Saturday, 4 May 2013

ABCs of psychiatric Medication

Antipsychotics


  • Used to treat and prevent the recurrence of symptoms pf psychosis in schizophrenia. These include hearing or seeing things which are actually not present, disorganized or unreal thoughts, suspiciousness, uncontrollable anger.
  • Two categories :
  1. Typical or first generation : chlorpromazine , haloperidol, sulpiride, trifluoperazine
  2. Atypical or second generation : clozapine, amisulpiride, olanzapine, risperidone, quetiapine, paliperidone, aripiprazole, ziprasidone
Typical antipsychotics can be used in Tourette's syndrome or to control severe behavioural problems in children. Some atypical antipsychotics can be used to treat bipolar mood disorder too.

How to used these medicines

Must be taken regularly for a few weeks before its full effect is felt

Tablets ( immediate and extended release), oral solutions and injections antipsychotics are available in the market.

Oral solutions can be mixed in drinking water, fruit juice, but not tea, cola or alcoholic drinks.

Extended-release tablets need to be swallowed whole with water and should not be crushed or chewed

Depot injections should be considered for patients who have difficulty taking oral medicines

Precautions

Typical antipsychotics: may make your skin more sensitive to sunlight. Avoid prolonged sun exposure and wear sunscreen
Atypical antipsychotics: may worsen cholesterol levels and blood glucose control.
Smoking may decrease the amount of olanzapine and clozapine in your body

Rare and serious sides effects

Stop the medicine immediately and see your doctor as soon as possible if you experience:

  • Severe muscle stiffness
  • Muscle spasm (such as in the neck, back, or eyelids), twitching or uncontrolled face, tongue or jaw movements.
  • High fever and confusion
  • Restlessness
  • Difficulty in speaking or swallowing
  • Irregular heartbeat
  • Seizures
  • Allergic reactions: skin rash or itching, difficulty in breathing, swelling in the face or lips
A note on clozapine 
Unique and effective antipsychotics, but may cause a serious and potentially fatal blood condition called agranulocytosis which is a decrease in white blood cell count in the body

Your doctor will order blood tests before starting your treatment, weekly for the first 18 weeks and at least monthly after. It is dangerous to take Clozapine without regular blood tests.

If you have high fever, sore throat and feel very tired while on clozapine, seek immediate medical attention