Some people need to keep taking it long term. If you have only had one psychotic episode and you have recovered well, you would normally need to continue treatment for 1–2 years after recovery. If you have another psychotic episode, you may need to take antipsychotic medication for longer, up to 5 years.
After symptom remission, continuation of antipsychotic treatment is associated with lower relapse rates and lower symptom severity compared to dose reduction/discontinuation. Therefore, most guidelines recommend continuation of treatment with antipsychotic medication for at least 1 year.
Taking antipsychotics can increase your risk of developing metabolic syndrome. If you experiencing metabolic syndrome, this means you are at higher risk of developing: diabetes. stroke.
But with the right treatment, most people can live complete and fulfilling lives – thanks mainly to their antipsychotic medication. But of course, all medications have side-effects and for some people on antipsychotics these side-effects can range from mildly debilitating to life threatening.
Antipsychotic drugs can cause serious side effects, and the risk increases with continued use over weeks and months. Possible negative effects of antipsychotics include: drowsiness or confusion.
When people who are prescribed antipsychotics for psychotic disorders stop taking them, some relapse, meaning that their psychosis returns. However, some patients are able to sustain a psychosis-free existence after the cessation of antipsychotics.
Thus, early exposure to antipsychotic drugs may permanently alter neuronal development with a lasting impact on behavior.
After a first episode of psychosis in schizophrenia and related disorders, stopping antipsychotics is considered when the patient has made a full recovery and been well for at least 12 months.
All antipsychotics are generally effective, although differences exist in terms of efficacy but also in side effect profile. So far, all antipsychotics block the dopamine-2 (D2) receptor in the brain, including recently available antipsychotics such as lurasidone, cariprazine and brexpiprazole.
Clozapine and olanzapine have the safest therapeutic effect, while the side effect of neutropenia must be controlled by 3 weekly blood controls. If schizophrenia has remitted and if patients show a good compliance, the adverse effects can be controlled.
Evidence of the rapidity at which antipsychotics can affect brain volume in humans was recently provided by Tost and associates. These investigators found a significant, reversible decrease in striatal volume in healthy subjects within 2 hours after they were treated intravenously with haloperidol.
So while treatment with some antipsychotics seems to increase intelligence, others reduce symptoms without that effect. Other medications that are known to cause improved cognitive functioning had no effect when combined with those antipsychotics.
Although antipsychotic medications are effective, some have substantial side effects, including several types of movement disorders, weight gain, and effects on sugar and lipid regulation. They may increase the risk of stroke and are associated with higher rates of death in the elderly.
Antipsychotic medications work by altering brain chemistry to help reduce psychotic symptoms like hallucinations, delusions and disordered thinking. They can also help prevent those symptoms from returning.
You may find it's possible to manage your symptoms, or to make a full recovery, without medication. If you are taking antipsychotics, you may also want to use other options to support your mental health, as well as your medication.
27% of drug-treated patients experienced a relapse within 1 year. When we summarised the relapse rates of only the 11 studies included by Takeuchi et al, the results were more similar 55% v. 22% relapsed.
Agitation and sedation: Some people feel “wired” and unable to stop moving when taking antipsychotics. This effect may be mistaken for a worsening of illness rather than a side-effect of the medication. These same drugs can also have the opposite effect, making people feel tired.
These antipsychotic drugs come in a long-lasting form: Aripiprazole (Abilify Maintena) Aripiprazole lauroxil (Aristada) Fluphenazine (Prolixin)
Some people may be able to stop taking antipsychotics without problems, but others can find it very difficult. If you have been taking them for some time, it can be more difficult to come off them. This is especially if you have been taking them for one year or longer.
QOL and antipsychotic medication
In both studies, patients who received the antipsychotic showed significantly greater improvement in QOL than those treated with placebo.
You may experience agitation or episodes of high anxiety. Mental fog. You might have a hard time thinking clearly or focusing on a task. You might also have difficulty recalling information.
Blocking the action of dopamine.
Dopamine is a neurotransmitter, which means that it passes messages around your brain. Most antipsychotic drugs are known to block some of the dopamine receptors in the brain. This reduces the flow of these messages, which can help to reduce your psychotic symptoms.
The ability of antipsychotics to suppress people's trauma memories may contribute to post-traumatic avoidance. People with post-traumatic stress symptoms and psychosis should be provided with psycho-education about post-traumatic avoidance and its role in the maintenance of post-traumatic stress disorder.
Give yourself time
While it is sometimes possible to withdraw over a few weeks, it can be safer to do so over several months so that your body has a good amount of time to adjust. For some people who have been on medication for many years, withdrawing very slowly over a few years can also be helpful.
Mood stabilisers, including lithium and anticonvulsants such as carbamazepine have been proposed as an alternative therapy to standard antipsychotic treatments when individuals have sub-optimal responses to treatment.