How to Coach Yourself and Others Coaching and Counseling in Difficult Circumstances | Page 45

This book is in B&W, not color - Print page in Grayscale for Correct view! Antipsychotic medication What is it for? Antipsychotic drugs are called neuroleptics or, misleadingly, major tranquillisers. They are usually used only for the treatment of severe psychotic illnesses such as schizophrenia, mania and major depression with psychotic features. Their side-effects are common and often serious. They can also be used to help manage confusion, dementia, behaviour problems and personality disorders, or, in smaller doses, to help treat anxiety, tension and agitation. They have an initial, rapid, tranquillising (calming) effect. Their effect on psychotic symptoms, such as delusions and hallucinations, may not appear for several weeks. There are two main groups of drugs. • ‘Typical’ or classical antipsychotics: include ‘low-potency’ drugs, such as chlorpromazine (Largactil), which are used in hundreds of milligrams per day, and ‘high-potency’ drugs, such as haloperidol (Serenace) and fluphenazine (Moditen), which are used in tens of milligrams per day. • ‘Atypical’ antipsychotics: such as risperidone (Risperdal), olanzapine (Zyprexa) and clozapine (Clozaril). Clozapine is an ‘atypical’ antipsychotic that has, to date, a unique effectiveness with patients who have not improved with other antipsychotics (drug-resistant schizophrenia). Some typical antipsychotics are available as long-acting ‘depot injections’, such as fluphenazine decanoate (Modecate) and haloperidol decanoate (Haldol). Antipsychotic drugs have different side-effects to each other. If one drug does not suit a patient, another may be tried. Side-effects There is a wide range of side-effects. Many are common. They can cause significant impairment in functioning and may be the reason why some people stop taking their medication. They occur most commonly with the high potency typical antipsychotics. With appropriate advice and management, side-effects can be minimised. If a patient is distressed by side-effects, advise them to have a discussion with the doctor or mental-health nurse. Common side-effects • Constipation, dizziness, drowsiness, dry mouth, appetite increase, blurred vision. Movement disorders, known as ‘extrapyramidal’ side-effects, include shaky hands, feeling shaky, involuntary movements of the face, neck, eyes and tongue. Also, akathisia (acute feeling of restlessness in the legs, constant pacing). Rare but important side-effects • Fever and muscle stiffness could be ‘neuroleptic malignant syndrome’, which is rare but potentially fatal. Stop medication and call the doctor urgently. The patient should be cooled, and the body fluids and serum electrolytes monitored. Anticholinergic medication will be needed. • Skin rashes: stop medication and consult the doctor immediately. For [email protected] Property of Bookemon, do NOT distribute 47