Antipsychotic medications (also referred to as neuroleptics or major tranquillisers) may reduce or eliminate symptoms of psychosis. They are not a ‘cure’ for mental illnesses, but can be an effective part of treatment. Psychosis can be caused by any one of a number of illnesses that affect the brain and cause the person to lose contact with reality. Some examples include schizophrenia and bipolar mood disorder.
During a psychotic episode, the person may experience delusions, hallucinations or thought disturbances. Antipsychotic medications work to minimise these symptoms. A person should begin to feel better within six weeks of starting to take antipsychotic medication. However, it can take several months before they feel the full benefits.
Antipsychotic medications and psychotic symptoms
Medical research has shown that symptoms of psychosis are associated with changes in brain chemistry. Antipsychotic medications help to restore the brain’s natural chemical balance, thereby reducing or getting rid of the psychotic symptoms. The medication can take some weeks before starting to work.
Types of antipsychotic medications
There are two types of antipsychotic medications. These are known as:
- Typical – the older type of medications
- Atypical – the newer type of medications.
While both are effective, in general, the newer medications have several advantages over the older ones, including:
- Fewer side effects such as trembling or stiffening of muscles
- Less risk of developing ‘tardive dyskinesia’ – uncontrolled movement of the person’s mouth, tongue and sometimes, other parts of the body.
Some evidence suggests that the atypical medications may be effective in improving a person’s overall mood, thinking and motivation. Although these newer antipsychotic medications are more commonly used than the older ones, some people find that the older medications suit them better.
Injections or depot medication for psychotic symptoms
Depot medication is given by injection, which releases the drug slowly over some weeks. Some people prefer injections as they find it difficult to remember to take tablets. Some people are required to take depot medication as a condition of a court community-treatment order.
It is important to discuss with your doctor the different treatment options available, and which of them might be the best for you.
Side effects of antipsychotic medications
Common side effects of antipsychotic medications include:
- Weight gain
- Loss of menstrual periods in women
- A drop in blood pressure when standing up, which can cause dizziness
- Stiffness or trembling in muscles.
Other possible side effects include:
- Fluid retention
- Sexual problems
- Dry mouth
It is important to remember that the same medication can affect different people in different ways. Not everyone will have the same unwanted side effects.
Discuss antipsychotic medication side effects with your doctor
Medication side effects can be worrying. You should immediately discuss any side effects with your doctor. To manage or reduce side effects, your doctor may:
- Change the dose you take
- Prescribe another medication
- Suggest that you change the time of day the medication is taken.
You can also manage weight gain with advice about diet and exercise.
Medication after a psychotic episode
After you have had a psychotic episode, ‘maintenance’ doses of an antipsychotic medication are important to minimise the risk of further episodes. If you suddenly stop taking antipsychotic medication against your doctor’s advice, you may have a return of psychotic symptoms.
Other treatments for psychotic illnesses
Taking antipsychotic medication is one important step in getting better, but this is rarely enough on its own. As well as medication, effective treatment for schizophrenia and related disorders usually includes ongoing clinical support in the community, psychological therapies, education about the illness and how to deal with it, psychosocial rehabilitation, and accommodation and employment support.
Where to get help
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