Medications and Psychosis: A Psychiatrist’s Guide to Antipsychotic Treatment

By Dr. Babor Aganren. MD, MRCPsych, Consultant Psychiatrist

From my first days in psychiatry, I have been continually moved by the strength of my patients and their families. The journey of navigating psychosis can be profound. From my experience though, I can say that the path to mental health wellness, though challenging, is one paved with hope. This article’s focus is on the role that medications play on this journey.

What is Psychosis?

Before we go any further, let me provide a brief overview of Psychosis. My previous blog post goes a bit deeper and can be referred to. Essentially, it is a profound mental health condition. Psychosis disconnects individuals from reality, often leading to hallucinations, delusions, or disjointed thoughts.

Anna’s Journey with Psychosis

Anna, a 28-year-old graphic designer, once told me about her harrowing experience with auditory hallucinations. She would hear voices ridiculing her every decision. The voices were persistent and pervasive. It disrupted her life and strained relationships. However, with early intervention and the right medication, she regained control over her life.

The Prominence of Antipsychotic Medications

Antipsychotic medications have been a useful tool in combating symptoms of psychosis for years. They primarily function by influencing brain chemicals known as neurotransmitters in the brain. Dopamine is the main neurotransmitter it helps to modulate, but there are other brain chemicals that medications can affect like noradrenaline and serotonin. 

It is important to note that antipsychotic medications are just one part of managing Psychosis.Other important aspects such as Talking therapies, and Social elements should be used in tandem with medications.

Benefits:

Symptom Control: Antipsychotic medication can dramatically reduce, or even eliminate, hallucinations, and delusions.

Improved Cognitive Function: Antipsychotic helps to ease disjointed and chaotic thinking. Patients have described having a clearer mind. This allows patients to participate more effectively in therapy and other treatments.

A Look at the Antipsychotics

Antipsychotic medications are broadly classified into First generation antipsychotics also referred to as typical antipsychotic and Second generation Antipsychotics also known as atypical. 

In practice however, These are not always clear cut. For example, Clozapine would be considered second generation but is amongst one of the earlier discovered antipsychotic medications. 

First-generation antipsychotics: Older but effective, examples include haloperidol. However, they might come with side effects associated with abnormal movement issues when compared to Second generation antipsychotics.

Second-generation antipsychotics: These newer versions, like risperidone or olanzapine, can be more tolerable for many with regards Side effects of abnormal movements. However this broad class of medication could be more likely to lead to metabolic side effects, compared to First generation antipsychotics. This is not always the case and depends on the exact medication used 

Michael’s Medication Story

Michael, a father of two, experienced paranoia. Convinced that his coworkers were plotting against him, he withdrew socially. Starting on a first-generation antipsychotic, he experienced a tremor which impacted his work as a craftsman. But after switching to a second-generation medication, he found balance without debilitating side effects, showcasing the importance of individualized treatment.

The Potential Side Effects

No medication is without its side effects. Common ones for antipsychotics include drowsiness, weight gain, or dry mouth. Other side effects could include tremors, stiffness and an internal sense of restlessness.

There are various options to tackle side effects so regular check-ins with your psychiatrist can help tailor your medication regimen to your needs. It is important to stress that not everyone will experience side effects and there is help available if needed.

Lily’s Balancing Act

Lily, a school teacher, battled weight gain from her medication. While it controlled her delusional thoughts effectively, the added weight affected her self-esteem. After discussing her concerns, we adjusted her treatment. Today, she is a beacon of hope for her students and is actively advocating for mental health in schools.

Embracing Hope in Mental Health

Psychosis doesn’t define anyone. Through the stories of Anna, Michael, and Lily, we see the intertwining threads of challenge, resilience, and triumph. Medications are one tool among many in the journey towards improved mental health. With the right support, treatment, and hope, there’s always a way forward.

Remember, always consult a medical professional for personalized advice.