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What Works For Anxiety Disorders–Anti-Anxiety Drugs

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Antipsychotics

Submitted by on December 9, 2010 – 6:51 pm | 484 views

Antipsychotics

What are antipsychotics used for?

Antipsychotics are usually used to help treat people with and similar conditions such as . They are also used to treat other problems such as , hypomania and . Occasionally antipsychotics are used to help manage agitation or anxiety. Medicines are often used to treat more than one condition, so if you are not sure why you have been prescribed an antipsychotic, you should discuss this with your doctor.

Antipsychotics are classified into two groups, ‘typical’ or ‘first-generation’ antipsychotics and ‘atypical’ or ‘second generation’ antipsychotics. Examples of ‘typical antipsychotics’ include, , and flupentixol. Examples of ‘atypical antipsychotics’ include risperidone, olanzapine, and . The difference between the two groups includes the type and frequency of the side effects that they may cause.

What are the benefits of taking antipsychotics?

People with schizophrenia or psychosis may have a range of symptoms that are often thought of in two groups – ‘positive’ and ‘negative’ symptoms. Positive symptoms include hallucinations and delusions, which can include symptoms such as hearing voices, or experiencing ‘strange things’ such as seeing or feeling things that may not be real or having mistaken beliefs. People may also feel suspicious or paranoid, or feel that other people can read their thoughts. Negative symptoms are less noticeable than positive symptoms, and include tiredness, lack of concentration and lack of energy. People may become quite inactive and withdrawn from normal everyday activities.

Antipsychotics can help to treat some of these symptoms and keep them under control in the long term. Treating these symptoms should help people feel less confused, anxious and restless, and help them to think more clearly. This will help them to cope better with the stresses of everyday life, and help them to return to normal activities such as work or hobbies. Antipsychotics may also help people engage better with other kinds of therapies such as psychological treatments and therefore allow for a better response.

How quickly do antipsychotics work?

Antipsychotics work over a period of weeks. People may find that they feel calmer soon after starting treatment, but it may take several weeks until they have their full effect. Not everybody benefits from antipsychotics but most people do. If you do not feel any benefit or improvement in your symptoms after six to eight weeks, you should discuss this with your doctor or healthcare worker.

What are the usual doses of antipsychotics and how should I take them?

People will usually be started on a low dose, which will then slowly be increased to the usual effective dosage range for that medicine. Refer to the manufacturer’s patient information leaflet for the antipsychotic that you have been given. Do not change your dose of medication without checking with your doctor, as it can affect your response to the medication, or may be harmful.

What should I do if I miss a dose?

You will get the most out of your medication when taken correctly and regularly. If you miss, or forget a dose at your usual time, but remember within an hour or two take it straight away. If it is longer than this just leave out the missed dose and take the next dose at the usual time. Never take extra medication at the next dose. If you find it difficult to remember taking medication speak to your pharmacist or healthcare worker.

For how long should I take antipsychotics?

Your doctor will discuss with you how long you will need to take medication for, which will vary depending on the type of illness you have. Some people may need to take medication for a number of years and others need to stay on medication longer. Taking medication regularly may prevent you from becoming unwell. Your doctor should regularly review your medication to check whether you are experiencing any unwanted effects and make sure that your dose is still right for you. Stopping antipsychotics suddenly may cause ‘discontinuation symptoms’ such as jerky movements and nausea. Your original symptoms may also return after three to six months of stopping. The dose should usually be reduced gradually before stopping. Check with your doctor for advice about this. Antipsychotics are not addictive.

What are the side effects of antipsychotics?

As with all medicines there is a risk of unwanted effects (side effects). Some can occur soon after starting treatment so you may experience these before you feel better. Most are temporary and should go away after a few days or weeks. Not everyone will get side effects and people experience them to different degrees. If you feel that you have side effects that are causing you discomfort, discuss this with your doctor, pharmacist, nurse or healthcare worker. The table on the following page lists some of the main recognised side effects of antipsychotics but these will depend on the individual antipsychotic you are taking.

What about alcohol and ‘street’ drugs?

Both alcohol and antipsychotics can affect the brain so it is not recommended that you drink alcohol while taking antipsychotics. Drinking alcohol can make psychosis worse and in combination with antipsychotics can cause severe drowsiness. Once you are used to the medication and know the effects of taking alcohol you may be able to drink alcohol occasionally and in small amounts. It is good to be cautious because alcohol affects people in different ways, especially when taking medication.

Do not stop taking your medication because you feel like drinking alcohol. If you drink alcohol, drink only small amounts. Never drink alcohol and drive while taking medication.

‘Street’ drugs (for example, cannabis, ecstasy, speed, heroin and cocaine) can often also make psychosis worse. People taking ecstasy whilst on antipsychotics are more likely to experience movement disorders. There is very little information on taking antipsychotics with other ‘street’ drugs, so the effect and safety of doing this is unknown. It is best if you do not take ‘street’ drugs whilst taking antipsychotics. You may need to get advice and support to help you do this.

What about other medicines?

If you take any other medicines or herbal remedies including any that have been newly prescribed or bought, it is important to check with your doctor or pharmacist that they are safe with antipsychotics. You must take particular care when taking drugs that lower your blood pressure with antipsychotics.

When should I be cautious?

It is usually safe to take antipsychotics regularly, as prescribed by your doctor, but they are not suitable for everyone. If any of the following situations apply to you, you should tell your doctor immediately.

1 If you are allergic to antipsychotics (if you have taken it before and developed a rash, itching, swollen mouth or throat);

2 If you have diabetes, epilepsy (or have had a fit in the past), suffer from kidney disease, heart problems or have had a stroke;

3 If you have Parkinson’s disease or take any medicines usually used to treat this;

4 If you have an abnormal heart rate or take medicines to control your heart rate;

5 If you have ever had a history of breast cancer or a prolactin dependent tumour;

6 If you have phaeochromocytoma (a tumour of the adrenal gland);

7 If you are pregnant, or are planning to become pregnant; or

8 If you are breastfeeding.

Side Effect

What is it?

What should I do if it happens to me?

Akathisia

Feeling restless or wanting to move all the time.

This is most common at the start of treatment. It should settle after a couple of weeks. If this continues after a couple of weeks, or gets worse, speak to your doctor at your next appointment.

Feeling tense, fearful or on edge.

Try relaxation methods. Speak to your doctor over the next few days if this does not go away or gets worse.

Drowsiness

Feeling sleepy or sluggish.

Do not drive or use machinery. This is most common at the start of treatment. If your medicine is taken once a day, it may help to take it at bedtime. Speak to your doctor over the next few days if this continues for more than a couple of weeks.

Blurred vision

Things look blurry and you cannot focus properly.

Do not drive. Speak to your doctor over the next few days if this continues or gets worse.

Constipation

Difficulty going to the toilet or opening the bowels.

Make sure you drink plenty of fluid. Eat more fibre for example bran, fruit and vegetables and take regular exercise. If this does not help speak to your doctor over the next few days.

Dizziness

Feeling light-headed and faint.

Do not stand up too quickly. Try and lie down. Do not drive. Speak to your doctor over the next few days if this continues after a couple of weeks.

Dry mouth

Lack of saliva in the mouth.

This is most common at the start of treatment. Frequent sips of water, sugar-free boiled sweets, chewing gum or citrus fruits will often help. Speak to your doctor at your next appointment if it continues after a few weeks.

Hypotension

A low blood pressure. You may feel faint or dizzy when you stand up.

Try to stand up slowly. If you feel dizzy, do not drive. Speak to your doctor over the next few days if this does not stop.

Urinary incontinence

Leakage of urine that you are unable to control.

Speak to your doctor over the next few days.

Movement disorders /

Parkinsonism

Symptoms may include tremor, shaking, muscle stiffness, pain, weakness or spasms, problems with speech.

Speak to your doctor over the next few days. Your doctor may be able to give you something for it or change the medicine to something else.

Hyperglycaemia / diabetes

High blood sugar. You may frequently feel very thirsty, need to urinate a lot (particularly at night time) and feel very tired.

Speak with your doctor at your next appointment or over the next few days if it gets worse.

Rises in prolactin levels (prolactin is a naturally occurring hormone in the body) may affect ‘periods’ in women. It may also cause milk secretion, breast tenderness or enlargement in men and women.

You may need to have your dose or medicine changed. Speak to your doctor at your next appointment.

Sexual dysfunction

Change in sex drive or sexual ability, for example lack of orgasm, abnormal erection and ejaculation.

Speak to your doctor at your next appointment.

Neuroleptic malignant syndrome

High body temperature, sweating, increased heart rate, confusion, muscle stiffness and difficulty moving.

Contact your doctor immediately.

Tardive dyskinesia

Unusual movements of the body (usually the tongue and face) that cannot be controlled.

This may be associated with long-term treatment. Speak to your doctor over the next few days.

Weight gain

Eating more and putting on weight.

Avoid fatty and sugary foods. Try to eat plenty of fruit, vegetables and fibre. Take regular exercise. If this becomes a problem or you are worried speak to your doctor at your next appointment.

Please refer to the manufacturer’s patient information leaflet that comes with your medicine for more information and the full list of side effects and precautions. If you have any questions or concerns about your medicines, or if you are worried about anything you think might be a side effect, ask your doctor, pharmacist or nurse.

This leaflet gives you some information about this medicine. It does not replace the expertise or judgement of a doctor, pharmacist or other healthcare professional. It is not a manufacturer’s patient information leaflet and is not to be taken as a substitute for, or an endorsement of, the manufacturer’s information or advice in respect of any medicine referred to in this leaflet. You might find more information in other leaflets or books, or on the internet but remember, the internet is not always accurate.

Whilst every care has been taken in the compilation of this leaflet, CNWL is not responsible for any loss or damage howsoever caused as a result of any inaccuracy or error contained in this leaflet, including (for the avoidance of doubt) in relation to breach of contract, misrepresentation or negligence whether of CNWL or any other person; but nothing in this leaflet shall exclude or restrict liability for death or personal injury resulting from negligence.

The information given in this leaflet is current as at the publication date.

This leaflet has been written by Central and North West London Mental Health NHS Trust Pharmacy Department, 30 Eastbourne Terrace, London W2 6LA www.cnwl.orgPublication Date: May 2007

Source: http://beh.zedcore.com

A previous article entitled The Side Effects Of Common Psychiatric Drugs: Antipsychotics provides information... a gland near the stomach that helps digestion), Abilify (aripiprazole) ve Abnormal gait (manner of walking)

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