Antipsychotic medicines

There are many types of antipsychotic medicines. A simple way of grouping them is:
• older antipsychotics, such as chlorpromazine, thioradazine, trifluoperazine and haloperidol;
• newer antipsychotics, such as olanzapine, clozapine and risperidone.
As a general rule, the older drugs produce more side-effects but are much cheaper than the newer drugs.
Antipsychotic drugs are used to treat the severe mental disorders and to help calm people who are aggressive or confused. Thus, they can also be given to people with mental retardation or
dementia who have disturbed behaviour.
You should note the following points when prescribing these drugs:
• They can take several weeks to reach full effect.
• In brief psychoses, treatment may be reduced gradually after as little as two weeks. If symptoms
recur, return to the original dose, continue for three months and then try to withdraw them again.
• Treat schizophrenia for at least one year (many patients will need treatment for much longer).
• Treat mania until symptoms subside and for three months thereafter. During this period, start a
different medicine to prevent further episodes (see below).
• Side-effects are common but are mild for most people.
• Small reductions in dose can help reduce side-effects.
• Use procyclidine or benzhexol to reduce the side-effects of tremor and stiffness. Some mental health specialists advise giving these medicines to all patients to make sure that there are fewer
side-effects. This may help improve compliance.