What are antipsychotics?
Antipsychotics are medications that are prescribed to treat hallucinations (seeing or hearing things that aren’t there) and delusions (fixed beliefs with no basis in reality).
They are the main type of medication used to treat schizophrenia.
Antipsychotic medications may also be helpful for anxiety and agitation, and problems with mood, thinking and socialising.
Most antipsychotic medications are tablets, capsules or liquid taken every day.
Some antipsychotic medications are available as an injection. Antipsychotic medications are not addictive.
What types are there?
Examples of antipsychotic medications are amisulpride, olanzapine, quetiapine and risperidone. There are several different brand names for most of these medications.
Clozapine is another antipsychotic medication, which is used to treat people who haven’t had good results from other medications.
What should I know if I’ve been prescribed an antipsychotic?
When you are starting any new medication, your doctor should explain the expected benefits. They should also explain the possible side effects, and make sure you understand.
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- Take every dose of your medication at the time recommended by your psychiatrist.
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- When starting an antipsychotic medication, give it time to start working properly.
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- Never stop or change your medication unless you and your psychiatrist talk about it and agree to change your treatment plan.
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- If you have symptoms that you think could be side effects of medications, tell your doctor as soon as possible.
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- It can take time to find the right type and dose of medication to manage your symptoms. Work with your doctor to find what works best for you.
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- When you take an antipsychotic medication, your doctor should check your weight and do blood tests for diabetes and cholesterol levels. These checks should be done when you start taking the medication, several times during the first year, then once each year after that.
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- If you take clozapine you need to be in a special program for regular health checks.
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- Taking antipsychotic medication will not change your personality.
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What are the side effects?
Antipsychotic medications can sometimes cause side effects.
Side effects differ between antipsychotic medications and between people. Ask your doctor or pharmacist to explain the possible side effects, and ask for a printed leaflet.
If you have side effects that bother you, speak to your doctor about them. They might be able to reduce the side effects by changing the dose of medication or switching to a different medication. Some side effects can be treated with other medications.
Side effects can include:
Weight gain
Drowsiness, sleepiness
Constipation
Increased levels of blood fats and sugars and high blood pressure
Breast problems
Sexual problems
Dizziness or light-headedness
Problems with nerves and muscles
Dry mouth
How long will I need to take an antipsychotic?
How long you need to take antipsychotic medication for depends on your symptoms. Some people need to keep taking it long term.
If you have only had one psychotic episode and you have recovered well, you would normally need to continue treatment for 1–2 years after recovery.
If you have another psychotic episode, you may need to take antipsychotic medication for longer, up to 5 years. This is because the risk of schizophrenia symptoms recurring (relapse) is high for the first few years after a psychotic episode.
People who have had several psychotic episodes may need to keep taking antipsychotic medication for most of their life.
What if the medication doesn’t work for me?
If you have tried one or two antipsychotic medications and your symptoms have not improved, you will need a thorough review.
First, your doctor will check that you have remembered to take the medication regularly, check that the dose was correct, and check for other possible causes, such as medical problems or cannabis use.
Your doctor may suggest other treatments, such as:
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- psychological treatment
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- adding another medication
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- trying a depot (injection) medication
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- switching to clozapine.
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Clozapine sometimes works when other medications have not. If you need to take clozapine, you will need regular check-ups, including blood tests.
Most people will only need to take one medication, but some people may need several.
Taking antipsychotic medication every day
Many people with schizophrenia find it hard to keep taking their medications.
If you have trouble remembering to take your medication, or you are taking several different medications, ask your pharmacist to package your tablets in containers with compartments for each day. They might use a blister pack (sometimes called a Webster-Pak or Medico Pak) or a plastic container (called a dosette box). Or you may decide that a depot injection would be best for you.
It is a good idea to always go to the same pharmacy so they can keep track of all your medications and give advice about them when needed.
Can I be forced to take my medication?
You can be given treatment without your consent if you are at risk of harming yourself or others. This is called involuntary treatment. If the risks are very severe you may have to spend time in hospital while you receive treatment.
If this happens, your doctor should give you a booklet that explains your rights. If you don’t get a booklet, ask for it.
Involuntary treatment can only continue while it is necessary to keep you safe. You, and your family or carers, have the right to have the decision reviewed by an independent authority, such as a court or tribunal.
Pregnancy and breastfeeding
For many antipsychotic medications, we don’t yet know if they’re safe for pregnant women to take. Some medications could harm an unborn baby, but stopping antipsychotic medication during pregnancy is risky for the mother.
If you are planning to get pregnant, discuss this with your doctor. It’s best if you plan how to keep yourself and your baby safe before you get pregnant.
If you are already pregnant, talk to your doctor as soon as possible about keeping yourself and your baby safe during pregnancy and breastfeeding.
Other medication
As well as your antipsychotic medication, your GP or psychiatrist may prescribe other medications to manage your symptoms.
Common examples include:
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- anti-anxiety medications
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- antidepressant medications
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- medications to manage abnormal mood changes, such as lithium, carbamazepine or sodium valproate (mood stabilisers)
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- sleeping tablets
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- medications to treat the side effects of antipsychotic medications.
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It is also a good idea to take fish oil supplements – ask your pharmacist which is the best one.
REMEMBER
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- Antipsychotics are the main type of medication used to treat schizophrenia.
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- When starting an antipsychotic medication, give it time to start working properly.
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- It can take time to find the right type and dose of medication to manage your symptoms.
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- Antipsychotics can sometimes cause side effects.
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Reprinted from <https://www.yourhealthinmind.org/treatments-medication/antipsychotic-medication>