What You Should Know About

Antipsychotic Medications
The medicines used to treat mental illness are known as your return to a more normal life.
psychotropic medications. There are four major
categories of psychotropic medications. They are: Typical Antipsychotics
· antipsychotics Today, older medications are often referred to as
· antidepressants typical or first generation antipsychotics. They are still
· mood stabilizers used with good results by some people.
· antianxiety medications
These may be prescribed alone or in combination. Chlorpromazine was the first medication used for
thought disorder. (Thorazine is the brand name in the
Psychotropic medicines are quite safe when properly United States.) Chlorpromazine changed the way
used. However, it can take time to reach the right people with serious mental illnesses were treated. It
dosage and combination of medications. Adjustments was the first medicine to control the major symptoms of
in the dosages may be needed to deal with unwanted psychosis. It made it possible for many patients to be
side effects. Here are some of the reasons: released from hospitals. However, chlorpromazine
· People respond differently to medications, so didn’t work for everyone. It had little effect on some
several may need to be tried. symptoms such as feeling “flat” or withdrawal from
· Dosages sometimes need to be adjusted, especially others. Chlorpromazine and other drugs like it
as treatment progresses. (phenothiazines) can cause side effects such as:
· More than one medication may be needed. This
may be due to other symptoms or treatable side · drowsiness
effects. · constipation
· Some medicines need to be taken for several days · dizziness when rising from a sitting or lying
or weeks before they become fully effective. position
· dry mouth
Antipsychotic Medications · blurry vision
Antipsychotic medications are prescribed for serious · shaking
thought and mood disorders or any condition with · slowed movements
psychosis. If they have been prescribed for you, taking · muscle spasms
them the right way can eliminate primary (or · hormone-related changes
“positive”) symptoms such as hallucinations and
delusions. To offset these side effects, other medicines could be
· Hallucinations are perceptions that you hear, see, prescribed or the dosage changed.
smell, or feel that other people do not experience.
· Delusions are strongly held beliefs that are not true. Although the phenothiazines were improved and
They usually seem strange or odd to other people. refined, the next major breakthrough in medication
Antipsychotic medications can also help you become came in the late 1970s with haloperidol. (Haldol is the
more organized in your thinking and speech. Some brand name in the United states.) It helped many
help eliminate other signs of psychosis, often referred people who did not respond to the earlier
to as the “negative” symptoms. These may include antipsychotics.
withdrawal and isolation, an inability to show or feel
emotion, or trouble making decisions. In short, Phenothiazines and haloperidol can have side effects
antipsychotics can help you have a better connection that impact the muscles. They can make a person shake,
with reality. They are not addictive medications. have spasms, or be restless. These are known as EPS or
Taking antipsychotic medicine is a basic element in extrapyramidal symptoms. Other side effects that many
patients find disturbing result from the effect these including men---find that their breasts enlarge and start
medicines have on hormone levels. Some people--- to drip. This is called galactorrhea.
Some patients on these medications report sexual include:
problems. These can include impotence in men and · Seroquel (quetiapine fumarate)
irregular periods in women. Side effects are discussed · Risperdal (risperidone)
in more detail later. · Zyprexa (olanzapine)
· Geodon (ziprasidone)
“Atypical” Antipsychotics · Abilify (aripiprazole)
A newer group of antipsychotic drugs is now in use
thanks to ongoing research. They are called atypical Certain antipsychotic medications can increase the risk
drugs or second-generation antipsychotics. of diabetes. For this reason, many many doctors screen
and monitor patients taking any of these drugs. i
The atypicals manage a wide range of symptoms of
serious mental illness including: They offer new hope for people with serious mental
· hearing voices illness and are allowing many more patients to have
· bizarre thinking patterns productive lives.
· speaking incoherently
· inability to relate to others Safety and Side-Effect Issues
· feeling flat Safety issues and side effects are a natural concern
for patients, families, and prescribers.
These newer antipsychotic medications usually cause
fewer and often milder side effects. They can greatly Although medications can have great effects, they all
reduce the risk of muscular side effects and have little come with some risks. This is called the medication’s
or no effect of hormone levels. The atypicals are safety profile. Prescribers must sometimes balance the
creating opportunities for wellness for many patients positive effect of medication against any possible harm
who had limited chances for recovery in the past. it might cause. Everyone responds differently to
various medicines, so several may be tried to see which
The government approved the first atypical in 1989. It is the most effective with the fewest side effects.
was clozapine. (Clozaril is the brand name in the
United States.) Many people who did not respond to Psychotropic medications are relatively safe. However,
other antipsychotics or had significant problems with the safety of their use also assumes that:
side effects improved on this medication. The major · A proper diagnosis has been made.
drawbacks were its high cost in part due to the need for · Other medical conditions that could contribute to
weekly blood test. Regular blood tests are needed or imitate mental illness have been identified,
because in rare cases this medicine can cause a serious treated, or ruled out.
white blood cell disorder called agranulocytosis. · Proper medical follow-up is being done.

Recently other atypicals have been approved for use in Side Effects
the United States. Each is a unique chemical Psychotropic medications, like any prescribed
compound that has undergone much research and medicine, have possible side effects. That’s why these
testing. The newer atypicals: medication must be ordered and monitored by a
· are as effective as the older medicines in treating prescribing specialist, usually a psychiatrist. Some
the primary symptoms of psychosis (hallucinations, medications have mild side effects that often go away
delusions, incoherent thinking and speech) in a short period of time. However, more serious side
· are as effective as clozapine in treating withdrawal, effects are possible. For example, most antianxiety
flat feelings, and ambivalence drugs can be habit forming. A few other medications
· do not require weekly blood testing because they require frequent blood testing for safe use. The most
have far less risk of white blood cell disorder common side effects for antipsychotic medications are
· may be more cost-effective than clozapine grouped into anticholinergic effects and extrapyramidal
Brand names of these newer atypical medicines symptoms (EPS).
 Anticholinergic Effects

Anticholinergic effects are caused when a medication discussed above. It is not yet known whether the newer
interferes with acetylcholine, one of the chemicals the atypical products have a lower potential to cause TD.
body makes to help nerve cells communicate with each However, there is some research which suggests this
other. Muscles and glands may be affected. may be the case.
Anticholinergic effects may include:
· confusion Other Side Effects
· blurred vision A rare but serious side effect is neuroleptic malignant
· constipation syndrome. This involves unusual muscle rigidity and
· dry mouth and nasal passages elevated body temperatures. Vital signs may be
· light-headedness unstable, and the person may drift in and out of
· difficulty with urination consciousness. If a person has these symptoms, seek
· problems with bladder control immediate medical attention.
· palpitations
As discussed earlier, side effects related to hormones
can include breast enlargement and fluid discharge,
Sometimes these effects lessen as the body adjusts to
impotence, and other sexual problems. There are fewer
the psychotropic medication. Many can be managed
of these problems with the newer medications.
with small adjustments to the dose. Other nonmedical
management methods can include sucking on hard
Some patients may become light-headed or feel dizzy
candies for dry mouth or adding more fiber to your diet
when they get up from lying down. This is called
to relieve constipation.
postural or orthostatic hypotension. It can usually be
helped by getting up slowly and sitting on the edge of
Extrapyramidal Symptoms (EPS)
the bed for a moment or so before standing.
There is a network of nerve pathways in the brain
known as the extrapyramidal system. This influences
Early intervention may prevent or lessen these and
messages sent from the brain to the muscles. Certain
other serious side effects. Let your treatment team
medication---usually older types of antipsychotics---
know if you have any problems than might be related to
may disturb this system.
your medicine. Also, the diaries and records you keep
can help your treatment team see both your progress
This can lead to:
and problems.
· involuntary movements such as tremors, writhing
movements, rigidity, and jerking motions
For more information about Mental Illnesses -
· problems with muscle tone and making the desired Contact:
movements---such as slowed movement and The National Alliance on Mental Illness
rigidity seen with Parkinson’s disease. of Greater Chicago
NAMI of Greater Chicago
Most patients do not develop EPS. For those who do, 1536 West Chicago Ave, Chicago, IL 60642
adjusting the medication dosage may solve the Phone: 312-563-0445
problem. If the problem continues, the prescriber may FAX: 312-563-0467
change to another medication or add another medicine. www.namigc.org
[email protected]
The newer antipsychotics have far fewer problems with
EPS. As these medications become more common in
the treatment of psychosis, EPS may become a less
frequent problem.

Another possible side effect involving the