ANTIPSYCHOTICS
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Why have I been prescribed an antipsychotic?
Antipsychotics are medicines used to help treat schizophrenia and similar conditions, such as psychosis.
When they have schizophrenia, many people hear voices talking to them or about them. They may also become suspicious
or paranoid. Some people also have problems with their thinking and feel that other people can read their thoughts. These
are called "positive symptoms". Antipsychotics can help to relieve these symptoms. Many people with schizophrenia also
experience "negative symptoms". They feel tired and lacking in energy and may become quite inactive and withdrawn.
Antipsychotics may help relieve these symptoms as well. Antipsychotics are also useful to help manage agitation, anxiety,
mania or hypomania, nausea, sleep problems and many other conditions.
What exactly are antipsychotics?
Schizophrenia and similar disorders are sometimes referred to as psychoses, hence the name given to this group of
medicines, which is the “antipsychotics”. They are sometimes also called the neuroleptics or (incorrectly) major
tranquillisers. Some examples of antipsychotics include chlorpromazine (‘Largactil’), haloperidol (‘Serenace’, ‘Haldol’’,
levomepromazine or methotrimeprazine (‘Nozinan’), loxapine (Loxapac’) pericyazine (‘Neulactil’), pimozide (‘Orap’),
promazine, thioridazine (‘Melleril’) and trifluoperazine (‘Stelazine’). There are some others.
These older ones are some times referred to as “typical” antipsychotics whilst the newer ones (such as olanzapine and
clozapine) are referred to as “atypicals”. Some typical antipsychotics can be given as "depot" injections. This is so that you
don't need to remember to take tablets every day. Some examples are fluphenazine (‘Modecate’), flupenthixol (‘Depixol’),
zuclopenthixol (‘Clopixol’) and haloperidol (‘Haldol Decanoate’).
Are the antipsychotics safe to take?
It is usually safe to have antipsychotics regularly as prescribed by your doctor, but they don’t suit everyone. Let your doctor
know if any of the following apply to you, as extra care may be needed:
a) if you have epilepsy, diabetes, depression, myasthenia gravis, phaeochromocytoma, Parkinson's disease or glaucoma,
or suffer from heart, liver, breathing, kidney, or prostate trouble;
b) if you are taking any other medication. This includes medicine from your pharmacist, such as antihistamines;
c) if you are pregnant, breast feeding, or wish to become pregnant.
How should I take my antipsychotic?
Look at the label on your medicine; it should have all the necessary instructions on it. Follow this advice carefully. If you
have any questions, speak to your doctor or pharmacist. Most medicines are now supplied with an information leaflet.
What should I do if I miss a dose?
Never change your dose without checking with your doctor. If you forget a dose, take it as soon as you remember, as long
as it is within a few hours of the usual time.
When I feel better, can I stop taking them?
No. If you stop taking antipsychotics, your original symptoms may return, but this may not be for 3 to 6 months after you
stop the drug. You and your doctor should decide together when you can come off them. Most people need to be on an
antipsychotic for quite a long time, sometimes years. This is not thought to be harmful. Antipsychotics are not addictive.
What will happen to me when I start taking my antipsychotic?
Antipsychotics do not work straight away. For example, it may take several days or even weeks for some of the symptoms
to reduce. To begin with, most people find that this medication will help them feel more relaxed and calm. Later, after one
or two weeks, other symptoms should begin to improve.
Unfortunately, you might get some side effects before you start to feel any better. Most side effects should go away after a
few weeks. Some antipsychotics suit some people better than others. Look at the table over the page. It tells you what to do
if you get any side effects. Not all the antipsychotics have the side effects in the table. There are many other possible side
effects. Ask your pharmacist, doctor or nurse if you are worried about anything else that you think might be a side effect.
Side effect What is it? What should I do if it happens to me?
COMMON
AKATHISIA
You feel restless, unable to feel comfortable
unless you are moving.
Tell your doctor about this. It may be possible to change your drug or dose, or
give you something to reduce these feelings.
Dry mouth, not much saliva or spit. Sugar-free boiled sweets, chewing gum or eating citrus fruits usually helps. If
not, your doctor can give you a mouth spray. A change in medicine or dose
may be possible.
Blurred vision Things look fuzzy and you can’t focus properly. See your doctor if you are
worried. You won’t need glasses.
Feeling "bunged up" inside. You can't pass a
motion or stool.
Eat more fibre e.g. bran, fruit and vegetables. Do more walking. Make sure you
drink plenty of fluid. A mild laxative might help.
ANTI-
CHOLINERGIC
EFFECTS
Difficulty in passing urine Contact your doctor now.
DROWSINESS
Feeling sleepy or sluggish. It can last for a few
hours after taking your dose.
Don't drive or use machinery. Ask your doctor if you can take your
antipsychotic at a different time.
MOVEMENT
DISORDERS
Feeling shaky or having a tremor. Your neck
may twist back. Your eyes and tongue may
move on their own.
It is not usually dangerous. If it is bad or worries you, tell your doctor. He or she
can give you something for it.
RAISED
PROLACTIN
Prolactin is a natural chemical we all have.
High levels can affect periods in women or
cause impotence in men. It may also cause
breast tenderness and milk secretion, in men
as well as women.
This sometimes wears off in a few weeks, but discuss this with your doctor
anyway. It may be that a change in dose or different drug will help.
WEIGHT GAIN
Eating more and putting on weight. Avoid fatty foods like chocolate, crisps and fizzy drinks. A diet full of vegetables
and fibre will usually help, as will physical activities such as walking. If it
becomes a problem, ask to see a dietician.
UNCOMMON
HYPOTENSION
A low blood pressure. You may feel faint when
you stand up.
Try not to stand up too quickly. If you feel dizzy, don’t drive. This dizziness is
not dangerous
PALPITATIONS
A fast heart beat. It is not usually dangerous but mention it to your doctor.
SEXUAL
DYSFUNCTION
Finding it hard to have an orgasm. No desire
for sex. Men can become impotent.
Discuss this with your doctor when you next meet.
RARE
PHOTO-
SENSITIVITY
Going blotchy in the sun. Can be common with chlorpromazine in particular. Avoid direct sunlight or sun-
lamps. Use a high factor sun block cream.
SKIN RASHES
Blotches seen anywhere. Stop taking the antipsychotic - see your doctor now.
VERY RARE
NMS
Neuroleptic Malignant Syndrome includes a
high body temperature, muscle stiffness and
being unable to move.
It usually occurs within a few weeks of a dose change. Contact your doctor
immediately. Keep cool, with fans or cool water.
AGRANULO-
CYTOSIS
Low numbers of white cells in the blood. You
may get more infections.
Always tell your doctor if you have a sore throat, fever, or just feel ill. You may
need a blood test.
What about alcohol?
It is officially recommended that people taking antipsychotics should not drink alcohol. This is because both antipsychotics and alcohol
can cause drowsiness. If the two are taken at the same time, severe drowsiness can result. This can lead to falls or accidents. As well
as this, drinking alcohol often makes schizophrenia or psychosis worse. Excessive drinking is especially likely to do this. Once people
are used to taking medication, they can sometimes drink alcohol in small amounts without any harm. Avoid alcohol altogether for the
first one or two months. After this, if you want a drink, try a glass of your normal drink and see how you feel. If this doesn’t make you
feel drowsy, then it is probably OK to drink small amounts. It pays to be very cautious because alcohol affects people in different ways,
especially when they are taking medication.
Don't stop taking your medication because you fancy a drink. Discuss any concerns you may have with your doctor, pharmacist or
nurse. If you do drink alcohol, drink only small amounts. Never drink any alcohol and drive
.
Remember, leaflets like this can only describe some of the effects of medication. You may also find other books
or leaflets useful. If you have access to the internet you may find a lot of information there as well, but be
careful, as internet based information is not always accurate.
2001 United Kingdom Psychiatric Pharmacy Group www.ukppg.org.uk
This leaflet is to help you understand about your medicine. It is not an official manufacturer's Patient Information Leaflet. For more
information call the UKPPG National Telephone Helpline, 11am to 5pm, Monday to Friday
on 020 7919 2999 or visit www.nmhct.nhs.uk/pharmacy
This leaflet has been supplied by:
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