are the different types of Atypical Antipsychotics?
There are currently 10 different atypical antipsychotics that are in use in the United Kingdom. These medicines are often used as a first-line treatment for many psychotic disorders.
- Amisulpride (Solian)
- Aripiprazole (Abilify)
- Asenapine (Sycrest)
- Cariprazine (Reagila)
- Lurasidone (Latuda)
- Olanzapine (Zyprexa)
- Paliperidone (Invega)
- Quetiapine (Seroquel)
- Risperidone (Risperdal)
How do Atypical Antipsychotics work?
It is believed that symptoms of any psychotic disorder 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. Atypical antipsychotics also act on the neurotransmitter serotonin – which is linked to mood and emotion.
Side Effects of Atypical Antipsychotics
Side effects are common with atypical antipsychotics. While each atypical antipsychotic will feature different adverse effects, there are some consistent side effects.
However, atypical antipsychotics generally feature fewer adverse effects compared to the older typical antipsychotics. 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 atypical antipsychotics will often cause discomfort. Some side effects should only last a few days as the body gets used to the medication. Unfortunately, some side effects may persist throughout treatment.
Common side effects of atypical antipsychotics include dry mouth, weight gain, headaches, agitation, insomnia, constipation, sedation, tardive dyskinesia, breast enlargement, tiredness, nausea, drowsiness, constipation, akathisia, dizziness, fatigue, 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 mentioned above appears, it is important to contact a Doctor or emergency department immediately.
Cautions of Atypical 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. After the body has adjusted to the medication, it is still advisable to not consume alcohol, as it can worsen side effects.
- 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.
- 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.
- Antipsychotics should not be suddenly stopped. If an individual wishes to withdraw from an antipsychotic, it is important to gradually withdraw – best achieved by gradually lowering the dose over a period of few weeks. Sudden withdrawal can cause withdrawal symptoms, and in some cases, the potentially fatal Neuroleptic Malignant Syndrome.
Atypical antipsychotics have helped many people with psychotic conditions to control their symptoms – and generally improve their quality of life.
But they are also associated with a slew of side effects. It is important to consider your options before taking an atypical antipsychotic.
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