The use of medication is an important part of treatment for psychosis along with individual and group counselling, peer support, family therapy, school and vocational support. This combination helps people manage symptoms and improve quality of life.
Taking care of your physical health is important while taking antipsychotic medication. There is an increased risk of diabetes, weight gain, sugar and lipid abnormalities, sexual side effects. Maintaining regular appointments with your doctor and nurse can help you to have good physical health.
Antipsychotic medications are the main class of drugs used to treat people with psychosis and schizophrenia. They are also used to stabilize moods in bipolar disorder, reduce anxiety in anxiety disorders.
Goal:
- to relieve symptoms of psychosis such as delusions (false beliefs) and hallucinations (seeing or hearing something that is not there)
- Calm and clear mental confusion
- reduce the stress and anxiety these symptoms cause
- prevent further episodes of psychosis
- Reduce and control psychotic symptoms while keeping side effects at a minimum
How Antipsychotic Medications Work:
Psychosis is thought to be caused by a dysregulation of the brain chemical called dopamine. The antipsychotic medication helps modify this dopamine effect which makes the symptoms of psychosis (hallucinations and delusions) less commanding and preoccupying. It does not always make the symptoms go away completely. People may still hear voices and have delusions but they are more able to recognize what isn’t real and focus on other things like work, school, hobbies, and family.
Types of Antipsychotic Medications:
Most people are taking the second generation (also called atypical) antipsychotic medication. They can also treat mood and anxiety disorders and have milder movement related side effects. People may need to try different antipsychotics before finding the one that works best for them. This medication is available in tablets and long acting injections.
Some people may need to use a combination of medications to treat other symptoms of mental health problems or to offset side effects.
Typical Antipsychotics Include:
- Risperidone (Risperdal)
- Quetiapine (Seroquel)
- Olanzapine (Zyprexa)
- Ziprasidone (Zeldox)
- Paliperidone (Invega)
- Aripiprazole (Abilify)
- Clozapine (Clozaril)
- Risperdal Consta ( every 2 week injection)
- Invega Sustenna (monthly injection)
- Invega Trinza ( every three month injection)
- Abilify Maintena (monthly injection)
Side Effects:
Antipsychotic medication can cause side effects and these may go away as your body adjusts to the medication. The following are common side effects that people may or may not experience:
- Sedation (sleepiness, low energy)
- Weight gain
- Decreased sex drive and function, discharge from breasts
- menstrual cycle irregularities
- Dizziness
- Movement effects ( tremor, muscle stiffness)
- Restlessness
- Repetitive involuntary movements (rare)
Some people accept the side effects as a tradeoff for relief of psychotic symptoms, others find the side effects distressing.
Do not stop taking the medication until you check with your Psychiatrist or nurse.
Your side effects will be monitored closely and there are a variety of ways to help manage them. Your psychiatrist may:
- Adjust the medication dose
- Prescribe another medication to help control the side effect
- Change the medication
Dosage and Duration:
Initially a low dose of antipsychotic will be started, which may be gradually increased over time. It may take several weeks for the medication to have its full effect. If the
antipsychotic medication does not produce satisfactory results another antipsychotic can be tried.
It is recommended that you take your medications everyday as prescribed even after your symptoms of psychosis are gone. Recommended that you take medication for 2 years.
If you miss a dose take it as soon as you remember; unless it is close to the next scheduled time that you would normally take the medication.
There are other medications that may also be used to help with other symptoms such as sleeping difficulties, depression, anxiety and mood swings.
If you have questions about your medications or their side effects please contact your clinician, nurse and speak with your psychiatrist.