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Dr. Vijayakumar D.R MBBS, DPM, DNB (NIMHANS), CCST (UK)
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Antipsychotic Medications

 

What are antipsychotic medications?

Antipsychotic medications are a group of medications given for patients who suffer from psychotic symptoms.

Some of the psychotic symptoms are a s follows

  1. Hallucinations:  A false perception in the absence of a stimulus. EG: hearing voices when alone, seeing things not there etc
  2. Delusions: A false belief which is firm. Fixed and unshakable and not accepted by other people from the same cultural background. Eg. Delusions of persecution, delusion of infidelity, grandiose delusions etc
  3. Difficulty in thinking clearly ( thought disorders)

What are the types of anti psychotic?

Anti psychotics are broadly divided into two groups

A)  Older or typical antipsychotics like haloperidol, chlorpromazine, trifluoperazine, pimozide etc

B)  Newer or typical antipsychotics like risperidone, olanzapine, quetiapine, aripiprazole, amisulpride, clozapine etc

The older and the newer medication differ in the side effect profiles.

What are the side effects of antipsychotics?

A)  Newer antipsychotics:  Some of the side effects of the newer antipsychotics are weight gain, increased appetite, sedation, hypotension, elevates the prolactin levels and cause periods to stop (amenorrhea), restlessness, sexual side effects, can raise the lipid levels. The medications can also impair concentration and have other cognitive issues.

For a complete list of side effects consult your doctor, pharmacology books or the literature given along with the medication.

If you experience any side effects on the medications consult your doctor and he will treat it appropriately or switch to a medication which does not have the particular side effect you are experiencing.

It is also advisable to discuss with your psychiatrist about the side effects before starting the medications so as to get the correct antipsychotic for you. For eg. If you are concerned about the weight gain speak to your psychiatrist and he will put you on a medication which has very less weight gain potential.

 

B)  Older antipsychotics:  Some of the side effects of the older group of medications are tremors (shakes) of the limbs, stiffness, drooling of saliva, slowness in movements, slowing down of thought processes, restlessness, weight gain, sedation, lowers the blood pressure, constipation, dryness of mouth. Long term use of older antipsychotics can cause involuntary movements of the tongue and mouth which appears like the person is constantly chewing something, this is called tardive dyskinesia (TD) which can be difficult to treat.

POINT TO NOTE:  Always weigh the therapeutic benefit with the side effect profile of the medication.

How do antipsychotics work?

Antipsychotics work on chemicals in the rain called neurotransmitters. They work mainly on a chemical called dopamine, which in excess causes psychotic symptoms. The anti psychotic reduces the action of dopamine thereby reducing the symptoms. The newer antipsychotics also act on a chemical called serotonin in the brain and give additional benefit to the patient.

Are there any alternatives to medications for psychosis?

Medications are the best and fastest mode of treatment for psychosis. Alternative forms of treatment like talk therapy will not work when patient is symptomatic, it can be used as an adjunct or add on therapy for psychosis along with medications.