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Antipsychotic Medicines
Antipsychotics are medicines that are mainly used to treat schizophrenia or mania caused by
bipolar disorder. There are two main types of antipsychotics: atypical antipsychotics and older
antipsychotics. Both types are thought to work as well as each other. Side-effects are common with
antipsychotics. You will need regular tests to monitor for side-effects while you take theses
medicines.
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As discussed above, antipsychotics are usually prescribed to help to ease the symptoms of schizophrenia,
mania (caused by bipolar disorder), severe depression or severe anxiety. Normally they are started by a
specialist in psychiatry, or your GP will ask a specialist for advice on when to start them.
Also, for many years antipsychotics were used to calm elderly people who had dementia, but this use is no
longer recommended. This is because these medicines are thought to increase the risk of stroke and early death
- by a small amount. Risperidone is the only antipsychotic recommended for use in these people. Even then, it
should only be used for short period of time (less than six weeks) and for severe symptoms.
Stopping antipsychotics
If you want to stop taking an antipsychotic you should always talk to your doctor first. This is in order to help you
decide if stopping is the best thing for you, and how you should stop taking your medicine. These medicines are
usually stopped slowly over a number of weeks. If you stop taking an antipsychotic medicine suddenly, you may
become unwell quite quickly. Your doctor will usually advise you to reduce the dose slowly to see what effect the
lower dose has on your symptoms.
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Side-effects can sometimes be troublesome. There is often a trade-off between easing symptoms and having to
put up with some side-effects from treatment. The different antipsychotic medicines can have different types of
side-effects. Also, sometimes one medicine causes side-effects in some people and not in others. Therefore, it is
not unusual to try two or more different medicines before one is found that is best suited to an individual.
The following are the main side-effects that sometimes occur. However, you should read the information leaflet
that comes in each medicine packet for a full list of possible side-effects.
Common side-effects include:
Dry mouth, blurred vision, flushing and constipation. These may ease off when you get used to the
medicine.
Drowsiness (sedation), which is also common but may be an indication that the dose is too high. A
reduced dose may be an option.
Weight gain which some people develop. Weight gain may increase the risk of developing diabetes
and heart problems in the longer term. This appears to be a particular problem with the atypical
antipsychotics - notably, clozapine and olanzapine.
Movement disorders which develop in some cases. These include:
Parkinsonism - this can cause symptoms similar to those that occur in people with
Parkinson's disease - for example, tremor and muscle stiffness.
Akathisia - this is like a restlessness of the legs.
Dystonia - this means abnormal movements of the face and body.
Tardive dyskinesia (TD) - this is a movement disorder that can occur if you take
antipsychotics for several years. It causes rhythmical, involuntary movements. These are
usually lip-smacking and tongue-rotating movements, although it can affect the arms and
legs too. About 1 in 5 people treated with typical antipsychotics eventually develops TD.
Atypical antipsychotic medicines are thought to be less likely to cause movement disorder side-effects than
typical antipsychotic medicines. This reduced incidence of movement disorder is the main reason why an
atypical antipsychotic is often used first-line. Atypicals do, however, have their own risks - in particular, the risk of
weight gain. If movement disorder side-effects occur then other medicines may be used to try to counteract
them.
Note: people taking clozapine need weekly blood tests for the first six months and two-weekly blood tests after
that. This is because it can have a serious effect on how many blood cells you make.
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No - they are only available from your pharmacist, with a doctor's prescription.
SANE
1st Floor, Cityside House, 40 Adler Street, London, E1 1EE
Tel: (Helpline) 0845 767 8000
Web: www.sane.org.uk
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical
conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its
accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions.
For details see our conditions.
Original Author:
Dr Tim Kenny
Current Version:
Mrs Jenny Whitehall
Peer Reviewer:
Dr Tim Kenny
Document ID:
13868 (v2)
Last Checked:
19/07/2012
Next Review:
19/07/2015
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