Use:
The
primary use of this medication is to treat
symptoms of acute or chronic psychosis, including schizophrenia,
mania, delusional disorders
and organic disorders. There
are several other uses for these drugs (e.g. Tourett’s
Syndrome, Impulsive/aggressive behavior, etc)
What
symptoms will this drug help control?
Symptoms
of psychosis differ between individuals, both as to the type of
symptoms and severity. Some common which antipsychotics have
been found to help include:
-
Hallucinations
(e.g. hearing voices, smelling odors, feeling unusual body
sensations)
-
Fixed
beliefs often of paranoid nature (i.e. someone is
persecuting or following you ; people are taking about you.
-
Disorganized
thoughts( difficulty in focusing on a thought), or speeded
up thoughts
-
Irritability,
agitation, hyperexcitement, over-elated mood
Some
anti-psychotics may also help symptoms of social withdrawal,
lack of interest in oneself and in others, and poor motivation.
How
quickly will the drug start working?
Antipsychotics
begin to relieve agitation in about 1 week, help control
mood changes in about 2 weeks, and help difficulties in thoughts
and awareness in 6-8 weeks; voices (hallucinations) will
decrease in intensity and frequency over 2-8 weeks.
Because
antipsychotics require time to work, do not increase or decrease
the dose or stop the medication without discussing this with
your doctor.
How
long should you take the medication?
Following
the first episode of psychosis, it is recommended that
antipsychotic medication be continued for 1-2 years; this
decreases the chance of being ill again.
For
individuals that have had a psychotic illness for several years,
antipsychotic medication should be continued indefinitely. The
physician will adjust the dose, from time to time, to determine
the need for continued treatment.
Preparations
for antipsychotics
Antipsychotics
are available in different forms:
-
Fast
acting injection-to help control symptoms quickly, when the
patient is in distress
-
Oral
liquid-Convenient for individuals who have difficulty in
swallowing tablets.
-
Oral
tablets-the usual most common form
-
Long
acting (depot) injection-Convenient for patients who have
been stabilsed on an oral anti-psychotic. An injection is
given every 1- 4 weeks; this eliminates the need for the
patient to remember to take his/ her medcation daily, helps
in compliance with treatment and has been shown to lower the
risk of relapse.
Side
effects
Side
effects occur, to some degree, with all medication.They are
usually not serious and do not occur in all individuals. Most
will decrease or dissappeat with time. If a side effect
continues, speak to your doctor about appropriate treatment.
-
Common
side effects that should be reported to your doctor
immediately include:
-
Muscle
spasms, excessive rigidity, shaking or restlessness.
These symptoms can be controlled with antiparkinsonian
agents (e.g Cogentin, Akineton, Kemadrin, etc.)
-
Common
side effects that should be reported to your doctor at the
next appointment include:
-
Drowsiness
and lethargy- this problem goes away with time. Use of
other drugs that make you drowsy will worsen the
problem. Avoid driving a car or operating machinery if
drowsiness persists.
-
Dizziness-Get
up from lying or sitting position slowly; dangle your
legs over the edge of the bed for few minutes before
getting up. Sit or lie down if dizziness persists or if
you feel faint , then contact your doctor.
-
Dry
mouth-Sour candy and sugarless gum help increase saliva
in your mouth; try to avoid sweet, calorie-laden
beverages. Drink water and wash your teeth regularly.
-
Blurred
vision-This usually occurs at the start of treatment and
may last 1-2 weeks. Reading under a bright light or at a
distance may help; a magnifying glass can be of
temporary use. If the problem continues, advise your
doctor.
-
Constipation-increase
bulk foods in your diet (e.g. salads, bran) and drink
plenty of fluids. Some individuals find a bulk laxative
(e.g. Metamucil, Fibrayx) or a stool softener (Colace,
Surfak) helps regulate their bowels. If these remedies
are not effective , consult your doctor or pharmacist.
-
Stuffy
nose-Increase humidity. Temporary use of a decongestant
nose spray (e.g. Otrivin) may help.
-
Weight
changes-Monitor your food intake, you may notice a
craving for carbohydrates (e.g sweets , potatoes, rice
pasta) but try to avoid
foods with high fat content (e.g. cakes, pastry)
-
Nausea
or heartburn- If this happens take the medication with
food.
-
Breast
tenderness, liquid discharge from breasts, or missed
periods.
-
Tardive
dyskinesia can
occur in some patients who have been treated with
neuroleptics, usually for many years. It involves
involuntary movements of certain muscles, usually of the
lips and tongue, and sometimes those of the hands, neck
and other parts of the body. Movements tend to increase
over several years, but then stabilize and in many
patients decrease with time; in a few patients symptoms
worsen with withdrawal of the antipsychotic
-
At
the first signs of tardive dyskinesia , or switching to
an “atypical”class of drug , improves the chance
that this adverse effect will diseappear with time. This
has to be balanced against the risk of recurrent
illness.
-
Rare side
effects you should report to your doctor immediately
include:
-
Skin
rash or itching
-
Unusual
headache, persistent dizziness or fainting
-
Nausea,
vomiting, loss of appetite, lethargy weakness, fever, or
flu- like symptoms.
-
Soreness
of the mouths, gums and throat.
-
Yellow
tinge in the eyes or to the skin; dark colored urine
-
Inability
to pass urine (more than 24 hours)
-
Inability
to have a bowel movement( more than 2-3 days)
-
Fever(
high temperature) with muscle stiffness/rigidity
Let your
doctor know as soon as possible if you miss your period or
suspect you may be pregnant.
What
should you do if you forget to take a dose of your medication?
If
you take your total dose of antipsychotic at bedtime and you
forget to take it, DO NOT take the dose in the morning , but
continue with your schedule the next day. If you take the drug
several times a day , take the missed dose when you remember,
then continue with your regular schedule.
Interactions
with other medication
Because antipsychotic drugs
can change the effect of other medication, or may be affected by
other medication, always check with your doctor or pharmacist
before taking other drugs, including over- the counter
medication such as cold remedies. Always inform any doctor or
dentist that you see that you are taking an antipsychotic
medication.
Precautions
-
Do
not increase or decrease your dose without consulting your
doctor.
-
Take
your drugs with meal or with water, milk or orange juice;
avoid apple or grape fruit juice as they may interfere with
the effect of the drug.
-
This
drug may impair the mental and physical disabilities
required for driving a car or operating machinery. Avoid
these activities if you feel drowsy or slowed down.
-
This
drug may increase the effects of alcohol, making you more
sleepy dizzy and lightheaded.
-
Avoid
exposure to extreme heat and humidity (e.g. saunas) since
this drug may effect your body’s ability to regulate
temperature changes.
-
Antacids
(e.g. Gelucil, Maalox, Amphogel, etc) interfere with
absorption of these drugs in your stomach and
therefore may decrease their effect. To avoid this Take the
antacids at least 2h before or 1 hour after taking your
antipsychotic drug.
-
Some
patients may get a serious sunburn with little exposure to
sunlight. Avoid direct sun , wear protective clothing and
use a sunsreen preparation on exposed areas.
-
Excessive
use of caffeinated beverages (coffee, tea, colas, etc) can
cause anxiety agitation and restlessness and counteract some
of the beneficial effects of your medication.
-
Cigarette
smoking can change the amount of antipsychotic that remains
in your blood stream; inform your doctor if you make any
changes to your current smoking habit.
-
Do
not stop your drug suddenly as this may result in withdrawal
symptoms such as nausea, dizziness, sweating , headache,
sleeping problems, agitation and tremor, and also result in
the return of psychotic symptoms.
-
Store
your medication in a clean, dry area at room temperature.
Keep all medication out of reach of children.
If you
have any questions regarding this medication, do not hesitate to
contact your doctor, pharmacist, or nurse.
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