Nature of Psychosis

It is a state of a person being affected by mental diseases such as bipolar disorder, schizophrenia, etc., which will cause the person to lose the sense of reality. When a person is in a psychotic state, he/she will be overwhelmed by delirium, and obsessive thoughts. These medications give relief to those symptoms.

Antipsychotic medications are best suited in curing severe psychotic condition caused by several psychiatric disorders. These medications are also known as neuroleptics. These are useful in the treatment of psychosis related disorders. These are most prescribed drugs to treat schizophrenia and its disorders. But people do not conform to prescribed drug regimen because of its other ill effects and lack of conviction in the effectiveness of the medication.

These medications act on brain chemicals and restore their compositions. This will moderate the effect of psychotic disorder. In bipolar disorder cases, these medicines are used as a short time measure till mood-balancer drugs start taking effect. These drugs help in moderating the effects of delirium and obsessive behavior.

Antipsychotic Medications:

These medications act on certain brain chemicals called neurotransmitters. One such neurotransmitter is dopamine. It is assumed that changes in dopamine levels are connected with symptoms of schizophrenia. People with mental illnesses need to be tried with several medications before narrowing down to suitable drugs and dosages as different people react differently with various drugs

Older antipsychotic medications, such ‘typical’ drugs as perphenazine, often have additional ill effects, such as tremor, muscle stiffness, etc., prompting the need to look for newer medications. But clozapine, which is a later ‘atypical’ version medication, has shown to be effective in the treatment of schizophrenia. It has a serious ill effect such as agranulocytosis. It is a condition of decrease in number of white blood cells that fight infections. But still, clozapine is the treatment of choice of medical fraternity.

New antipsychotic ‘atypical’ drugs have entered the realm of treatment and have less ill effects. They are more efficient than older drugs. Amisulpride, aripiprazole, olanzapine, quetiapine, resperidone, etc., medications are very effective in the treatment of schizophrenia. Olanzapine can also be used for bipolar disorder. And quetiapine is found to be suitable for acute mania with bipolar disorder.

Dosage and Duration:

These psychotic medications will have side effects is a known fact. But people worry that these medications will become addictive in the long run which is contrary to the fact. These will decrease the recurrence and severity of future psychotic episodes in the people who were cured before. But even with regular medication, some will still suffer relapses. Obviously, some will be more prone to relapses when they discontinue the prescribed medications. The degree of severity will decide the potency of maintenance dosage. A full-fledged relapse can be prevented by short-term increase in medication.

After Effects:

The medications that are used to treat schizophrenia and other mental disorders produce severe after effects in patients. Some of the after effects are:

• Tardive dyskinesia*
• Sleepiness
• Increase in weight
• Irregular menstrual periods in women
• Giddiness
• Muscle stiffness

Some possible effects:

• Mouth dryness
• Headaches
• Constipation
• Fluid retention
• Sexual dysfunction

It is associated with involuntary movements (spasms) that are felt in very few people who have been getting antipsychotic medications on long-term basis. The affected parts are usually the mouth and the tongue, although this symptom may also appear in other parts of the body as well. Tardive dyskinesia can be avoided with the lowest possible usage of antipsychotic drugs.)

Adherence:

People with schizophrenia need to adhere strictly to treatment regimen to keep the disorder in constant check. Family and treatment provider can help the patient to follow the drug-ingestion schedule properly. The patient should be made to take prescribed medicines with right dosages and at scheduled times. The patient should also keep all appointments with the treatment provider. But adherence to treatment may become tedious for patients because of severe side effects.

Non-adherence may have many reasons. The very disease, schizophrenia, itself may be the reason. It makes the patient forgetful, disorganized, and disinterested. They may think that they are fine and do not need any medications. Or they may not remember to take daily doses. The after effects of medicine may make the patients to think of discontinuing. They may start to dread the severity of after effects and may feel that discontinuance of medicine is better than having after effects. Or doctors may not enquire about patients who do not keep appointments. Or a patient may feel discouraged by the obstinacy of doctor about any changes of medications. Or the patient may be worried about the cost factor. Family and the physician should encourage the patient and educate him/her the likely consequences of non-adherence and the effect on their mental health.