Uses of Antipsychotics
There are a number of antipsychotic medications that are used to treat hallucinations, such as are seen in schizophrenia, for patients who are combative, for people with bipolar disorder, for hallucinations unrelated to schizophrenia, for hostility and for people with sleep disorders. Some people use the term psychotropic medication synonymously with antipsychotic medications.
There have been antipsychotic medications available to treat hallucinations and other positive features of schizophrenia since the middle of the 1950s. Negative features of schizophrenia, such as social isolation, lack of emotion, lack of feeling pleasure, and having little interest in hygiene are not easily treated with these medications. These older medications are termed “typical” antipsychotic medications and include the following:
While these medications were effective in managing symptoms of schizophrenia and other mental disorders, they had significant side effects. One of the worst was facial tics and grimaces which progressed to a disease called tardive dyskinesia that tended to last even when the medications were stopped. Many people suffered from this disorder along with their schizophrenia or bipolar disorder.
From the middle of the 1990s, newer classes of antipsychotic medications were discovered and have largely replaced the older medication. They are known as “atypical” antipsychotics to differentiate them from the older medications. These medications include:
Clozapine (Clozaril®). This medication was the first of the atypical antipsychotics. It is not used much because it can cause agranulocytosis or a lack of white blood cells. For people on this medication, it means having a white blood cell count checked every 1-2 weeks.
These antipsychotics were much less likely to cause agranulocytosis but it has rarely been reported. These medications are also used to treat unresponsive depression and bipolar depression. On the other hand, there has been an FDA advisory for all atypical antipsychotic medications. They determined that elderly people with dementia die at a higher rate than those not on atypical antipsychotics. This is also true of typical antipsychotics. Therefore antipsychotic medications are not recommended for any disorder that is coexisting with dementia.
There are side effects in some people when just starting atypical antipsychotics. These side effects tend to be transitory in nature so people should still take them unless the side effects are persistent. These include sleepiness, blurry vision, dizziness, fast heart rate, sun sensitivity, menstrual disorders in women, and skin rashes.
Weight gain is a major side effect of atypical antipsychotics because it alters a person’s metabolism. Weight gain such as is seen in this situation can lead to high cholesterol and diabetes. This is why a person should have their weight, glucose level and lipid levels assessed every so often by a treating physician when they are taking an atypical antipsychotic medication. There are often more long lasting side effects with atypical antipsychotics including problems with muscle spasms in the large muscles, rigidity, restlessness and tremors. These are usually minor and do not occur in every patient needing an antipsychotic medication.
Muscle Relaxants may be used to reduce muscle spasms or spasticity.