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Side Effects of Antipsychotics in Treating Psychosis

Psychosis is a condition that affects the brain’s functionality. It can cause psychotic symptoms such as hallucinations or delusional thoughts. There are different ways of treating psychosis, one of which is antipsychotic medication. However, there are many side effects to be aware of when taking antipsychotics for psychosis.

What is Psychosis? 

When someone is experiencing a psychotic episode, they may become confused with reality and believe that imagined things are real. For example, they may hear voices or might see or taste things that are not there. Equally, they may develop strong beliefs about something that is not true. 

Experiencing psychosis can be extremely stressful and may feel like you are losing self-control. Mental health is just as important as physical health so if you are experiencing psychosis or know someone who is, it is important to understand the treatment options available and assess what is suitable. Often, when someone is diagnosed with this mental health condition, they will be offered antipsychotic medication or psychological therapies such as cognitive behavioral therapy or supportive psychotherapy. However, after discussion, with a health professional, if antipsychotic medication is the chosen method of treatment then it is important to be aware of the symptoms and side effects that can occur. 

Causes of Psychosis

There are many reasons why someone could develop psychotic symptoms. An underlying mental illness such as schizophrenia or bipolar disorder could cause someone to be at an increased risk of developing psychosis. However, someone does not need to have these mental health conditions to develop psychosis. Other factors to trigger psychosis involve: 

  • Drug or alcohol misuse 
  • A traumatic experience 
  • Stress 
  • Side effects of prescribed medication 

If someone becomes detached from reality and experiences a psychotic episode without an underlying mental health condition such as bipolar disorder or schizophrenia then it is likely it has been triggered by an external factor such as trauma, alcohol, or drug use. 

Symptoms of Psychosis 

Individuals who have psychosis will experience symptoms that may be unique to themselves. However, there are a few psychotic symptoms that are easy to recognize: 

  • Hallucinations, and auditory hallucinations – This could occur by believing you are seeing, hearing, touching, or tasting things that are not there. 
  • Delusions – This could manifest as a persistent thought about a specific belief or thought process that is untrue. 
  • Confused or disturbing thoughts – This might result in an individual acting somewhat erratically. Someone experiencing an episode of psychosis may show rapid speech or stop in the middle of a conversation. This is due to the loss of train of thought brought on by the severe mental illness. 

If you have experienced any of these symptoms or recognize them in someone you know, it may be time to seek help from mental health professionals, such as a mental health worker or a doctor. From there, they will be able to provide a thorough assessment and may advise treatment such as antipsychotic drugs or psychiatric therapy and other psychological treatments. 

Psychosis vs Bipolar Disorder and Schizophrenia 

Different mental health conditions can affect people in different ways, however, they may present the same symptoms. Therefore it is important to be able to recognize the difference between different mental illnesses in order to seek the correct help. 

Recognizing Schizophrenia – Psychosis and schizophrenia are very closely related and show similar symptoms such as hallucinations, delusion, and confused thought. However, there are a few distinct differences, and to be diagnosed with schizophrenia you need to meet other criteria such as paranoia, delusions of grandeur, and lack of motivation for everyday tasks. Typically, people who have psychosis or schizophrenia will be closely monitored to ensure treatment is effective. The treatment for schizophrenia will be different from psychosis treatment and may require alternative antipsychotic medicine to reduce psychotic symptoms. 

Recognizing Bipolar Disorder – Bipolar is very different from psychosis as it is a mood disorder that can cause times of mania and equally times of severe depression. Typically, someone with bipolar will lack control of their emotions. Someone who has bipolar is more likely to be prone to developing psychosis if treatment is not maintained or if they become exposed to triggers. 

Treating Psychosis 

When someone is diagnosed with psychosis they will be offered a few different treatment options depending on the severity of the symptoms. Typically they will be passed over to early intervention teams who will assess the patient’s needs. Treatment on offer can range from:

  • Antipsychotic medications 
  • Talking therapies
  • Family therapy or intervention 
  • Self-help groups 
  • Arts therapies 

Antipsychotic Medications 

After a psychosis diagnosis, the first step in treatment after a consultation with a doctor may be antipsychotic medicines. Taking antipsychotic medicines may provide initial relief from symptoms such as delusions, hearing voices, and hallucinations, they may also prevent any future psychotic episodes from occurring. However, antipsychotics may not be for everyone as they can cause some negative symptoms and side effects. Some of the more common medications that may be offered will include: 

  • Chlorpromazine (Thorazine)
  • Fluphenazine (Prolixin)
  • Haloperidol (Haldol)
  • Perphenazine (Trilafon)
  • Thioridazine (Mellaril)

How Do Antipsychotic Medications Work

Psychosis is thought to be caused by an overactivity of dopamine. Antipsychotic medications reduce the likelihood of a psychotic episode by blocking the dopamine effect. Although it may help to alleviate the symptoms, taking antipsychotic medication does not guarantee that symptoms such as delusions and hallucinations will disappear. 

Side Effects of Antipsychotics in Treating Psychosis

Side-Effects of Antipsychotic Medications

A lot of antipsychotics can be proscribed in high doses and can have a strong effect on the individual that is taking them. Typically they will dull the senses and provide an anti-depressant effect. However, there are negative side effects that can occur. Some of the most common side effects that antipsychotics can cause are: 

  • Mood swings – The effects of antipsychotics can often cause unpredictable moods that will fluctuate throughout the day. 
  • Weight Gain – A lot of medications will cause a sedentary feeling which will lead to a lack of motivation, therefore, it can be easy to suffer from weight gain, especially if the person taking medication is typically active. Depending on the type of antipsychotic medication taken and the susceptibility of the person, the drug may affect the sense of feeling full so it may become more likely to consume an excess of food. 
  • Dizziness – This may occur over time in individuals after taking antipsychotics. 
  • Diabetes – Certain medications have been shown to increase the risk of diabetes in certain individuals. 
  • Tardive dyskinesia – This is a condition that may cause you to perform involuntary muscle movements. This can develop over time and in rare cases can become permanent. 
  • Neuroleptic malignant syndrome – Is a condition that can cause fever, muscular rigidity, and altered mental function. This is typically a rare side effect of taking antipsychotics, however, it can be potentially life-threatening if left untreated. 
  • Impacted movement – Due to the effect antipsychotic drugs can have on muscle movement, it may become difficult to physically function at the same efficiency as you did pre-medication. 
  • Blurred Vision – After taking medication, sight may become reduced or blurred. 

Atypical Antipsychotics 

Atypical antipsychotics are also known as second-generation antipsychotics. This type of medication acts on the dopaminergic system, blocking the dopamine type 2 (D2) receptors. These were introduced in the 1970s to treat a wide range of psychotic symptoms including psychosis and can sometimes be used when another medication has failed. Some of these include paliperidone (Invega), aripiprazole (Abilify), and clozapine (Clozaril). However, like standard antipsychotics, they also have an extensive list of side effects that must be taken into account. Although they will affect people differently, typical symptoms include:

  • Loss of libido 
  • Increased weight gain.
  • Diabetes.
  • Drowsiness.
  • Sun sensitivity.
  • Diabetes.
  • Seizures.
  • Increased cholesterol.

Ways to Control the Side Effects of Antipsychotics 

There are a few things that can be done to control or even reduce the side effects of antipsychotic medication.

  • Speak to the qualified healthcare professional responsible for administering your medication and discuss the potential for a lower dosage. Adjusting the dosage may help to alleviate the negative symptoms of the medication. 
  • Adjusting your diet and eating healthily can help counteract weight gain that may occur and reduce the risk of diabetes. If you are unsure of what to eat, you can speak to a health care professional who will advise you on eating a healthy and balanced diet. Ensuring you are getting plenty of exercise will also help towards weight loss. 

The Mental Health Act (1983)

If psychosis is not controlled via medication or therapy and you experience severe episodes, you can be compulsorily detained at a hospital under the mental health act (1983). This is for the protection of yourself and those around you. It will also allow healthcare professionals and an early intervention team to assess treatment and offer support.

Other Help Available 

For a lot of people who suffer from psychosis, antipsychotic medication may not be the most effective form of treatment as everyone will respond differently. Therefore, it is important to know that other help is available. Other forms of help include: 

  • Cognitive Behavioural Therapy (CBT) – CBT is a psychological therapy based on helping someone understand their experiences. A CBT therapist will help find ways to help you rethink your challenges and offer guidance, support, and techniques to overcome stress and psychosis-related symptoms. 
  • Family Intervention – This is a great way of helping both you and your family through your diagnosis. Mental health professionals working alongside family members will help gain an understanding so full support can be provided, they can also learn practical tips for managing someone with psychosis. 

Self-help groups or a community mental health team – If you have had a recent diagnosis, it may help to hear from other individuals who have experienced similar things. Sharing experiences may help you understand your symptoms better and may encourage methods of coping. 

At Addcounsel, we offer a range of treatments to help with psychosis. If you have received a diagnosis of psychosis or are close to someone who has, it is important to know the methods and types of treatment that are on offer as well as the side effects that can occur from taking antipsychotic medication, in order to have an informed approach towards the treatment process. 

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