Antipsychotic Medications: Classifications, How Does It Work, Withdrawal Symptoms & Side Effects of Antipsychotic Medications
Psychosis is a general term to describe the disorder which affects the mental condition of the person. Antipsychotic medicines are used to treat psychosis and similar conditions that cause undesirable mental symptoms. In this article, we discuss all that you need to know about antipsychotic medications.
Antipsychotic medications are effective in reducing the symptoms (delusions, hallucination) of psychotic disorders like schizoaffective disorder, schizophrenia, bipolar disorder. Most antipsychotics are in a tablet, capsule or liquid form. They are strictly available only on a prescription. They are also used to treat severe anxiety and some kinds of physical problems.
What is Psychosis?
Psychosis is a general term to describe the disorder which affects the mental condition of the person. The people who suffer from psychosis experiences hallucinations or delusions or both. They see or hear things which do not exist in real life. At times, it can be very scary and can cause them to harm themselves or other people around them. However, sometimes people with a mental disorder may appear completely normal but may have episodes due to their condition. Schizophrenia is one such mental condition that causes delusions, hallucinations, lack of motivation and difficulty in concentration. Studies suggest that Schizophrenia is prevalent across the globe and it affects men and women equally but may have an early onset in men.1
Some of the most common symptoms of psychosis include the following
- Difficulty in concentrating
- Catatonia (unresponsiveness)
- Problems in sleeping
Complications of Psychosis
While psychosis can be a problem for a person, the treatment and some antipsychotic medications too can cause more trouble. Some of the complications of psychosis include,
Tardive Dyskinesia: It causes muscle changes that are not under human control. This is a very rare condition. Long-term use of antipsychotic medications can lead to Tardive Dyskinesia. Even after quitting antipsychotics, some people are not able to recover from this.
Suicide or self-harm: People going through psychosis are more likely to harm other people or try committing suicide.
Drugs or Alcohol misuse: People having psychosis try to take high amounts of drugs with hopes of reducing the symptoms but it may end up causing other problems or worsening them. This can ultimately result in drug addiction or alcohol abuse.
Causes of Psychosis
While the exact cause of psychosis is not clear, some factors may contribute to the problem. Some of them are given here.
Hormones: Changes in hormonal levels or sleep disruptions can cause psychosis
Brain Changes: Changes were discovered in brain chemicals in people who have psychosis.
All you Need to Know about Antipsychotic Medications
Anti-psychotic medications are used to treat psychosis and related disorders. It is necessary to know about antipsychotic medications to be able to use them judiciously. Psychosis is a problem, often seen in many mental illnesses and are often treated with antipsychotic medications. While each of these conditions has its own set of symptoms, psychosis may often be seen.
Schizophrenia: It affects the person’s thinking and feeling the ability and also how the person acts.
Schizoaffective Disorder: The person going through it, faces abnormal thought processes and an unstable mood.
Bipolar Psychosis: It causes periods of depression and periods of abnormally elevated mood. It was earlier known as manic depression.
Psychotic Depression: The person faces a major depressive episode with psychotic symptoms.
Delusional Disorder: In this condition, the person experiences delusions but no hallucinations like thought disorders.
Classification of Antipsychotic Medicines
When discussing anti-psychotic medications, it is necessary to understand their classification.
First-Generation Antipsychotics, also known as Typical Antipsychotics (Neuroleptics)- They were discovered and licensed in the 1950s. This type of antipsychotics includes perphenazine, fluphenazine, haloperidol. These block the subtype of the dopamine receptor called D2.
Second-Generation Antipsychotics, also known as Atypical Antipsychotics- They were discovered and licensed in the 1990s. This type of antipsychotics includes ziprasidone, olanzapine, lurasidone. These are most commonly used in the United States. These block the D2 receptor, as well as, a specific subtype referred to as the serotonin receptor, the 5HT2A receptor.
Clozapine - An Antipsychotic
Clozapine is the most effective antipsychotic but it can also cause serious side effects which can be fatal at times.
When other medications and therapies fail to reduce symptoms of psychosis, clozapine is the choice which is can be used because it is highly efficient. Clozapine can also be used to treat tardive dyskinesia. When severe symptoms of psychosis are indicated, the clozapine is used.
Depot Antipsychotics refers to psychosis medications which are given as injections every 2-4 weeks, not as medicines. The medication is released slowly during this period of time.
How Do Antipsychotic Medications Work?
Usually, overactivity of a brain chemical called dopamine causes psychosis. Dopamine is a chemical which is released by nerve cells to send signals to other nerve cells.
Antipsychotic medications help in blocking the overactivity of dopamine. This leads to reduced symptoms of psychosis and enables to concentrate more on their work or studies.
It can take up to 6 weeks from the first dose to start reducing symptoms and may take several months when the person feels its full effect.
Considerations While Taking Antipsychotic Medications
Antipsychotic medicines shouldn’t be shared with another person. The prescription is designed according to the symptoms and health conditions of a particular person, it cannot be used by another person.
- The dose should be taken as per the prescription. Taking a high dose can harm the person and taking a less dose can reduce its effectiveness.
- The medicines shouldn’t be exposed to heat, so they should be kept in a container in a cool and dry place.
- They should be kept at a height, where children are not able to reach them.
How Long The Person Needs To Take Antipsychotic Medications?
The dosage and duration of antipsychotic medications basically depend on the symptoms of psychosis. Some people may need them in the short-term, while some have to take it for the long-term.
Usually, if a person had only one psychotic episode and recovered well, then they may be advised antipsychotic medications for a shorter time duration (around 2 years) after recovery. However, for people with more than one episode, long term treatment with antipsychotic medications may be needed. Those people who often experience psychotic episodes and face difficulty in recovering, they have to take antipsychotic medications for a very long time, sometimes they have to take them for a lifetime.
Antipsychotic medications help to control the following major symptoms of psychosis,
- Hallucinations- The person hears voices which are not real.
- Delusions- The person sees things which aren’t real.
- Extreme mood swings
- Severe Depression
- Thought Disorder- The person is not able to think properly.
Withdrawal Symptoms of Antipsychotic Medications
A person may experience the following withdrawal symptoms on reducing the dosage or discontinuing the antipsychotic medicines.
Side Effects of Antipsychotic Medications
Some side effects of antipsychotic medications can be very severe when taken in high doses. However, the body adjusts accordingly after some time and the side effects may reduce. Alternatively, the dose of the antipsychotic medications may have to be adjusted to be tolerable. Studies have shown that with careful evaluation and dose reduction or addition of other medicines, some side effects of antipsychotic medications can be managed.2
But the dose of medicines should only be reduced gradually and with medical advice, as cutting down suddenly may cause effects like vomiting, dizziness, and nausea.
Some of the common side effects of antipsychotic medications include the following
The long-term use of antipsychotics can have adverse effects like gynecomastia, weight gain, involuntary movement disorder, and impotence.
How to Reduce the Side Effects of Antipsychotic Medicines?
Follow medical advice and a healthy lifestyle to reduce the side effects of antipsychotic medications,
Regular Exercise and hiring an expert for a good diet plan which includes low-sugar and high-fiber food. It can reduce the chances of getting diabetes and gaining weight.
Drinking water and brushing regularly may help in reducing dry mouth.
Psychotherapies to Cure Psychosis or Alternatives to Antipsychotic Medications
Apart from antipsychotic medications, there are various therapies with the help of which psychosis can be managed.
Support Groups: People who have a similar experience of hallucination (hearing voices that aren’t there in real life) come together and discuss how they cope with it.
Awareness: This program helps the person and his/her families to know better about the disorder and how can they deal with it and treatments available.
Family Therapy: In this therapy, the whole family is involved. The professionals give them practical advice to cope with day-to-day problems.
Cognitive Behavior Therapy: It is a talking therapy. If a person is facing distressing and severe psychotic symptoms, this therapy can help them control those symptoms feel less distressed.
Antipsychotic medications help in reducing the symptoms of psychotic disorders like schizoaffective disorder, schizophrenia, bipolar disorder. There are two types of antipsychotic medicines, first-generation and second-generation.
Clozapine is the most effective antipsychotic but it can also cause serious side effects which can be fatal at times. It is used when other medications or therapies fail to reduce symptoms of psychosis. Depot Antipsychotics is a type of medication which is given through the injections every 2-4 week, not through tablets or capsules.
Antipsychotic medications can cause some side effects like dizziness drowsiness, nausea. The long-term use of antipsychotics can cause adverse side effects and other problems. These can be managed with dose adjustment, so follow medical advice. Drinking water and brushing teeth regularly can reduce side effects like dry mouth. The antipsychotics decrease the dopamine level to reduce its overactivity.
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