Psychosis & medication.pdf

Psychosis and Medication
The information below is adapted from a Royal College of Psychiatry information leaflet The aim of medication is to reduce the effects of the symptoms on your life. Medication should: § weaken delusions and hallucinations gradually, over a period of a § increase your motivation and ability to look after yourself.
How is it taken?
§ Medication comes as tablets, capsules, or syrup. § If you find it hard to take tablets every day, you may find it easier to take antipsychotic medication as an injection. This is called a 'depot injection' and is given at weekly or every 2, 3 or 4 weeks. Most of the depot injections are older, "typical" antipsychotics, but one of the atypicals, Risperidone, is now available in this form.
"Typical" antipsychotics
In the mid-1950s, several medications appeared that could reduce the symptoms of schizophrenia. They became known as "antipsychotic" medications. These older drugs are called "typical"or "first-generation" antipsychotics. They work by reducing the action of a particular chemical messenger in the brain called dopamine. Side-effects § Stiffness and shakiness, like Parkinson's disease, along with feeling sluggish and slow in your thinking. In most cases, this will mean that you are taking too much of the medication. It should be reduced to a level at which these symptoms disappear. If you need higher doses, these side-effects can be controlled with anti-Parkinsonian medication. § Uncomfortable restlessness (akathisia). § A long-term side-effect is tardive dyskinesia (TD for short) - persistent movements, usually of the mouth and tongue. This affects about 1 in 20 people every year who are taking these medications.
Some Typical antipsychotics:

"Atypical" antipsychotics
Over the last 10 years, several newer medications have appeared. They
work on a different range of chemical messengers in the brain (such as serotonin) and are called "atypical" or "second-generation" antipsychotics. They are less likely to cause Parkinsonian side-effects, although they may cause weight gain and problems with sexual function. They may also help the negative symptoms, on which the older drugs have very little effect. They also seem much less likely to produce tardive dyskinesia. Many people who use these newer medications have found the side-effects less troublesome than those of the older medications. Side-effects § Increased chance of developing diabetes. § In high doses, some may produce the same Parkinsonian side-
Some Atypical antipsychotics:

How well does medication work?
§ These medications work well for many people - about 4 in 5 people get help from them. They control the disorder, but do not cure it. You have to go on taking the medication to prevent the symptoms returning. § Even if the medication helps, the symptoms may come back. This is much less likely to happen if you carry on taking medication, even when you feel well.
How long will I have to take medication for?
§ Most psychiatrists will suggest that you take medication for a long § If you want to reduce or stop your medication, discuss this with § You should usually reduce your medication gradually so you can notice any symptoms returning, before you become unwell again.
What happens if you stop your medication?
If you stop taking the tablets, the symptoms of schizophrenia will usually
come back - not immediately, but often within 6 months.
Is medication enough?
Medication is very useful. However, even if you are taking medication,
you will usually need to use other types of help to give yourself the best
chance of a good recovery.


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