Days in a Psychiatric Department: What are Antipsychotics?
“He is suffering from Psychosis”, “She is Psychotic”, “He needs to take Antipsychotics to reduce his symptoms”. We often heard about “Psychotic”, “Psychosis” and “Antipsychotics”, but what are they actually?
“PSYCHOSIS” VS. “PSYCHOTIC”
“Psychosis” refers to the abnormal condition in which the mind has ‘lost contact with the reality’ which leads the patients might have seen or heard things that are unreal (visual & audio hallucinations), have false beliefs (eg: paranoid delusion: believe that someone is plotting against them).
“Psychotic” refers to people suffering from “Psychosis”;
“Antipsychotics” are a class of Psychiatric medications which are mainly prescribed for treating Schizophrenia and reducing symptoms stemmed from the Psychotic conditions.
Antipsychotic drugs have been proven effectively in improving Schizophrenia symptoms and reducing the future relapse of psychotic episodes. Antipsychotics are generally divided into two types: Typical (first generation) and Atypical (second generation).
Adapted from http://ijpm.info
Chlorpromazine was the first antipsychotic drug for schizophrenia, followed by haloperidol, loxapine and others. These first generation antipsychotics are effective in treating positive symptoms of Schizophrenia (eg: hallucinations, delusions) but ineffective against negative symptoms (eg: social withdrawal). Patients will also suffer from experiencing side effects such as involuntary movements after taking this generation of drug.
Soon after, Atypical (second generation antipsychotics) were introduced. For instance, Chlozapine (Clozaril) has been shown effectively in treating Schizophrenia and comes with less severe side effect compared to Typical. However, patients might experience minor issues of obesity, increase of cholesterol and blood sugar which can be easier encountered by practicing healthy eating life style and daily exercise. Other subsequently introduced atypical antipsychotics are Risperidone, Aripiprazole (Abilify), Asenapine (Saphris), brexpiprazole (Rexulti)and others have allowed successful treatment for patients suffering from Schizophrenia.
Due to the higher chance of relapse of schizophrenia, patients are always encouraged to follow the treatment plan by doctors and cooperate with their families in order to take correct dose of medications and ensure that they can always attend the follow-up treatment. Some patients might resist taking medication because their relatives and friends tell them that they need to take these medicines for the rest of their lives. It’s true that many patients with Schizophrenia need to depend on medication for their whole life to prevent any relapse and the dose of the medication will be decreased under the supervision of Psychiatrists only if their symptoms are improving from time to time.
Another thing that might break their nerves are the risk of having kidney failure due to the ‘excessive amount’ of medication taken over the long course of their lives. There is a public misconception about taking medicines is medicines will cause kidney failue, in fact not all medicines will contribute to kidney failure and Psychiatrists will always consider the risk factor of prescribing certain medications for patients from certain age group, eg: Benzodiazepine is not encouraged to be taken by elderly patients because of its side effects.
Antipsychotics are prescribed to control and reduce Psychosis symptoms, yet, antipsychotics by themselves, are not able to address the root of the problem, behavioural difficulties or emotional issues. Antipsychotics aside, Family Support, Psychotherapy and Counseling are also greatly needed for patients’ mental health benefits so that they can develop better understanding towards their own mental issue and develop better coping strategies to deal with it.
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