Schizophrenia and related disorders istreated with antipsychotic medication. The conventional antipsychotics were created in the min 1950s. The commonly used medications include: halopendol, fluphenazine, chlorpromazine, and perphenazine.
Newer medications, called “atypical” medications were designed in the 1990s.
A very effective medication is clozapine. It treats the hallucinations, breaks in reality, and other psychotic symptoms from which those with schizophrenia may suffer. While it is effective it can also cause a serious health problem known as agranulocytosis. Agranulocytosis is the loss of white blood cells that help fight infections. Because of this, those on clozapine have to endure additional weekly blood tests to check the white cell count. Additional tests can make clozapine a cost prohibitive solution despite how effective it is.
Clozapine is not the only medication to cause agranulocytosis. While less likely to occur it has been reported with these medications:
- Lurasidone (Latuda)
- Ziprasidone (Geodon)
- Paliperidone (Invega)
- Olanzapine (Zyprexa)
- Risperidone (Risperdal)
- Quetiapine (Seroquel)
- Aripiprazole (Abilify)
What side effects can be expected?
As with any medication, there are some side effects. More often the side effects dissipate over time or become more manageable. Since one of the main side effects of antipsychotic medications is drowsiness, you should not drive until you adjust to your medication. Other side effects include:
- Blurred vision
- Skin rashes
- Rapid heartbeat
- Menstrual problems for women
- Sensitivity to the sun
- Dizziness when changing positions
In addition to these side effects, atypical antipsychotics can also change the patient’s metabolism and cause significant weight gain. The change in weight can also increase the person’s risk for high cholesterol and diabetes. While taking an atypical antipsychotic, doctors should monitor lipids, weight and glucose levels.
Physical movements can also be affected by antipsychotic medications. Patients may experience:
- Persistent muscle spasms.
Extended use of antipsychotics have been linked to the condition tardive dyskinesia, or TD. A person suffering from TD will have muscle movement he or she cannot control, with the most common area being around the mouth. TD symptoms range from mild to severe. Sometimes a person can recover partially from TD by ceasing medication. Others never recover from the disorder.
Those taking typical antipsychotic medications are more likely to develop TD. Approximately 5 percent of patients taking typical antipsychotic medications develop TD. As new atypical medications are developed, fewer people are developing the condition. Anyone taking antipsychotic medication should speak to their doctor before stopping medication.
How do people react and how are antipsychotics taken?
Those suffering from schizophrenia usually see symptoms like hallucinations and agitation goes away within a few days of starting medication. More severe symptoms such as delusions go away within a few weeks. It can take up to six weeks to see full improvement of symptoms.
Everyone responds differently to medication. Unfortunately, there is no way to know how a person will respond before administering the medication. Often there is a series of trial and error to get the right mix of medications. Patients must be willing to work with their doctors to find the right prescription and dose.
Sometimes symptoms do get worse or comeback. This is known as a relapse. The main reason for a relapse is the person has stopped taking the medication or is only taking the medication on occasion instead of as prescribed. Some reasons for this are they feel they don’t need the medication or they don’t like the side effects from the medication. Patients should not stop taking medications without being directed to do so by their doctor. These medications require gradual reduction prior to stopping.
Antipsychotics are given as either a pill or liquid to take orally. Shots are also an option and they are given once or twice a month.
How do antipsychotics and other medications interact?
Some medications can have adverse effects when taken with antipsychotics. Patients need to make their doctors aware of all the medications they are on. This includes prescription, vitamins, herbal supplements, over-the-counter medications, and minerals. Alcohol and drug use should also be discussed with the doctor.
Note: The FDA has not approved antipsychotic medications for patients suffering from dementia. The FDA has found a higher death rate among elderly patients taking atypical antipsychotics for dementia.