Many people with psychosis or bipolar disorder are prescribed medication as part of their treatment.
What are the different kinds of medication for?
Antipsychotics – The Facts
- Antipsychotics can reduce or stop the symptoms of psychosis
- In some cases antipsychotics cut down the risk of relapse into a psychotic episode
Antipsychotics are also commonly used to treat mania or hypomania and sometimes depression
- There are two groups: ‘Typical’ (older) and ‘Atypical’ (newer)
- Antipsychotics are all about equally effective, but different people respond better to one than another. For people who do not seem to be responding to other antipsychotics, clozapine may be recommended. Clozapine can be more effective for some people than other antipsychotics, but can also cause very serious side effects and so needs to be monitored very carefully.
- Sometimes, several different medications are tried before the ‘right’ one is found
- Antipsychotics tend to be better at reducing positive symptoms of psychosis and are less effective at reducing negative symptoms
- Side effects differ widely between medications. It’s important to find out what the side effects are for any specific medication your relative is given
Antidepressants – The Facts
- Depressed mood is common in people with psychosis or bipolar and antidepressant medication may be helpful
- Some people with bipolar disorder can develop mania in response to antidepressants. Therefore antidepressants are not recommended on their own for this group. Antipsychotics and /or mood stabilisers may be offered in combination or as an alternative.
- There are many different antidepressants available
- The most commonly prescribed are called Specific Serotonin Re-uptake Inhibitors (SSRIs). They are also sometimes prescribed for some kinds of anxiety
- SSRIs work by affecting the levels of a neurotransmitter called serotonin in the brain
- Antidepressants take at least 2-3 weeks to start working
- Different antidepressants have different side effects so it’s about finding one to suit
- Antidepressants should not be stopped suddenly, as there is evidence that some people can experience worsening of mood symptoms
- Taking antidepressants for several months after mood has improved is thought to prevent future relapse
Mood Stabilisers – The Facts
- Mood stabilisers include lithium, sodium valporate and carbamazepine
- They are prescribed to prevent extreme mood episodes which most commonly occur in bipolar disorder
- They are usually prescribed for long periods of time and need to be taken daily even when the person is feeling well
- They are often prescribed in combination with antipsychotics to manage mania, or with antidepressants to manage depression
Other Commonly Prescribed Medications
Other kinds of medication can be helpful. Benzodiazepines (such as diazepam, lorazepam, or clonazepam) are used to treat anxiety. Other medications (such as zopiclone) can help with sleep. They are used for short periods because if taken for more than a few weeks they can be addictive, and become less effective.
Non-Prescribed Medications and Herbal Preparations
Some of these may cause problems when mixed with prescribed medication. It is important that your relative discusses with their psychiatrist if they are thinking of trying any. Some may cause no problems and may even be helpful e.g. fish oils, whereas some may have serious interactions with prescribed medicines.
For information about specific medications you need to read the accompanying leaflets or you can look them up at www.medicines.org.uk/emc or www.chooseyourmedication.org (note the latter site requires a subscription). Medications generally come in different forms; tablet, liquid or injection. It is worth noting most drugs have two names – the drug name and the trade name, e.g. olanzapine (drug name) has several trade names including brand names: Zyprexa, Zyprexa Zydis, Zyprexa Intramuscular and Zyprexa Relprevv.