Antipsychotic drugs are among those drugs that, if prescribed to someone, are likely to cause fear and panic in that person, but we must know that controlling and managing any disease is definitely better than leaving it alone. A person may have delusions and hallucinations or may periodically experience good and bad moods. To control these mental disorders, antipsychotic drugs, or antipsychotic drugs, are usually prescribed.
Antipsychotic drugs: These drugs are prescribed entirely at the discretion of the doctor depending on the type of illness, which can be of various types, including bipolar disorder, depression, schizophrenia, post-traumatic stress disorder, or others. In many cases, it has been seen that a person can continue their normal life without any problems by taking these antipsychotic drugs.
What is psychosis?
Psychosis is actually a set of symptoms that a person may experience due to lack of sleep, taking a certain medication, genetic alcohol consumption, or a severe or acute change in health. People who experience these symptoms experience things or feelings that are not real and that others would not experience in the same situation.
Before we look at antipsychotic medications, we need to know what the symptoms of psychosis are. Below are some of them:
- Mood swings related to bipolar disorder
- Meaningless or long-winded conversations
- Violent or destructive behavior
- Auditory and visual hallucinations
- Social isolation
- Lack of motivation
- Depression
- Being bored
- Insomnia
- Delusion
People who suffer from psychosis do not necessarily experience all of these symptoms and may only experience a few. The severity of the symptoms is also important, as it helps a specialist doctor diagnose the type of illness and can prescribe the appropriate antipsychotic medication for the individual if needed. The diagnosis of psychosis is the responsibility of a specialist doctor only and only after specialized evaluations, and self-diagnosis or treatment should be strictly avoided.
Mechanism of action of antipsychotic drugs
The brain has chemicals that are responsible for transmitting messages from one part of the brain to another. Antipsychotic medications reduce or control symptoms of mental disorders by targeting certain neurotransmitters in the brain. These medications affect the function or levels of those transmitters. These transmitters include serotonin, norepinephrine, and dopamine, which we will briefly discuss below:
- Dopamine: Antipsychotic drugs work by affecting this neurotransmitter, reducing or regulating its activity, which results in managing emotions and controlling movement. Dopamine helps a person know what is important or interesting, creates motivation, and allows a person to experience pleasure and reward.
- Norepinephrine: Antipsychotic medications increase norepinephrine levels, which helps reduce depression and regulate sleep.
- Serotonin: By increasing the levels of this transmitter in the brain, antipsychotic medications help control symptoms such as mood, eating, and sexual behavior.
Similarities and differences between antipsychotics and antidepressants
Despite the similarities between antipsychotic drugs and antidepressants, they actually differ in their mechanisms of action and are each prescribed for specific symptoms. As mentioned, the function of antipsychotic drugs is to control and reduce the function of certain neurotransmitters, while the mechanism of action of antidepressants increases the availability of these neurotransmitter compounds.
The goal of antidepressants is to reduce the symptoms of depression and the anxiety that results from it, while the goal of antipsychotic medications is to control and manage the symptoms caused by mental disorders and psychosis.
Both antidepressants and antipsychotics affect the brain's chemical transmitters, including serotonin, dopamine, and norepinephrine. Types of antidepressants include: SSRIs (selective serotonin reuptake inhibitors), SDRIs (selective serotonin and dopamine reuptake inhibitors), and SNRIs (selective serotonin and norepinephrine reuptake inhibitors). We will also discuss the types of antipsychotics in detail below.
Types of antipsychotic drugs
Antipsychotic drugs can be divided into two categories based on their mode of action and mechanism of action: first-generation or typical antipsychotic drugs (old generation) and second-generation or atypical antipsychotic drugs (new generation). In general, antipsychotic drugs are prescribed to improve, control, and manage mental disorders, including the following:
- Tourette syndrome
- People with bipolar disorder
- People with major depression
- Adults with dementia
- People with personality disorders and psychotic symptoms
- Alcohol users who also experience psychotic symptoms.
Based on the symptoms observed and the tests performed, the neurologist and psychiatrist may prescribe either a first- or second-generation antipsychotic medication. Some of these long-acting antipsychotic medications may be given as monthly injections. Below is an overview of these two drug groups.
First-generation or typical antipsychotics
First-generation antipsychotic drugs, which have been used since the 1950s, work by affecting dopamine to reduce symptoms of mental disorders and psychosis. These drugs often have side effects such as muscle cramps, vomiting, and weight gain. Examples of the most common first-generation antipsychotics, also known as typical drugs, are listed below:
- HaloperidolIt is specifically designed to treat children's impulsive behaviors, psychotic disorders, and Tourette's syndrome.
- FluphenazineControls and manages conditions such as schizophrenia and delusions.
- ChlorpromazineIt is a type of first-generation antipsychotic medication that is prescribed to control and reduce the symptoms of schizophrenia, psychotic disorders, and manic mood in bipolar disorder, and severe behavioral problems in children.
Perphenazine, molindone, thiothixene, loxapine, and trifluoperazine are other first-generation antipsychotics.
Second-generation or atypical antipsychotics
Second-generation antipsychotic drugs, which have been in use since the 1990s, are usually prescribed more often because they are newer and have a better mechanism of action. The most prominent second-generation antipsychotic drugs, also known as atypicals, include:
Quetiapine: This drug is produced by the Kish Medipharm Pharmaceutical Group under the brand name Quemind, and given that it is approved by the Food and Drug Administration, it is generally recommended for the following conditions: major depression, bipolar disorder, and schizophrenia.
Clozapine It is usually prescribed for people who have been resistant to previous treatments, meaning other medications have failed to control or reduce the symptoms of psychosis.
Aripiprazole and lurasidone Other antipsychotic medications are commonly prescribed and used to control schizophrenia and bipolar disorder.
AripiprazolePaliperidone, risperidone, and olanzapine are considered second-generation antipsychotic drugs, which are also administered as injections on a monthly basis for long-term, slow-release effects.
Please note that many neuroleptics, including antipsychotics, have off-label uses that, at the discretion of a specialist, may be prescribed outside the therapeutic categories mentioned in references and textbooks and based on official, globally approved guidelines in cases not listed in the classification.
First-generation and second-generation antipsychotics are divided into two categories based on their different mechanisms of action. The most common second-generation antipsychotic is Co-amniotic fluid, which is highly effective in controlling mental disorders. Although both generations of drugs are effective in controlling mental disorders, second-generation antipsychotics also have some advantages (fewer side effects such as tremor or slowness of movement, lower risk of tardive dyskinesia).
Side effects of antipsychotic medications
Although the use of antipsychotic medications has had a positive impact on many people throughout history, it should be noted that in some cases, if the dosage is not adhered to, it can be arbitrarily discontinued, cause medication errors, and in other cases, may result in unwanted and irreversible side effects.
These side effects can be short-term, meaning that the person only experiences these problems for a short period of time due to the new start of this medication, or they can have long-term effects. However, it is important that in all these cases, the specialist doctor is aware of all your conditions. Below we have mentioned some of the side effects of antipsychotic drugs.
- Sexual side effects, including erectile dysfunction and decreased libido
- Parkinsonism (stiffness, slowness, and tremors during movement)
- Arrhythmia (irregular and abnormal heartbeat)
- Changes in blood sugar or cholesterol levels
- Increased appetite and ultimately weight gain
- Headache, dizziness, and nausea
- Sialorrhea, or excessive saliva production
- Allergic skin and dermatitis
- Constipation or difficulty urinating
- Sensitivity to light and temperature
- Drowsiness
- Restlessness
- Seizure
In addition to its benefits, every drug may also have complications. The complications from taking antipsychotic drugs can be so dangerous and severe that they can lead to heart attacks and ultimately death, especially in elderly people who also have dementia. Therefore, it is very important to pay attention to the symptoms after taking any drug, especially antipsychotic drugs, and to inform the specialist.
Antipsychotic drug interactions with other medications
Taking some antipsychotics with other medications may cause interference, either interfering with or completely eliminating each other's effectiveness, so be sure to mention all the necessary information, including the medications you are currently taking, during your appointment with your specialist.
For example, a number of antipsychotic medications may interact with some tricyclic antidepressants and should not be used together. Antipsychotic medications can interact with some of these medications:
Anti-anxiety medications such as benzodiazepines (lorazepam and diazepam)
Anticonvulsants (carbamazepine)
Anti-Parkinson drugs (L-DOPA)
Anti-bleeding medications (warfarin)
Frequently asked questions about psychotic disorders and antipsychotic medications
In this section, we will answer some of the most common questions people have about psychotic disorders and antipsychotic medications. It is important to note that these are only general questions and may not apply to everyone or may have different answers depending on different circumstances.
Should the treatment of psychosis change during menopause?
Given that psychotic symptoms are likely to intensify during this period, it may be necessary to change the dosage, administration method, or substitute another medication.
Can taking antipsychotic medications cause driving impairment?
Given that the use of these drugs may cause symptoms such as lack of concentration and movement disorders, it is necessary to avoid driving and doing tasks that require concentration during the first few times of taking these antipsychotic drugs. After you are sure that taking antipsychotic drugs does not cause you to lose concentration, and if your doctor allows it, you can return to your previous routine.
Can alcohol consumption cause interactions with antipsychotic medications?
Alcohol consumption can interfere with the absorption of these medications and increase the sedative and unconsciousness symptoms of these medications, so do not drink alcohol while taking antipsychotic medications. In addition to the above, alcohol, through its direct effects on the brain, can exacerbate neurological and psychiatric symptoms.
Taking antipsychotic medications with certain conditions such as pregnancy, aging, alcohol consumption, and tobacco use can have irreparable risks.
Conclusion
Just as achieving physical health is very important, follow-up should also be done for the desire for mental health. In this article, we have tried to explain the entire course and period of observation to treatment of psychosis. It should be noted that the use of antipsychotic drugs, whether first-generation or second-generation, requires a doctor's prescription and it is better to be under the supervision of a specialist throughout the treatment. Antipsychotic drugs are usually prescribed to control and reduce mental disorders including major depression, bipolar disorder, and schizophrenia.
To avoid any problems during the treatment period, be sure to read the brochures inside the box of the pharmaceutical products, especially if they are antipsychotic drugs. One of the drugs that is usually prescribed by a specialist doctor by people with schizophrenia, bipolar disorder, and major depression is Quemind, which is produced in doses of 25, 100, 150, and 200 mg by the Kish Medipharm pharmaceutical factory.
