Everything You Need to Know About Antipsychotics
If you’re struggling with your mental health, there may come a time when your doctor suggests antipsychotics. This class of medication can be very helpful, but it’s not for everyone. Keep reading to discover how antipsychotics work and what you can expect if your doctor recommends that you take them.
What Are Antipsychotics?
As you can probably tell from the name, antipsychotics are a class of drugs that can help to inhibit psychosis. Psychosis is a medical symptom that involves a person losing their grasp on one or more facets of reality. While dealing with psychosis, you might experience issues like disturbed thoughts, false beliefs, paranoia, inappropriate behavior, or hallucinations. Those who live with psychosis often interact with the world differently. They may experience, see or believe things that are at odds with reality.
Antipsychotic medications help to address these symptoms. They can reduce the frequency of things like delusions, disordered thoughts, and hallucinations. Different antipsychotics work in different ways and have different impacts on the body. The main thing they all have in common is that they can help people to manage psychotic episodes. Not all antipsychotics are a cure-all, however. While you’re on antipsychotics, you may instead have more time between psychotic symptoms or experience milder versions of your usual symptoms.
Explore the Types of Antipsychotics
Antipsychotics are divided into two different categories based on when they were made. First-generation antipsychotics were developed in the 1950s and are still in use today. Second-generation antipsychotics were first prescribed in the 1990s. They can have slightly different impacts and side effects. No class of antipsychotic is clearly better than the other. The right choice varies depending on the patient, their diagnosis, and their brain chemistry.
Also called typical antipsychotics, these are medications that have a calming effect on the entire body. In addition to their mental impact, first-generation antipsychotics can also affect your body movements more. Examples of first-generation antipsychotics include:
Second-generation antipsychotics, also known as atypical antipsychotics, tend to slow brain processes without affecting bodily processes quite as much. They’re sometimes less effective, but they tend to have fewer side effects. Examples of second-generation antipsychotics include:
How Antipsychotics Work
Antipsychotics have a very interesting impact on the brain. They were initially used as anesthetics for surgery or calming drugs for people having breakdowns. Over time, scientists discovered that small, steady doses of these drugs could help people to manage psychosis symptoms. Why does this happen? The majority of antipsychotics work by blocking dopamine absorption in the brain. Dopamine is a powerful brain chemical that helps to transmit messages between cells. It’s responsible for everything from bonding with loved ones to getting a good night’s sleep. However, when you have too much dopamine, it can become a problem.
Though researchers still aren’t fully aware of why psychosis happens, they’ve found that drugs that reduce dopamine transfer in the center of the brain help to halt psychosis. Keep in mind that different medications have slightly different effects. The most traditional antipsychotics just block dopamine, but many newer antipsychotics also block serotonin. Serotonin is another similar neurotransmitter that’s usually associated with a positive, uplifted mood. However, when certain parts of the brain are getting bombarded with excess serotonin, psychosis can occur. Therefore, second-generation antipsychotics that block serotonin can be just as effective as older ones that block dopamine.
What Conditions Are Treated With Antipsychotics?
Antipsychotics are incredibly common. They can be prescribed in any situation that involves psychosis, so a wide variety of people end up using them. The most frequent reason a person is prescribed antipsychotics is for schizophrenia. This mental health condition causes a breakdown between reality and perceptions, so regular antipsychotic usage can be quite helpful. Antipsychotics are also helpful for bipolar disorder. During bouts of intense mania, people with bipolar disorder can lose grip on reality, and antipsychotics are very useful.
There are also many other diagnosable mental health conditions, like depression, dementia, and generalized anxiety, that can benefit from antipsychotic usage. In some cases, even people without a defined mental health problem may need antipsychotics. Psychosis can happen during any mental health breakdown. Especially if a person has been abusing certain substances, they can experience psychosis despite not having underlying mental health issues. In other cases, people may need psychosis after undergoing certain physical health problems like a head injury.
Potential Side Effects of Antipsychotics
Antipsychotics are generally quite effective at stopping psychosis. However, due to the way they work, they also impact other parts of the body. Dopamine and serotonin regulate everything from your heart rate to your memory, so tinkering with your body’s dopamine levels can have some unusual effects. Different antipsychotics have different side effects, and every person experiences them differently. Therefore, it’s quite common for your doctor to recommend different medications at different dosages until you can find one that works without causing too many side effects. While you’re trying to find the right regimen, you might encounter one or more side effects.
Common Side Effects
Like any other medication, antipsychotics can have some adverse effects. There are a wide range of side effects you may encounter, including:
- Frequently feeling twitchy or restless
- Decline in libido
- Feeling sleepy or physically slowed-down
- Weight gain
- Dry mouth
- Breast milk production
- Blurred vision
- Tardive dyskinesia (random, uncontrollable muscle movements)
Immunity Issues Associated With Clozapine
Clozapine is a less-frequently prescribed antipsychotic because it has some unusually drastic side effects. However, if other medications are not working, clozapine might be necessary. The unusual thing about this antipsychotic is that it can cause your white blood cell count to drop. Though it only occurs in about 3% of people using clozapine, it can be quite dangerous. Without enough white blood cells, you can end up with drastically lowered immunity. If you’re immunocompromised, you are more likely to end up catching other illnesses. Therefore, people on clozapine need to get regular white blood cell tests to see if their body is still producing enough immune cells.
Potential Increased Risk of Heart Issues
Another rare side effect to be aware of is cardiovascular issues. In some cases, patients have developed abnormal heart rhythms or blood pressure levels after using antipsychotics. These side effects are more likely to happen when taking second-generation antipsychotics, but they can happen to anyone. Due to these side effects, your doctor might suggest extra monitoring if you have a heart condition or a family history of cardiovascular problems. Regular tests to examine your blood pressure and heart rate can help you identify and manage these side effects.
Your Guide to Taking Antipsychotics
Every person is different, so no one has the same experience on antipsychotics. Some people take high doses for years, while others take a small dose for just a short amount of time. Whenever you’re prescribed antipsychotics, you’ll need to carefully follow your doctor’s instructions. Though no one’s experience is exactly the same, there are a few basic things you can expect when you take antipsychotics.
Common Dosage Amounts
Antipsychotics come in many forms. You might take a pill, drink a liquid, or even have an injection. Your dosage will vary quite a bit depending on the form of the medication you take. For example, if you’re taking cariprazine, you might just need 1.5 milligrams of medication a day. Meanwhile, if you’re taking clozapine, you might need 600 milligrams per day. Whatever the medication, your doctor will usually start you with a slow dosage and gradually increase your dose if you aren’t getting enough assistance from the medication. Keep in mind that some medications have extended-release versions that let you take one high dose occasionally instead of several low doses repeatedly. As with any medication, speak with your doctor to learn about the correct recommended dosage for your prescription.
Length of Use
Antipsychotics are usually a long-term type of medication. Though one high dose can provide some relief during a psychotic episode, you get more impact with consistent use. It’s quite common for the full effects to only be felt after four to six weeks of taking the medication. The exact length of time you have to take it will depend on your personal health. Some people recovering from a single psychotic episode might just need the medication for a year. Those who have a chronic condition that causes constant psychosis may need to take antipsychotics for most of their life.
Interactions With Other Medications
It’s fairly common for people who use antipsychotics to also need other medications. However, keep in mind that antipsychotics can interact poorly with other medications. For example, they can make you drowsy, so they shouldn’t be combined with benzodiazepines. Some types of antipsychotics can also interact poorly with antidepressants, beta-blockers, ACE inhibitors, and anti-epileptic medications. Therefore, it’s very important to try to give your doctor your complete medical history. You need to let them know about every drug you take, even non-prescription ones, so they can make sure they prescribe you a safe antipsychotic.
Here are some frequently asked questions you might be wondering about.
- Can you smoke with antipsychotics? Tobacco use can make it hard for your body to absorb antipsychotics safely. It’s important to let your doctor know you smoke before they prescribe antipsychotics.
- Will antipsychotics make it hard to drive? Some antipsychotics can make you very drowsy. If you have this side effect, it might not be safe to drive a car or operate other heavy medications. Doctors recommend you take at least a few weeks off from driving when you start the medication. This can help you see how the medicine affects you, so you can figure out if you’re safe to drive.
- Do antipsychotics affect pregnancies? There is an increased risk of complications if you take antipsychotics while pregnant. Therefore, some women might want to stop taking this medication while pregnant. However, in many cases, quitting antipsychotics can be even more dangerous because a mental health crisis can drastically harm your health and the fetus’ health. Your doctor will need to help you decide if you should keep using antipsychotics while pregnant.
- Can you be forced to take antipsychotics? Usually, you have the right to decide your medications yourself. However, if you’re likely to harm yourself or others, your healthcare providers might be able to administer treatments against your will. However, you can only be forced to take this medication if you’re a threat. You always have the right to appeal the decision legally and see if you can quit taking the medication.
- What if the antipsychotics don’t work for you? It’s fairly common for people to need to try one or two different medications before settling on a treatment regimen. If you aren’t noticing any reduction in your symptoms after a few weeks, talk to your doctor. They can adjust your dosage or recommend a different antipsychotic medication.
Using Antipsychotics in Recovery
If you are struggling with substance use issues and psychosis, there is help. Research has found that antipsychotics can help some people improve their mental health and reduce their substance abuse. In some cases, antipsychotics can be a helpful tool for recovering from drug-induced psychosis. In other situations, these medications can help you treat your underlying mental health condition, so you can better resist urges to abuse substances.
At Granite Recovery Centers, we specialize in evidence-based treatment. Our highly-trained team can help diagnose untreated psychosis and get you the assistance you need. We’ll help you explore your options and figure out if antipsychotics are a good option for your situation. To schedule a consultation, get in touch with us today.