Antipsychotics

Psychotic means having distorted thoughts and sensory experiences. Psychoses is a typical part of schizophrenia. Psychosis interferes with daily activities and takes away much of a person's enjoyment of life.

Antipsychotics are often prescribed for schizophrenia. They can be roughly divided into 'conventional' and 'atypical'.

Conventional medicines like Haldol, Thorazine and Mellaril still work well for many people. While these older medicines are inexpensive, newer medicines are preferred these days. Older medicines can cause shakes and movement disorders, and worsen that listless feeling which can be a problem in schizophrenia.

The listless feeling and the shakes and movement disorders led many people with schizophrenia to refuse to take these old medicines in the past. As a result, their schizophrenia often went untreated and worsened over the years. Thus the search for better medicines was of the utmost importance.

'Atypical' medicines are new. Risperdal, Zyprexa, Seroquel and Geodon are examples. With these to choose from, most people with schizophrenia can find one medicine that works quite well for them as an individual.

An unusual new atypical is Clozaril, used when other medicines fail to help with severe illness. It must be used with care. Blood tests will be done every two weeks to be sure Clozaril is not affecting the immune system, which can be very serious. This happens in about 1 per cent of people who try Clozaril. The makers of Clozaril are working on a new version, Clozaprexine, that will not affect the immune system. Meanwhile, many use Clozaril successfully by following the directions for use carefully. This medicine brought my friend's brother out of complete nursing care where he was unable to speak or move or care for himself for 14 years. Now, he is home and does all daily living skills.

These new 'atypical' medicines have far fewer problems, but are more expensive than the older medicines. Weight gain can be an issue for some people using these new medicines.

All antipsychotics stop the ''positive symptoms'' of hallucinations (voices, visions) and paranoia (suspicion) and impulses (sudden urges to do unusual things). Often these medicines work so quickly that a person can go home from the hospital in just a few days, though rest and careful recovery is still needed.

The new 'atypicals' are remarkable because they help with ''negative symptoms'' of listlessness, lack of feeling, lack of interest. Sometimes the loss of interest and drive is far more disabling than the more dramatic symptoms of schizophrenia.

These new medicines are much less likely to cause drowsiness and thinking problems. The new 'atypicals' are welcomed both by doctors and those with schizophrenia.

The new 'atypicals' often help other disorders. See the section below on antidepressants and bipolar disorder. The 'atypicals' also can help autistic children and adults, as well as children with rages and impulses. But for children the dose must be very small. Children are very sensitive to medicines.