Psychosis (read more on psychosis) is a serious but treatable condition. People with a psychotic illness, such as schizophrenia, experience some loss of contact with reality. They may, for example, experience visual or auditory hallucinations, and believe that other’s can control or manipulate them and/or their thoughts. Psychosis can be a debilitating illness, often causing sufferers to neglect to wash or groom themselves, and to be unable to function at work or school, or communicate their needs to others. Despite the severity of the symptoms, the sufferer may be unaware that they are ill.
In many people, antipsychotic medication effectively treats the symptoms of psychosis, but does not cure the illness. Antipsychotic medications have been available since the 1950s and have allowed many people with psychosis to lead more fulfilling, productive lives by alleviating symptoms. The same antipsychotic medication may affect different people differently. The degree to which symptoms are alleviated, or the length of time it takes for the medication to act on the symptoms, may vary from one person to another. Many people, however, will experience significant relief from symptoms by the sixth week of treatment. If there is no improvement, the doctor may decide to either adjust the dosage or try an alternate medication.
It’s not unusual that an individual may need to try more than one medication before finding the one that is most effective and causes the fewest side effects. Once the person is feeling better, there is often a temptation to stop taking the medication. This should not be attempted without consulting with their doctor. In some cases, the medication may be needed for a limited time only. In other cases, the individual may need to take the medication indefinitely to prevent the return of symptoms. Even when the decision is taken to stop the medication, it must be done gradually over a period of time to avoid adverse effects, and needs to be monitored by a physician.
Over the last two decades, new antipsychotic medications have been developed, particularly for schizophrenia, that have fewer side effects than older antipsychotics. These new medications, such as quetiapine (Seroquel®), risperidone (Risperdal®), and olanzapine (Zyprexa®), have been found to be just as effective as earlier antipsychotic medications, but generally better tolerated. Side effects do still occur, so anyone taking these medications should be carefully monitored by a physician.
Some people will experience rapid heartbeat, drowsiness, and dizziness while taking these newer antipsychotics; others may gain weight and need to make changes to their diet or exercise regimes. A decrease in sexual performance or libido, changes in menstrual cycles, sunburn and skin rashes are some other possible side effects. Some antipsychotic medications interact with other medications, such as antihypertensive medication (for high blood pressure), anticonvulsant medication, and medications used for Parkinson’s disease. Antipsychotics may also potentiate the effects of central nervous system depressants such as certain sleep medications, narcotics, alcohol, and antihistamines leading to serious consequences. However, most side effects are mild, and may lessen or disappear after the first few weeks of taking the medications.
Early antipsychotic medications, such as haloperidol (Haldol®) and chlorpromazine (Largactil®), also called “conventional” antipsychotic medications, had more unpleasant side effects including muscle stiffness, tremor and abnormal movements. They are, therefore, infrequently prescribed.