What Are The Different Types Of Antipsychotics
There are 2 types of antipsychotics. Your doctor might call them the following.
- Typical or 1st generation. These medications have been used since the 1950s. These were the first type of antipsychotics made.
- Atypical or 2nd generation. These medications have been used since the 1990s. These are newer types of antipsychotics.
The main difference between these types is in their side effects. 1st generation antipsychotics may have more of an effect on your body movement than newer antipsychotics. Although this doesnt mean newer generation antipsychotics dont have any side effects on your movement.
Recent research continues to suggest that side-effects for all antipsychotics are different. Your psychiatrist should work with you to find which medication works best for you.
Its important to think about each antipsychotic individually. This is because everyone reacts differently to medication. You can never be certain how you will be affected by side effects. This can mean that the first medication you try may not be the right one for you.
If you are struggling to cope with side effects after a few weeks speak to your healthcare professional.
Your doctor may prescribe you a different type of antipsychotic. Or give you a medication to help deal with the side effects. You can read more about side effects further below.
You can find more information about Medication choice and managing problems by clicking here.
How are antipsychotics taken?
What Else Should I Consider Before Taking Antipsychotics
Can antipsychotics cause sexual problems?
Sexual problems have been reported as a side effect of antipsychotics. Evidence shows that many people taking antipsychotics experience sexual problems. But some antipsychotics have less sexual side effects than others.
Some antipsychotics can cause a hormone called prolactin in your body to increase. This seems to be why antipsychotics can cause sexual side effects. The following side effects are common. Higher levels of prolactin can cause:
- periods to stop,
- a lack of sex drive,
- breast enlargement in both men and women,
- problems getting aroused, and
- erection and ejaculation problems for men.
If you are experiencing any of these problems, you should contact your doctor. They may reduce the dose or stop the medication. If you are advised to stay on it, you might be able to take medications to help with these problems.
What if Im pregnant or planning on getting pregnant?
You can speak to your doctor about the risks of medication while pregnant or breastfeeding. You could also discuss this with your midwife or health visitor. Taking antipsychotics during pregnancy may have certain risks. You shouldnt stop taking your antipsychotics without speaking to your doctor first.
It is thought that there may be a small risk of complications if you take antipsychotic drugs during pregnancy. Overall, the research isnt clear whether first generation or second-generation drugs will affect your unborn child.
New Medications For Schizophrenia: Antipsychotics
Researchers continue to develop new understandings of how antipsychotics work. They have very recently discovered how medications dock in the brainhow they bind to their targets in the brain. This understanding is paving the way for the development of new schizophrenia medication, a new generation of antipsychotics that is more effective and has fewer side effects than the first two generations.
The goal is to develop medications that treat the positive, negative, and cognitive symptoms of this serious mental illness. As of 2014, over 30 new medications for schizophrenia were under development . Some of those have failed. Some were existing medications for other conditions that have received approval for use in schizophrenia. Still others are current antipsychotics that are being developed in extended release form.
Of the almost three dozen new schizophrenia medications, several are completely new and are progressing through the phases of research, a process that can take years. These new medications offer the promise of improved negative and cognitive symptoms as well as milder side effects.
One of the new medications making progress through the developmental phases is referred to as MIN-101 . Minerva Neurosciences has developed and is testing this drug. The drug blocks serotonin and sigma receptors and is designed to
- Reduce the intensity of positive symptoms
- Improve negative symptoms
- Job and school assistance
- Antipsychotic medication when necessary
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Why Was This Study Needed
Around 30% of patients with schizophrenia do not respond sufficiently to standard second-generation antipsychotic drugs. For these patients, clozapine has been seen as the gold standard treatment. This is despite a known raised risk of weight gain and type 2 diabetes, as well as the serious but less common blood reaction agranulocytosis. These risks mean that patients taking clozapine require careful monitoring and blood tests.
However, recent summaries of randomised controlled trials have called the position of clozapine into question, with some finding standard antipsychotics equally effective. Results from systematic reviews of trials have been inconsistent. There is a concern that patients recruited to trials may not be representative of the wider population of people with treatment-resistant schizophrenia.
The authors of this review say cohort studies may better represent real-world patients. They carried out a systematic review of these observational studies to see how clozapine compared to other antipsychotic drugs in this population and if the results were comparable to the existing trials.
How Is Schizophrenia Treated
The treatment for schizophrenia is a combination of therapy and drugs. Schizophrenia drugs are a lifelong commitment at best, they control the outbursts of psychosis. Antipsychotic schizophrenia drugs have actually been used considering that the 1950s to cut psychosis and to prevent relapses. A few of these were fluphenazine, haloperidol, and chlorpromazine. These drugs were infamous for their degenerative side effects. Considering that the 1990s, lots of newer generation schizophrenia drugs have actually been developed. Fortunately, these drugs do not have a number of the side effects of the older generation of schizophrenia drugs.
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What Side Effects Might I Experience From Taking Antipsychotics
Your medication should come with a leaflet called a patient information leaflet. This leaflet will tell you what the side effects are and explain what to do if you are experiencing any side effects.
Side effects of antipsychotics can include the following.
- Uncontrollable movements of the jaw, lips and tongue. This is known as tardive dyskinesia. This includes shakiness. This can often be reduced by lowering the dose. But, if a high dose is necessary, the shakiness can be treated with antimuscarinic medication.
- Uncomfortable restlessness, known as akathisia.
- Sexual problems due to hormonal changes.
- Sedation. Such as sleepiness and slowness.
- Weight gain.
- Hyperprolactinaemia, such as the production of milk in both men and women from their breasts.
- Blurred vision.
Not all antipsychotics will have these side effects and medication can affect different people in different ways. Second generation or atypical antipsychotics are less likely to cause movement side effects, but you might still experience them. If you do, then your doctor might change your medication. Or they may give you medication to help manage the involuntary movements.
You can find more information about Medication choice and managing problems by clicking here.
You may also find the following websites helpful learn more about antipsychotics:
How might antipsychotics effect my physical health?
Can Schizophrenia Be Cured Naturally Without Medication Not Completely
Many people with schizophrenia are in search of a cure for their condition. It is completely natural to look for cases of people that have been cured of debilitating mental illness and other diseases. The truth is that there is no cure for schizophrenia at this particular time. However, science and researchers are advancing and it is hoped that a cure will eventually be discovered.
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Additional Treatments And Support
The most effective treatment plans for schizophrenia include some elements of medication and therapy, but supplement these two pillars of treatment with additional support. Very important to treating schizophrenia is the inclusion of social support, social skills, and social and family education. This may involve the use of group therapy, support groups, social skills training, and family psychoeducation, working with the family of the patient to learn more about the condition and how to live with and support a loved one.
Addressing and treating secondary issues, a holistic approach, is also important for effective management of schizophrenia. This may include weight loss and healthy eating, to help counteract the side effects of antipsychotics. It also includes addressing smoking cessation, as smoking is common in patients with schizophrenia. Patients may also have co-occurring mental illnesses or other substance use disorders that need to be diagnosed and treated.
Finally, there are support services that can help patients with schizophrenia who are leaving treatment be able to live more independently. This may include vocational and job skills training, taking advantage of housing, transportation, and other social services, and getting involved in the community.
Preventing And Managing Complications
Another important part of managing schizophrenia is recognizing and dealing with the complications it can cause. All of the challenging symptoms can contribute to secondary problems, like suicide, self-harm, financial problems, academic difficulties, substance abuse, depression and anxiety, social isolation, and even being the victim of a crime or becoming homeless.
Only treating the condition does not necessarily help a person with schizophrenia live their best life. Anyone with this mental illness should be screened for other mental illnesses and substance use disorders and get treatment as needed. Family support is also crucial in helping manage or prevent some of these complications. Having family to live with, financial support, and a social support system can reduce the risk of negative behaviors, like self-harm, and can help a person maintain a job or get through school.
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Diabetes Risk And Atypical Antipsychotics
All atypical antipsychotic drugs can increase the risk of high blood sugar and type 2 diabetes.
The US Food and Drug Administration recommends that:
- People with an established diagnosis of diabetes who begin atypical antipsychotic treatment should be regularly monitored for worsening of blood sugar control.
- People with risk factors for diabetes should undergo fasting blood sugar testing at the beginning of atypical antipsychotic treatment and periodically during treatment.
- All people treated with atypical antipsychotics should be monitored for high blood sugar symptoms.
- People who develop hyperglycemia symptoms should undergo fasting blood sugar testing.
There may also be an increased background risk of diabetes in people with schizophrenia. As a precaution, many doctors advise that all people treated with atypical antipsychotics receive a baseline blood sugar level reading and be monitored for any increases in blood sugar levels during drug treatment. People should also have their cholesterol and other lipid levels monitored. In addition to diabetes, atypical antipsychotics are associated with increased risk for heart problems.
How Can You Help
People with schizophrenia often do not want to get treatment at first. They strongly believe their perceptions are real, and are afraid to give up control and enter one of the a schizophrenia treatment facilities. Some with paranoia believe you are kidnapping or intending to harm them. But this is the best way to help someone with this disorder. Family members might choose to take their loved one to the hospital for treatment if the psychosis becomes bad enough and the person is a danger to themselves or others or are unable to take care of themselves. In most cases, a professional long term schizophrenia treatment facility that is experienced in helping individuals with schizophrenia is the best option.
For those struggling with both schizophrenia and a substance use disorder , concurrent treatment of the conditions is necessary. Through medication and therapy, individuals with schizophrenia and substance use disorders can go on to lead a happy, fulfilling life.
Contact us at Lighthouse Network at 844-Life-Change today to learn more about your schizophrenia diagnosis and treatment options and other mental health issues.
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Assessment Of Methodological Risk Of Bias Of Individual Studies
Predefined criteria will be used to assess the quality, which correlates with the risk of bias, of individual controlled trials, systematic reviews, and observational studies by using clearly defined templates and criteria as appropriate. Randomized controlled trials will be evaluated with appropriate criteria and methods developed by the Drug Effectiveness Review Project .33 Systematic reviews will be assessed using the AMSTAR quality rating instrument.29 These criteria and methods will be used in conjunction with the approach recommended in the chapter, Assessing the Risk of Bias of Individual Studies When Comparing Medical Interventions28 in the AHRQ Methods Guide developed by the Agency for Healthcare Research and Quality. Studies will be rated as “good,” “fair,” or “poor,” or as specified by the particular criteria.
Studies rated “good” quality will be considered to have the least risk of bias, and their results will be considered valid. Good-quality studies include clear descriptions of the population, setting, interventions, and comparison groups a valid method for allocation of patients to treatment low dropout rates and clear reporting of dropouts appropriate means for preventing bias and appropriate measurement of outcomes.
Assessing Key Question 2 Interventions for Evidence Sufficiency
Those Key Question 2 intervention areas deemed sufficient on the selected key outcome will undergo full assessment and synthesis as described in the following sections.
Excessive Weight Gain With Antipsychotics
Second-generation medications for the treatment of schizophrenia and other mental disorders have the potential to induce significant weight gain. This side effect is of great concern because the medications are used over long periods of time and the health burden from obesity-related diabetes, cardiovascular disease, cancer, and other chronic disease is significant. Not everybody is equally at risk. A genome-wide association study in a large number of patients in American and European institutions pointed to variants in the melanocortin 4 receptor gene . Patients with two copies of the rs489693 A allele appear to be most consistently at risk. Three months of treatment with aripiprazole, quetiapine fumarate, or risperidone induced more than twice as much weight gain in patients with the rs489693 A/A genotype than in other patients. This means that drug-induced weight gain could be anticipated and preventive measures taken.
Neha S. Hudepohl, Henry A. Nasrallah, in, 2012
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Atypical Antipsychotics To Treat Schizophrenia:
|Lamotrigine||Mood stabilizer||Might be able to prevent some psychotic symptoms induced by NMDA receptor antagonists to treat symptoms of schizophrenia.|
|Lithium||Mood stabilizer||Works to stabilize mood and is often used as an add-on treatment in addition to antipsychotics to treat schizophrenia. Might reduce both depressive and manic symptoms.|
Talk to your psychiatrist or healthcare professional about the possible risks and benefits associated with the above medications before starting treatment.
Side Effects Of Antipsychotics
While the first-generation, older meds usually cost less, they can have different side effects than the newer antipsychotics. Some can cause higher levels of the hormone prolactin. This can affect sex drive, mood, menstrual cycles, and growth of breast tissue in both men and women.
One of the more serious side effects from long-term use of both the older and newer medications is a movement disorder called tardive dyskinesia. It makes your facial, tongue, and neck muscles move uncontrollably and can be permanent.
While both older and newer antipsychotics can cause tardive dyskinesia, researchers believe that the odds are higher with the older antipsychotics.
Antipsychotics come with other side effects as well. You could have any of the following:
- Weight gain
Be sure you see your doctor regularly while taking antipsychotic medication. And talk to your doctor if you have any concerns about side effects.
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Types Of Antipsychotic Medications
There are two groups of antipsychotics. Doctors call the older group of medications âfirst-generation,â âtypical,â or âconventionalâ antipsychotics. Some common ones are:
Note: Clozapine is the only FDA-approved medication for treating schizophrenia that is resistant to other treatments.
Common Medications For Schizophrenia Reviewed
Medications are the foundation of schizophrenia treatment, and antipsychotic medications are the most frequently prescribed drugs. Theyre believed to manage symptoms by affecting the brain neurotransmitter dopamine.
The objective of treatment with antipsychotic medications is to effectively manage symptoms and signs at the lowest possible dosage. The psychiatrist might try various drugs, different dosages or combinations with time to achieve the wanted result. Other medications also might help, such as antidepressants or anti-anxiety drugs. It can take several weeks to observe an improvement in symptoms.
Since medications used for schizophrenia can cause serious side effects, people with schizophrenia may be reluctant to take them. Willingness to comply with treatment may impact drug option. For example, someone who is resistant to taking medication consistently might need to be given injections rather of taking a tablet.
Ask your doctor about the advantages and side effects of any medication thats recommended.
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Last Resort Antipsychotic Remains The Gold Standard For Treatment
Among patients with schizophrenia that has not responded to other drugs, the antipsychotic drug clozapine cuts the chances of hospital admissions and drug discontinuation.
Recent trials have questioned the superior efficacy of clozapine compared with other standard antipsychotic drugs. However, a review of real-world data from observational studies confirms its place as a drug that may work when others fail. Patients prescribed clozapine had better outcomes, despite having more severe illness.
As expected the data show that clozapine increases the risk of weight gain and type 2 diabetes. The side effects associated with clozapine prevent its use as a first-line drug.
The findings suggest that clinicians should continue to offer a treatment trial of clozapine to people with schizophrenia who have not benefited from standard antipsychotic drugs.
A Novel Therapy With Fewer Side Effects
Although the exact way the drug works is unknown, it is thought to improve dysfunction through several effects on nerve cell chemicals and their receptors, says Dr. Satlin.
The dominant therapeutic approach for schizophrenia has been to modulate dopamine neurotransmission.
We need more medications like this one that work differently and dont just mediate the dopamine receptors, says Linda Stalters, a master of science in nursing and the chief executive officer of Schizophrenia and Related Disorders Alliance of America . Patients are screaming to have more and better medications.
While the latest studies, according to a press release, showed that Caplyta caused some tiredness and dry mouth , the medication had promising results when it came to metabolic changes. Weight gain, fasting glucose, triglycerides, and total cholesterol were about the same in both the Caplyta and placebo groups.
Often one of the side effects with schizophrenia medication is metabolic disorder where patients start gaining a lot of weight, and with that comes high cholesterol, diabetes, high blood pressure, and cardiovascular disease, says Stalters.
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