What are antipsychotic medicines?

Antipsychotic medicines are used to treat psychosis. Psychosis is a mental health condition that makes it hard to tell what is real and what isn't.

Psychosis may occur without a clear cause. This may follow drug use or as a symptom of schizophrenia, bipolar disorder or severe depression.

Psychosis can cause significant symptoms including:

• confused thinking
• delusions — false beliefs that you are certain are true or real
• paranoia — unjustified suspicion or mistrust of others
• hallucinations — seeing, hearing, feeling, smelling or tasting things that are not actually there

Antipsychotic medicines can help reduce or relieve symptoms associated with psychosis. They may also help anxiety and agitation, and problems with mood, thinking and socialising.

Some antipsychotic medicines work better if you also have psychological therapy and social support. This includes psychotherapy such as cognitive behavioural therapy, given by a psychiatrist or psychologist.

How do antipsychotic medicines work?

Many mental illnesses are associated with changes in naturally occurring chemicals in the brain and body. Antipsychotic medicines affect the balance of these chemicals, particularly dopamine, to reduce or relieve symptoms of psychosis.

What are the benefits of antipsychotic medicines?

The main benefit of using antipsychotic medicine is relieving symptoms of psychosis.

Psychosis is a serious condition that can significantly affect your health, safety and quality of life. Getting effective treatment for psychosis is important to reduce your risk of harm and improve your overall quality of life.

What types of antipsychotic medicines might I be prescribed?

There are different types of antipsychotic medicines. Talk with your doctor or mental health professional about what might work best for you. Each medicine has its own benefits and potential side effects.

There are 2 main types of antipsychotic medicines:

• 'Typical' antipsychotics, also known as'first-generation' medicines, are an older type of medicine that has been used for many decades. Examples include chlorpromazine and haloperidol.
• 'Atypical' antipsychotics, or second-generation medicines, are newer and have also been used for many years. Examples include risperidone, olanzapine and quetiapine.

Both types act on dopamine receptors in the brain to reduce or relieve symptoms of psychosis.

Atypical antipsychotics are generally more effective with fewer side effects (for example, they have less chance of causing stiff or shaking muscles). Some people prefer the older medicines, especially if they are troubled by side effects such as weight gain or sexual dysfunction. It's best to talk about your preferences with your doctor, to work out what is best for you. Sometimes a changes in dose or the type of medicine you take will make a big difference.

How do I take my antipsychotic medicine?

Most antipsychotic medicines come as tablets that you need to take every day. Others are given by regular injection (called a'depot' injection). These release medicine into the body slowly over several weeks. Your doctor may recommend a depot injection if you have trouble swallowing tablets or find it hard to remember to take your medicine regularly.

Most antipsychotic medicines can take several weeks or months to start working. Some people may need to try a few different kinds of antipsychotic medicine before they find the type and dose that works well for them with tolerable side effects.

If you are prescribed an antipsychotic medicine and it's taking a while to work, be patient. It can be dangerous to suddenly stop some antipsychotic medicines. Make sure to speak to your doctor before making any changes.

Your psychiatrist is the best person to advise you whether it is a good idea to change or stop your medicine, and how to go about it.

Some people are able to reduce their medicine dose or stop taking antipsychotics after they have fully recovered from an episode of psychosis. Other people may need to continue to take antipsychotics medicines long-term to prevent psychosis and the risk of harm associated with it.

Do antipsychotic medicines have any side effects?

Antipsychotic medicines, like all medicines, can cause side effects. Side effects are different for different people and vary depending on the type of medicine and dose.

Common side effects include:

• lethargy
• weight gain
• stiff muscles or restless movements
• dry mouth
• dizziness
• constipation, nausea or indigestion
• changes in sexual ability or desire

Some antipsychotic medicines may also increase your risk of developing certain heart conditions.

Some people experience severe side effects that significantly affect their quality of life, especially if they are younger or need to take them for a long time.

To avoid this, your doctor will likely suggest starting with a low dose and increasing it if you need it, unless you are seriously unwell.

If you are concerned about or are struggling with side effects from your medicine, it's important to talk to your mental health professional. There may be things you can do to reduce side effects, or other medicines that you can try instead.

When should I see my doctor?

You should see your doctor if you are experiencing severe side effects that negatively impact your quality of life. You should also see your doctor if you are still experiencing significant symptoms of psychosis despite taking your medicine as prescribed.

Your doctor can discuss strategies or changes to your medicine to help manage your symptoms and maximise your quality of life.

Are there any alternatives to this medicine?

Psychological therapies, such as cognitive behaviour therapy (CBT) and family intervention, are commonly used together with antipsychotic medicine to manage or prevent psychosis.

In some people at high risk of psychosis, psychological therapy and community support without medicine may be enough to prevent or delay another episode.

Other people may need to take antipsychotic medicines long-term to control or prevent psychosis.

If you are at a high risk of developing psychosis, see your doctor or mental health professional regularly. They will help you maintain your mental wellbeing and ensure that any new symptoms are treated early. Treating symptoms early reduces the chance of psychosis getting worse or causing harm to your health and wellbeing.

Resources and support

• healthdirect's medicines section allows you to search for medicines by brand name or active ingredient. It provides useful information about uses, side effects and availability on the Pharmaceutical Benefit Scheme (PBS).
• Visit SANE for information about mental health conditions and medicines used to treat them, as well as for help and support or call their support line on 1800 187 263.

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The Transcultural Mental Health Centre offer consumer medicine brochures in other languages.