Schizophrenia medication side effects

Contents

Antipsychotic medication

Antipsychotic medications work by altering your brain chemistry to reduce psychotic symptoms like hallucinations, delusions and disordered thinking. They also help prevent those symptoms from returning.

Antipsychotic medication facts

  • Experiences vary: all antipsychotic drugs are designed to do the same thing — reduce psychotic symptoms and keep them away — but they’re known to affect people in different ways, so your experience of taking them will be unique to you.
  • Antipsychotic medications are common: in 2011, nearly 350,000 Australians had at least one prescription filled for antipsychotic medication. That’s 1.6% of the population.

Antipsychotic medication myths

  • Myth: ‘You can get addicted to them’
  • Reality: Antipsychotic medications aren’t addictive and you won’t need to take more over time to get the same effect.
  • Myth: ‘They cure you’
  • Reality: Antipsychotics reduce psychotic symptoms and distress, but they’re not a cure for mental illness.
  • Myth: ‘They’re happy pills’
  • Reality: Antipsychotics don’t make you feel happy no matter what. You’ll still feel normal ups and downs in your emotions.
  • Myth: ‘Medication is the only treatment’
  • Reality: There are many other forms of help: psychological therapies, support with housing and work, physical and occupational therapy and more.

Kinds of antipsychotic medication

Modern medications for treating psychosis are known as ‘second-generation’ or ‘atypical’ antipsychotics. Some common atypical antipsychotics include:

  • aripiprazole
  • clozapine
  • olanzapine
  • quetiapine
  • risperidone
  • ziprasidone

These are the names of the drugs themselves, but they’re often sold under different brand names.

Older, ‘first-generation’ or ‘typical’ antipsychotic medications are generally only prescribed if the second-generation medications aren’t working for you.

I’m very grateful for the medication as it allowed me to sleep for the first time in five months

— Carlo

How antipsychotic medications work

Antipsychotics change the levels of chemicals in your brain called neurotransmitters — the chemicals that carry messages around your brain. The neurotransmitter most targeted by antipsychotics is called dopamine.

Changing the levels of these chemicals reduces, in almost all cases, the hallucinations and delusions of psychosis. In some cases, they also improve your mood and reduce anxiety.

Talking to doctors about medication

Here’s a list of some useful things you might want to discuss with your doctor.

  • Tell your doctor about:
    • any other medications you’re taking
    • any other physical conditions you have
    • your allergies.
  • If your doctor suggests medication, ask:
    • how long will it take to start working?
    • what side-effects and benefits will it have?
    • how long will you need to take it for?
  • Ask your doctor what is or isn’t recommended while taking medication. For example:
    • if your medication can make you drowsy, your doctor might suggest you don’t drive
    • you may need to avoid alcohol with some medications. This can be a challenge if alcohol is a big part of your social life. Talk to your doctor about what is a safe amount to drink and whether other treatment options are available.
    • if you’re planning to become pregnant, tell your doctor in case any changes need to be made.
  • While you’re taking medication, tell your doctor immediately about:
    • any side-effects you experience
    • difficulty remembering to take your medication
    • any changes to your physical health.

How to take antipsychotic medication

There are two ways to take antipsychotic medication: by mouth or as a depot (sometimes called a ‘long-acting injectable’). The dose you take each time usually starts low. As your symptoms are monitored over time, your doctor might increase it or keep it at the same level.

  • Medication by mouth usually means a tablet, once or twice a day. Listen to any instructions you’re given and read the pamphlet that comes with medication to make sure you follow the right method for taking them.
  • Medication by depot is when you take your medication as a regular injection. The depot sits under your skin and releases the medication over two or four weeks, so you get a steady dose. It’s the same medication as the tablet.

Depots are used when there’s a risk you might forget or stop taking your medication, which can lead to a rapid worsening of your symptoms.

You can choose a depot yourself, but there are circumstances where a doctor can legally require you to take medication by depot, even without your consent. That’s only done rarely, and always with your health and safety in mind.

How long until they work

It commonly takes up to six weeks from your first dose for medication to start reducing symptoms, and several months before you feel their full effect.

How long to take antipsychotic medication

If your psychotic symptoms reduce or go away, it doesn’t mean your medication is unnecessary. It means your medication is working — part of its job is to stop your symptoms coming back.

When people stop taking their medication too soon or too suddenly, they are at very high risk of having another episode. You should have completely recovered from psychosis and had 12 months of good mental health before even starting the discussion about stopping medication.

To give yourself the best possible chance of recovery and good health, take your doctor’s advice and, where advised, take your medication.

If you feel you need to change your medication, always do this in consultation with your doctor.

Side-effects

All antipsychotic medications have potential side-effects. They vary from person to person, but can include:

  • drowsiness
  • weight gain
  • unusually dry or watery mouth
  • restlessness
  • trembling, especially in the limbs
  • muscle stiffness
  • dizziness
  • eyesight problems
  • moving more slowly
  • changed interest in sex, problems having sex
  • nausea
  • constipation
  • increased sweating
  • pain or irregularity in menstruation.

If you’re taking antipsychotic medication, it’s very likely you will experience some side effects. Work is being done to improve medications, but at the moment it’s often necessary to live with side-effects to reduce your active psychotic symptoms.

If you start experiencing side-effects, make sure you tell your doctor about them straightaway.

Changing medications

For some people, it can take months to find the right medication — that’s normal.

If the side-effects of the medication you’re taking are too severe, or if your psychotic symptoms don’t subside, it might be possible to try other options.

Talk to your doctor. Changing medicine can take time and will need careful guidance and observation from a health professional.

Within three months of the change in his medication, Jock took over his own life. He didn’t look back

— Jock’s mother Dianne

Safety with medication

There are a few things you can do to make sure your experience with medication is safe:

  • Tell your doctor everything: your allergies, other medication you take, your alcohol, smoking and recreational drug habits, if you’re pregnant or breastfeeding, and anything else they ask. It all helps with finding the right medication plan for you.
  • Store your medication carefully: medicine doesn’t like heat or damp, so keep your medication out of bathrooms and cars. Keep it in a container in a cool, dry place. Store it high to make sure children can’t reach it.
  • Don’t share medication: your medication is designed for you and no one else. Don’t take anyone else’s medication and don’t let anyone take yours. It can do real harm.
  • Take the right dose: taking too little or too much reduces how effective your medicine is, and can do harm. Stick to the instructions on the packet.

Limits of antipsychotic medication

Some people with psychotic illness find that the usual antipsychotic medications don’t reduce their symptoms over time. If this happens, your doctor may suggest clozapine, a drug which is very effective but comes with a greater risk of side effects.

Antipsychotic medications are designed to reduce and prevent the return of psychotic symptoms, including hallucinations, delusions and disordered thinking. They may not affect the other symptoms of your illness, so you may need to get other treatments for these symptoms.

Antipsychotic medication is considered the main treatment for psychosis, but other treatments are available.

Related: Psychosis factsheet

Other medication you might need to take

Along with psychosis, you may experience other mental health issues, like depression, mania, anxiety, and the ‘negative’ symptoms of schizophrenia.

So you may be prescribed anti-anxiety medications, anti-depressants or mood stabilisers along with your antipsychotics. This is relatively common — the medications are often used together.

This SANE factsheet is currently being reviewed by industry professionals, carers and people with lived experience of psychosis.

‘4329.0.00.003 – Patterns Of Use Of Mental Health Services And Prescription Medications, 2011’ Abs.gov.au. Australian Bureau of Statistics, 2017. Accessed 17 March 2017.

Galletly et al (2016) ‘Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the management of schizophrenia and related disorders.’ Aust NZ J Psychiatry, Vol. 50(5) 1-117

Clozapine versus typical neuroleptic medication for schizophrenia

Schizophrenia is a serious, chronic and relapsing mental illness with a worldwide lifetime prevalence of about one per cent. Schizophrenia is characterised by ‘positive’ symptoms such as hallucinations and delusions and ‘negative’ symptoms such as emotional numbness and withdrawal. One quarter of those who have experienced an episode of schizophrenia recover and the illness does not recur. Another 25% experience an unremitting illness. Half do have a recurrent illness but with long episodes of considerable recovery from the positive symptoms. The overall cost of the illness to the individual, their carers and the community is considerable.

Antipsychotic medications are classified into typical and atypical drugs. First generation or ‘typical’ antipsychotic drugs such as chlorpromazine and haloperidol have been the mainstay of treatment, and are effective in reducing the positive symptoms of schizophrenia, but negative symptoms are fairly resistant to treatment. In addition, drug treatments are associated with adverse effects which can often compromise compliance with medication and therefore increase the incidences of relapse.

People who do not respond adequately to antipsychotic medication are sometimes given the ‘atypical’ antipsychotic drug clozapine, which has been found to be effective for some people with treatment-resistant schizophrenia. Clozapine is also associated with having fewer movement disorders than chlorpromazine, but may induce life-threatening decreases in white blood cells (agranulocytosis). We reviewed the affects of clozapine in people with schizophrenia compared with typical antipsychotic drugs drugs.

This review supports the notion that clozapine is more effective than typical antipsychotic drugs for people with schizophrenia in general, and for those who do not improve on typical antipsychotic drugs in particular. Clozapine is associated with less movement adverse effects than typical antipsychotic drugs, but it may cause serious blood-related adverse effects. White blood cell count monitoring is mandatory for all people taking clozapine. There is a worry, however, that studies are – at the very least – moderately prone to bias favouring clozapine. Better conduct and reporting of trials could greatly have increased our confidence in the results.

Antipsychotics

Antipsychotics are drugs that are used to treat symptoms of psychosis such as delusions (for example, hearing voices), hallucinations, paranoia, or confused thoughts. They are used in the treatment of schizophrenia, severe depression and severe anxiety. Antipsychotics are also useful at stabilizing episodes of mania in people with Bipolar Disorder.

Their main action is on dopamine receptors, reducing levels of excess dopamine. They may also affect levels of other neurotransmitters, namely acetylcholine, noradrenaline, and serotonin.

Older antipsychotics tend to be called typical antipsychotics, and antipsychotics that have been developed more recently are called atypical antipsychotics. Atypical antipsychotics are less likely to produce extrapyramidal side effects (such as tremor and Parkinson’s-like symptoms) and tardive dyskinesia (abnormal, repetitive facial movements). Atypical antipsychotics are also more likely to improve cognitive function. Clozapine (classed as an atypical antipsychotic even though it is quite an old drug) also improves delusions and hallucinations and reduces the risk of suicide.

Schizophrenia Treatment

There’s no cure for schizophrenia, but medications can help minimize symptoms. Stocksy

Treatments for schizophrenia are aimed at reducing or eliminating symptoms of schizophrenia, including hallucinations (seeing or hearing things that aren’t there), delusions (false beliefs not based on reality), and jumbled speech. (1)

There is, however, no cure for schizophrenia.

Most people with the disease will require a combination of medications and psychotherapy (talking with a trained therapist), and social services. (1)

Getting Schizophrenia Symptoms Under Control

Your doctor may suggest that you be admitted to a hospital at first to help get your symptoms under control.

The Prevalence of Schizophrenia: How Common Is the Disease?

Approximately 100,000 young people in the United States experience an episode of psychosis each year, according to the National Alliance on Mental Illness (NAMI). (2) Psychosis is a break with reality that can involve paranoia, hearing voices, or having other hallucinations or delusional thoughts.

Not everyone who experiences psychosis has a mental illness. Psychosis is a symptom, not a disease: It is characteristic of schizophrenia, but psychosis can also be caused by other psychiatric disorders, substances, and a variety of medical conditions. (3)

The Importance of Early Diagnosis and Treatment in Schizophrenia

Seek medical treatment immediately if you or someone you know might be experiencing signs of psychosis or schizophrenia. Early diagnosis — and treatment — can improve the chances of a successful recovery. (3)

With proper treatment, it’s possible to improve your quality of life by minimizing the symptoms of schizophrenia. Some people have a harder time controlling their symptoms than others do.

For most people, schizophrenia will require ongoing treatment, even after symptoms have subsided. (4)

RELATED: Early Schizophrenia Treatment Programs Multiply

Medications for Schizophrenia Treatment

Antipsychotic drugs are often used to treat schizophrenia. These medications help relieve hallucinations, delusions, and thinking problems.

Antipsychotics work by changing the way certain chemicals, called neurotransmitters, act in the brain. Antipsychotics help control the function of brain circuits involved in thinking, mood, and perception. (5)

There are many different antipsychotic drugs on the market. You may hear your doctor refer to first-generation (“typical”) or second-generation (“atypical”) antipsychotics.

Newer drugs aren’t necessarily better drugs. Several reviews and studies in adults and children have found that the differences between the classes are relatively small and difficult to predict. Both classes may be about as effective at reducing so-called “positive” schizophrenia symptoms, such as hallucinations or delusions, though second-generation antipsychotics may be better at treating so-called “negative” symptoms, such as depressed mood and social withdrawal. Not every drug will work for every person. (6,7,8)

Side Effects of Drugs Used to Treat Schizophrenia

Both older and newer antipsychotics can cause serious side effects.

First-generation antipsychotics, which began to be developed in the 1950s, can cause restless movements or muscle spasms as a side effect. While some of the movements or changes in muscle tone are treatable, in some cases people can develop long-term or even permanent abnormal movements. This side effect is typically related to the duration of treatment and is more common in older people.

Second-generation antipsychotics were developed later and don’t cause as many movement problems. They are, however, more likely to cause other side effects, such as weight gain, as well as the development of related issues, such as diabetes and high cholesterol.

Some commonly used first-generation antipsychotics:

  • Haldol (haloperidol)
  • Chlorpromazine
  • Perphenazine
  • Fluphenazine

Commonly used second-generation antipsychotics:

Antipsychotic Drugs and Possible Side Effects

Older and newer antipsychotic drugs can cause side effects, including the following:

  • Uncontrollable movements, such as tics, tremors, or muscle spasms (this risk is higher with first-generation antipsychotics)
  • Weight gain (this risk is higher with second-generation antipsychotics) and other metabolic effects like development of diabetes and high cholesterol
  • Drowsiness
  • Restlessness

Different antipsychotics have different possible side effects; it is important to speak with your doctor about the potential side effects from your particular medication.

Antipsychotics can also cause interactions with certain medications and supplements.

Discuss all other medications or supplements that you take with your doctor before starting on an antipsychotic.

This includes over-the-counter (OTC) drugs, supplements, and illegal and recreational drugs, including marijuana, which has been shown to worsen psychotic symptoms in those with and susceptible to schizophrenia.

Medication Adherence and Schizophrenia Treatment

Taking medications correctly can be a problem for people with schizophrenia. An estimated one-third of people with schizophrenia use their meds incorrectly or skip them altogether, according to research published in the journal Patient Related Outcome Measures. (9)

That may be due in part to the nature of the illness itself. Psychosis can make it difficult for someone to tell what’s real and what isn’t, so people with schizophrenia may believe they do not need medications or may forget to take them. They may not understand what’s happening or may feel confused or distressed.

Nondrug Therapies for Schizophrenia Treatment

In addition to medication, your doctor may recommend other therapies to help you cope with the everyday challenges of schizophrenia.

In 2009, the National Institute of Mental Health funded a series of clinical trials known as the RAISE Initiative to improve schizophrenia treatment. (10)

What Is Coordinated Specialty Care for Schizophrenia?

A 2016 RAISE study, published in the American Journal of Psychiatry, found that early intervention after the onset of a first episode of psychosis with a coordinated, team-based approach and low doses of antipsychotic medication resulted in more effective treatment for people with schizophrenia. (11)

This team approach is known as coordinated specialty care.

A coordinated specialty care team may include clinicians, therapists, and case workers with experience in the following areas: (12)

  • Psychotherapy
  • Family support
  • Medication management
  • Work or education support

Other therapies for schizophrenia may include these options: (1)

Cognitive behavioral therapy You’ll meet with a therapist to work on your thinking and behavior.

The therapist may teach you how to test the reality of your thoughts or perceptions, and help you develop ways to ignore the voices in your head.

Peer support groups These are safe places where you can meet people who are going through the same things as you. Professional therapists are usually not involved.

Family therapy This involves seeing a therapist along with members of your family.

It’s important that your family knows as much about your schizophrenia as possible. Therapists can help your family develop coping strategies and problem-solving skills.

Rehabilitation These programs can include job counseling, money management, and communications training.

Rehabilitation emphasizes skills that can help people with schizophrenia function better in their communities.

Integrated substance abuse treatment Some people with schizophrenia also have substance abuse problems. They often get better results when drug and alcohol treatment are part of their schizophrenia treatment program.

Psychosis Treatment Program Options

Psychosis is a condition that describes a situation where someone has lost touch with reality in one of several ways. This could include having delusions or hallucinations. People having an episode of psychosis may have false beliefs, or they might see, hear or feel things that are not there. Early intervention may prevent someone from hurting themselves or others and could stop a psychosis-related condition from worsening. If you or someone you know has developed symptoms of psychosis, you must seek help as soon as possible.

What Causes Psychosis?

There are several potential causes for psychosis, including some behaviors that are controllable as well as health problems that are not under your control. According to Medline Plus, the following may cause psychosis:

  • Alcohol, illegal drug use and certain prescription medications
  • Stroke
  • Dementia
  • Certain types of epilepsy
  • Diseases of the brain
  • Brain tumors
  • HIV

People who have certain personality disorders or who have schizophrenia, bipolar disorder or severe depression may also experience psychosis. The symptoms of psychosis could lessen with treatment for the mental health condition.

The use of certain drugs may cause psychotic episodes. According to NHS Choices, some of the substances known to be triggers for psychosis include:

  • Cocaine
  • Amphetamine
  • Methamphetamine
  • Mephedrone
  • MDMA
  • Cannabis
  • LSD
  • Psilocybin
  • Ketamine

Some experts think that there may be other causes based on observations of people with conditions that can cause psychosis, though these have not yet been established as certain causes. According to Mental Health Care, a vitamin D deficiency could contribute to psychosis symptoms. Other researchers suspect that changes to mitochondria could be related.

Is There a Cure for Psychosis?

There is no cure for psychosis, but there are many treatment options. In some cases where medication is to blame, ceasing the medication can stop the psychosis. In other instances, receiving treatment for an underlying condition may treat psychosis. This is another reason why getting help for treating psychosis is important: discovering a potentially life-threatening medical problem.

Some people may only need short-term treatment. Others may need long-term treatment with antipsychotic medication. A doctor might recommend psychological therapy or addiction counseling. It depends upon the cause of the psychosis.

Therapies for Psychosis

Therapies for psychosis include different types of psychotherapy, antipsychotic medication, mood stabilizers, substance abuse counseling, family therapy, and support from a group or therapist. If you are, or someone you care about is, experiencing symptoms of psychosis, call for assistance in identifying the correct treatment therapy.

Cognitive Therapy Treatments

Cognitive behavioral therapy looks at how people perceive situations and what causes them distress. By identifying patterns of thought that might trigger undesirable actions and feelings, cognitive behavioral therapy may be able to replace these with more helpful thoughts.

Cognitive therapy treatment is an effective form of treatment for schizophrenia and often paired with antipsychotic medication. It could, therefore, help someone experiencing psychosis. According to an article in Psychiatry, cognitive behavioral therapy is a standard treatment for schizophrenia in the United Kingdom and is becoming more popular in the United States as an adjunctive treatment. It may be helpful for other causes of psychosis, such as substance abuse and depression.

Other Therapeutic Methods

Cognitive behavioral therapy is only one type of therapy that a person with psychosis may need. You or a family member who may have experienced psychosis may benefit from attending family therapy. During family therapy, people meet informally to discuss other treatments being used for psychosis and how the affected individual is progressing. It is also a time when caretakers may ask for help with practical concerns. Caring for a person with a physical or mental disorder is stressful. Family therapy, therefore, seeks to both support people dealing with psychosis and their loved ones who are also affected.

You may find support at a self-help group as well. Individual counseling and attending meetings with people who are experiencing similar concerns can be beneficial. People with a substance abuse program may increase their chances of a successful recovery by attending meetings from support groups such as Alcoholics Anonymous or Narcotics Anonymous. Complete abstinence from drugs and alcohol is useful if you’re recovering from substance abuse problems, and this is especially important for someone who has had an episode of psychosis after using drugs or alcohol because of the greater risk of harm. People with HIV may also find comfort from self-help groups where they can openly discuss their concerns and personal struggles.

Residential Inpatient Psychosis Treatment Centers

Some people with psychosis require inpatient care. Residential and inpatient psychosis treatment centers provide around-the-clock care for people who need more help than an outpatient program offers. If you are experiencing symptoms of psychosis, you may need to be hospitalized. This allows medical professionals to observe patients closely so they can make an accurate diagnosis. A residential facility may be the best place for someone who has a severe medical condition or whose condition has suddenly worsened. An inpatient facility may be a long-term solution for people who need a lot of help or a short-term option for others.

The Benefits of Residential Neurological Disorder Treatment

People with a neurological disorder often require a team to provide comprehensive treatment. A residential program can offer full-time support and a variety of professionals in one place to provide help. Just some of the medical professionals who may offer treatment at a residential center include a speech therapist, dietitian, audiologist, physical therapist, neurologist and internist.

At a residential facility, you have access to counseling and help with activities of daily living, including bathing, getting dressed and eating. People are on hand to offer support and exercise assistance. According to the Wexner Medical Center at the Ohio State University, a neurological rehabilitation program can help people regain independence, return to their homes and experience an improved quality of life.

Luxury Neurological Treatment Facilities

You may have an easier time receiving treatment for psychosis at a luxury neurological treatment facility. These facilities offer all the same core treatment options, such as behavioral therapy and drug therapy, but they also give patients more privacy, amenities and comfortable surroundings.

Executive Neurological Treatment Programs

Executive treatment programs cater to those who need to continue working while in treatment. Neurological treatment programs include a wide variety of therapies, such as speech therapy and exercise programs. Whatever you need, you can get with an executive neurological treatment program. These programs offer the highest possible standards of care.

Outpatient Psychosis Rehab and Treatment Programs

Some people may experience an acute case of psychosis or have a condition that can be managed at home. In these cases, an outpatient psychosis rehab and treatment program may work better than an inpatient program. The idea of moving into a residential facility may be overwhelming to you and unnecessary if you have the support to undergo an outpatient program.

People who are involved in outpatient care still receive access to doctors, therapists and other support staff. Instead of staying in a hospital or residential facility, they live at home and attend meetings and office visits, following a complete treatment schedule.

Outpatient treatment may follow an inpatient program. For example, a person with a substance abuse problem that caused a psychotic episode may go to an inpatient facility for detoxification and then possibly a different facility for rehabilitation. However, people may go home following time at a detox center and receive help as an outpatient. Determining whether an inpatient or outpatient facility is best requires a thorough assessment by trained professionals. If you suspect someone you know is experiencing psychosis, you may have an easier time convincing them to consider outpatient care, but the decision should not be made without speaking to a doctor or going to a treatment facility for evaluation.

People who are in an outpatient program usually need help at first. This could mean family members driving them to appointments, filling their prescriptions, and possibly observing their behavior to report back to doctors or therapists. Because outpatient treatment programs require more discipline and independence, they are usually only recommended for people with mild conditions who are not a danger to themselves or others.

Prescription and Over-the-Counter Medications

Many people with psychosis benefit from antipsychotic medication. These may be given orally or by injection. These drugs are usually the first course of treatment advised for people with psychosis. These medications block the effects of the hormone dopamine. The benefits of antipsychotics include:

  • Decreased aggression
  • Less anxiety
  • Fewer delusions
  • Fewer hallucinations

Some people may experience benefits within a matter of hours, but it can often take days or weeks before people have fewer delusions or hallucinations.

Antipsychotics do not work for everyone. You may respond well to them, or they may not help you. It depends on the person and the cause of psychosis. People who have epilepsy or heart disease may need to be monitored by a medical professional if they take antipsychotics.

Some people need only take these drugs for a short while until their symptoms go away. People who have conditions like schizophrenia may need to take medications for the rest of their lives to manage their conditions.

These medications are not without side effects. Some of the possible side effects include:

  • Shaking, trembling, spasms and twitches
  • Fatigue
  • Restlessness
  • Constipation
  • Reduced sex drive
  • Dry mouth
  • Blurry vision
  • Dizziness

Long-term use may cause some people to gain weight or develop diabetes. Side effects should be discussed with a primary care physician.

Some examples of antipsychotic medications include aripiprazole, ziprasidone, risperidone and asenapine, among others. Side effects may vary for different medications, according to WebMD. If one type of medication is not working well for you, discuss this with your doctor, because another one could work better.

How to Find the Best Psychosis Treatment Facility

The ideal psychosis treatment facility is one that matches your needs and has a proven track record of dealing with your particular situation. The range of possible causes may make finding the best psychosis facility a challenge, but getting help as quickly as possible is paramount to protecting yourself and getting the symptoms of psychotic disorder under control.

Unlike a dentist or general practitioner, you can’t just ask your friends for a referral to a facility. The solution to the question of how to find the best psychosis treatment facility is to ask people who are knowledgeable about the different causes for psychosis and the programs that match the needs of people with these various conditions. We are here to help. Please call if you or someone you know needs help finding the best facility.

Schizophrenia: The Challenges of Taking Medication

For people with schizophrenia, a common question is, “How long is medication needed to treat schizophrenia?” The answer is usually: people most benefit from taking medication for schizophrenia most of their lives. But there are a few challenges with taking any medication for such a long period of time, including reduced effectiveness and unwanted long-term side effects.

Antipsychotic medications — including newer atypical antipsychotics — reduce the risk of future psychotic episodes in patients who have schizophrenia. Even with continued drug treatment, some people will typically suffer relapses — but far higher relapse rates are seen when medication is discontinued. In most cases, it would not be accurate to say that continued drug treatment prevents relapses; rather, it reduces their intensity and frequency. The treatment of severe psychotic symptoms generally requires higher dosages than those used for maintenance treatment. If symptoms reappear on a lower dosage, a temporary increase in dosage may prevent a full-blown relapse.

Sticking to the Treatment Plan

Because relapse is more likely when antipsychotic medications are discontinued or taken irregularly, it’s beneficial when people with schizophrenia stick to their treatment. Sticking to treatment is also called “adherence to treatment,” which simply means keeping to the treatment plan arrived at between the patient and their psychiatrist or therapist.

Good adherence involves taking prescribed medication at the correct dose and proper times each day, attending doctor’s appointments, and following other treatment efforts. Treatment adherence is often difficult for people with schizophrenia, but it can be made easier with the help of several strategies and can lead to improved quality of life.

There are a variety of reasons why people with schizophrenia may not adhere to treatment. Patients may not believe they are ill and may deny the need for medication, or they may have such disorganized thinking that they cannot remember to take their daily doses. Family members or friends may not understand schizophrenia and may inappropriately advise the person with schizophrenia to stop treatment when he or she is feeling better.

Psychiatrists and doctors, who play an important role in helping their patients with their treatment, may neglect to ask patients how often they are taking their medications. Or such professionals may be unwilling to accommodate a patient’s request to change dosages or try a new treatment.

Some patients report that side effects of the medications seem worse than the illness itself — and that’s the reason they stop taking their medication. Further, substance abuse can interfere with the effectiveness of treatment, leading patients to discontinue medications. When a complicated treatment plan is added to any of these factors, good adherence may become even more challenging.

Fortunately, there are many strategies that patients, doctors, and families can use to improve adherence and prevent worsening of the illness. Some antipsychotic medications, including ones like haloperidol (Haldol), fluphenazine (Prolixin), perphenazine (Trilafon), are available in long-acting injectable forms that eliminate the need to take pills every day.

A major goal of current research on treatments for schizophrenia is to develop a wider variety of long-acting antipsychotics, especially the newer agents with milder side effects, which can be delivered through injection. Medication calendars or pill boxes labeled with the days of the week can help patients and caregivers know when medications have or have not been taken. Using electronic timers that beep when medications should be taken, or pairing medication taking with routine daily events like meals, can help patients remember and adhere to their dosing schedule. Engaging family members in observing oral medication taking by patients can help ensure adherence. In addition, through a variety of other methods of adherence monitoring, doctors can identify when pill taking is a problem for their patients and can work with them to make adherence easier. It is important to help motivate patients to continue taking their medications properly.

In addition to any of these adherence strategies, patient and family education about schizophrenia, its symptoms, and the medications being prescribed to treat the disease is an important part of the treatment process and helps support the rationale for good adherence.

Schizophrenia Medication Side Effects

Antipsychotic drugs, like virtually all medications, have unwanted side effects along with their beneficial, therapeutic effects. During the early phases of drug treatment, patients may be troubled by side effects such as drowsiness, restlessness, muscle spasms, tremor, dry mouth, or blurring of vision. Most of these can be corrected by lowering the dosage or can be controlled by other medications. Different patients have different treatment responses and side effects to various antipsychotic drugs. A patient may do better with one drug than another.

The long-term side effects of antipsychotic drugs may pose a considerably more serious problem. Tardive dyskinesia (TD) is a disorder characterized by involuntary movements most often affecting the mouth, lips, and tongue, and sometimes the trunk or other parts of the body such as arms and legs. It occurs in about 15 to 20 percent of patients who have been receiving the older, “typical” antipsychotic drugs for many years, but TD can also develop in patients who have been treated with these drugs for shorter periods of time. In most cases, the symptoms of TD are mild, and the patient may be unaware of the movements.

Antipsychotic medications developed in recent years all appear to have a much lower risk of producing TD than the older, traditional antipsychotics. The risk is not zero, however, and they can produce side effects of their own such as weight gain. In addition, if given at too high of a dose, the newer medications may lead to problems such as social withdrawal and symptoms resembling Parkinson’s disease, a disorder that affects movement. Nevertheless, the newer antipsychotics are a significant advance in treatment, and their optimal use in people with schizophrenia is a subject of much current research.

Schizophrenia: The Challenges of Taking Medication

Treatment


Schizophrenia

Psychological treatment

Psychological treatment can help people with schizophrenia cope with the symptoms of hallucinations or delusions better.

They can also help treat some of the negative symptoms of schizophrenia, such as apathy or a lack of enjoyment and interest in things you used to enjoy.

Psychological treatments for schizophrenia work best when they’re combined with antipsychotic medication.

Common psychological treatments for schizophrenia include:

  • cognitive behavioural therapy (CBT)
  • family therapy
  • arts therapy

Cognitive behavioural therapy (CBT)

Cognitive behavioural therapy (CBT) aims to help you identify the thinking patterns that are causing you to have unwanted feelings and behaviour, and learn to change this thinking with more realistic and useful thoughts.

For example, you may be taught to recognise examples of delusional thinking. You may then receive help and advice about how to avoid acting on these thoughts.

Most people require a series of CBT sessions over the course of a number of months. CBT sessions usually last for about an hour.

Your GP or care co-ordinator should be able to arrange a referral to a CBT therapist.

Family therapy

Many people with schizophrenia rely on family members for their care and support. While most family members are happy to help, caring for somebody with schizophrenia can place a strain on any family.

Family therapy is a way of helping you and your family cope better with your condition. It involves a series of informal meetings over a period of around 6 months.

Meetings may include:

  • discussing information about schizophrenia
  • exploring ways of supporting somebody with schizophrenia
  • deciding how to solve practical problems that can be caused by the symptoms of schizophrenia

If you think you and your family could benefit from family therapy, speak to your care co-ordinator or GP.

Arts therapy

Arts therapies are designed to promote creative expression. Working with an arts therapist in a small group or individually can allow you to express your experiences with schizophrenia.

Some people find expressing things in a non-verbal way through the arts can provide a new experience of schizophrenia and help them develop new ways of relating to others.

Arts therapies have been shown to alleviate the negative symptoms of schizophrenia in some people.

The National Institute for Health and Care Excellence (NICE) recommends that arts therapies are provided by an arts therapist registered with the Health and Care Professions Council who has experience of working with people with schizophrenia.

Want to know more?

  • Mental Health Foundation: talking therapies
  • Mind: understanding talking treatments

What are the side effects of antipsychotics for schizophrenia?

While the first-generation, older meds usually cost less, they can have different side effects than the newer antipsychotics. Some can cause higher levels of the hormone prolactin. This can affect sex drive, mood, menstrual cycles, and growth of breast tissue in both men and women.

One of the common side effects of newer antipsychotics is weight gain. Your loved one may also have trouble keeping his blood sugar and cholesterol levels under control.

One of the more serious side effects from long-term use of both the older and newer medications is a movement disorder called tardive dyskinesia. It makes your facial, tongue, and neck muscles move uncontrollably and can be permanent.

While both older and newer antipsychotics can cause tardive dyskinesia, researchers believe that the odds are much higher with the older antipsychotics.

Antipsychotics come with other side effects as well. Your loved one could have any of the following:

  • Weight gain
  • Sexual problems
  • Drowsiness
  • Dizziness
  • Restlessness
  • Dry mouth
  • Constipation
  • Nausea
  • Blurred vision
  • Low blood pressure
  • Seizures
  • Low white blood cell count

Schizophrenia

What Is It?

Published: February, 2019

Schizophrenia is a chronic (long-lasting) brain disorder that is easily misunderstood. Although symptoms may vary widely, people with schizophrenia frequently have a hard time recognizing reality, thinking logically and behaving naturally in social situations. Schizophrenia is surprisingly common, affecting 1 in every 100 people worldwide.

Experts believe schizophrenia results from a combination of genetic and environmental causes. The chance of having schizophrenia is 10% if an immediate family member (a parent or sibling) has the illness. The risk is as high as 65% for those who have an identical twin with schizophrenia.

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Medication for Schizophrenia

Newer medications, called atypical antipsychotics, are also effective in relieving the symptoms of schizophrenia. These medications, including quetiapine, risperidone, and aripiprazole, are generally prescribed because they pose a lower risk of certain serious side effects than conventional antipsychotics.

But atypical antipsychotic medications aren’t without risk. They can cause changes to a person’s metabolism, increasing the risk of developing diabetes and high cholesterol. People taking atypical antipsychotics must have their weight monitored and the glucose and lipid levels in their blood checked regularly by a doctor during the course of treatment to avoid serious complications.

Clozapine, also an atypical antipsychotic, is sometimes prescribed when people do not respond adequately to other antipsychotic medications. However, it may cause additional side effects, such as kidney or bladder problems. For this reason, the doctor conducts frequent blood testing to monitor health and prevent serious complications.

Some symptoms of schizophrenia, such as feeling agitated, tend to disappear within days of taking antipsychotic medication. Symptoms like delusions and hallucinations usually go away within a few weeks. Most people take medication for schizophrenia on a long-term basis.

Antipsychotics: Do they do more harm than good?

Millions of people in the United States live with schizophrenia and other severe mental disorders. Many of these people control their symptoms with the help of antipsychotic medication, but do the side effects of antipsychotics outweigh the benefits? New research investigates.

Share on PinterestNew research suggests that antipsychotics are beneficial for people with schizophrenia, in both the short- and long-term.

More than 3.5 million U.S. adults (or 1.1 percent of the country’s population) are affected by schizophrenia. Additionally, it is estimated that in any given year in the U.S., around 9.8 million people develop a serious mental disorder that can majorly interfere with their lives.

It is not yet known what causes schizophrenia, but treatment options – such as antipsychotic drugs and psychosocial therapies – are available to help patients manage their symptoms. Almost 7 million people in the U.S. take antipsychotic medications to treat schizophrenia and other similar conditions.

Lately, however, some studies have suggested that antipsychotics may do more harm than good, especially in the long-term. Some researchers have raised concerns over the toxic effects of these medications, suggesting that patients may only benefit from the medication in the short-term.

These concerns have gained popularity, with some articles in mainstream media suggesting that patients with schizophrenia and mood disorders may be better off without medication.

In this context, an international team of researchers set out to examine the data behind this controversial view.

The team – led by Dr. Jeffrey Lieberman, Lawrence C. Kolb Professor and chairman of psychiatry at Columbia University College in New York – investigated the long-term effects of antipsychotic medications on the brain and behavior of people with schizophrenia, as reflected by existing research.

The findings were published in the American Journal of Psychiatry.

Benefits of antipsychotic medication far outweigh the risks

The research consisted of a meta-analysis of existing clinical studies, with a focus on the long-term effect of these medications on clinical outcomes and the patients’ brain structure.

Lieberman and team looked at clinical trials and neuroscientific data, and they found that the therapeutic benefits of antipsychotic medication far outweigh their side effects.

“The evidence from randomized clinical trials and neuroimaging studies overwhelmingly suggests that the majority of patients with schizophrenia benefit from antipsychotic treatment, both in the initial presentation of the disease and for longer-term maintenance to prevent relapse.”

Dr. Jeffrey Lieberman

“Anyone who doubts this conclusion should talk with people whose symptoms have been relieved by treatment and literally given back their lives,” Lieberman adds.

According to this latest research, delaying antipsychotic treatment or not administering medicine is linked to negative long-term patient outcomes.

“While a minority of patients who recover from an initial psychotic episode may maintain their remission without antipsychotic treatment, there is currently no clinical biomarker to identify them, and it is a very small number of patients who may fall into this subgroup,” Dr. Lieberman explains.

“Consequently, withholding treatment could be detrimental for most patients with schizophrenia.”

The new research also addresses the preclinical evidence available from rodent studies. Although some of these animal models have indicated that antipsychotic medication may sensitize the dopamine receptors and increase tolerance over time, the new study underscores the fact that there is not enough evidence to suggest that antipsychotics increase the risk of relapse.

Previous research has also shown that the use of antipsychotics may raise the risk of metabolic syndrome in patients with schizophrenia. Metabolic syndrome has, in turn, been associated with heart disease and diabetes.

However, the current study did not examine the risks and benefits of antipsychotics in relation to metabolic syndrome.

“While more research is needed to address these questions, the strong evidence supporting the benefits of antipsychotic medications should be made clear to patients and their families, while at the same time they should be used judiciously,” says Dr. Lieberman.

Learn how schizophrenia may begin in the womb.

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