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Antipsychotic medications work by altering your brain chemistry to reduce psychotic symptoms like hallucinations, delusions and disordered thinking. They also help prevent those symptoms from returning.
Modern medications for treating psychosis are known as ‘second-generation’ or ‘atypical’ antipsychotics. Some common atypical antipsychotics include:
These are the names of the drugs themselves, but they’re often sold under different brand names.
Older, ‘first-generation’ or ‘typical’ antipsychotic medications are generally only prescribed if the second-generation medications aren’t working for you.
I’m very grateful for the medication as it allowed me to sleep for the first time in five months
Antipsychotics change the levels of chemicals in your brain called neurotransmitters — the chemicals that carry messages around your brain. The neurotransmitter most targeted by antipsychotics is called dopamine.
Changing the levels of these chemicals reduces, in almost all cases, the hallucinations and delusions of psychosis. In some cases, they also improve your mood and reduce anxiety.
Here’s a list of some useful things you might want to discuss with your doctor.
Tell your doctor about:
If your doctor suggests medication, ask:
Ask your doctor what is or isn’t recommended while taking medication. For example:
While you’re taking medication, tell your doctor immediately about:
There are two ways to take antipsychotic medication: by mouth or as a depot (sometimes called a ‘long-acting injectable’). The dose you take each time usually starts low. As your symptoms are monitored over time, your doctor might increase it or keep it at the same level.
Depots are used when there’s a risk you might forget or stop taking your medication, which can lead to a rapid worsening of your symptoms.
You can choose a depot yourself, but there are circumstances where a doctor can legally require you to take medication by depot, even without your consent. That’s only done rarely, and always with your health and safety in mind.
It commonly takes up to six weeks from your first dose for medication to start reducing symptoms, and several months before you feel their full effect.
If your psychotic symptoms reduce or go away, it doesn’t mean your medication is unnecessary. It means your medication is working — part of its job is to stop your symptoms coming back.
When people stop taking their medication too soon or too suddenly, they are at very high risk of having another episode. You should have completely recovered from psychosis and had 12 months of good mental health before even starting the discussion about stopping medication.
To give yourself the best possible chance of recovery and good health, take your doctor’s advice and, where advised, take your medication.
If you feel you need to change your medication, always do this in consultation with your doctor.
All antipsychotic medications have potential side-effects. They vary from person to person, but can include:
If you’re taking antipsychotic medication, it’s very likely you will experience some side effects. Work is being done to improve medications, but at the moment it’s often necessary to live with side-effects to reduce your active psychotic symptoms.
If you start experiencing side-effects, make sure you tell your doctor about them straightaway.
For some people, it can take months to find the right medication — that’s normal.
If the side-effects of the medication you’re taking are too severe, or if your psychotic symptoms don’t subside, it might be possible to try other options.
Talk to your doctor. Changing medicine can take time and will need careful guidance and observation from a health professional.
Within three months of the change in his medication, Jock took over his own life. He didn’t look back
— Jock’s mother Dianne
There are a few things you can do to make sure your experience with medication is safe:
Some people with psychotic illness find that the usual antipsychotic medications don’t reduce their symptoms over time. If this happens, your doctor may suggest clozapine, a drug which is very effective but comes with a greater risk of side effects.
Antipsychotic medications are designed to reduce and prevent the return of psychotic symptoms, including hallucinations, delusions and disordered thinking. They may not affect the other symptoms of your illness, so you may need to get other treatments for these symptoms.
Antipsychotic medication is considered the main treatment for psychosis, but other treatments are available.
Related: Psychosis factsheet
Along with psychosis, you may experience other mental health issues, like depression, mania, anxiety, and the ‘negative’ symptoms of schizophrenia.
So you may be prescribed anti-anxiety medications, anti-depressants or mood stabilisers along with your antipsychotics. This is relatively common — the medications are often used together.
This SANE factsheet is currently being reviewed by industry professionals, carers and people with lived experience of psychosis.
‘4329.0.00.003 - Patterns Of Use Of Mental Health Services And Prescription Medications, 2011’ Abs.gov.au. Australian Bureau of Statistics, 2017. Accessed 17 March 2017.
Galletly et al (2016) ‘Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the management of schizophrenia and related disorders.’ Aust NZ J Psychiatry, Vol. 50(5) 1-117