Breakthroughs in Antipsychotic Medications

by Diamond, Ronald J.; Ross, Ruth; Scheifler, Patricia L.; Weiden, Peter J.

• ISBN13: 9780393703030
• ISBN10: 0393703037
• Edition: 00
• Format: Paperback
• Copyright: 1999-05-17
• Publisher: W. W. Norton & Company

Summary

Yet, older medications have serious side effects, do not completely alleviate the psychotic symptoms, and rarely affect other symptoms like lethargy. The new antipsychotics have several advantages over the older medications, and are transforming the lives of many people, but they are not for everyone: They also have side effects and the cost can be prohibitive. Breakthroughs in Antipsychotic Medications helps consumers and their families weigh the pros and cons of switching medications and guides them through the process of switching. With clear, simple language, the book answers such questions as: What are antipsychotic medications and what do they do? What kinds of antipsychotic are available and how are they different? How do I know if switching might (or might not) be a good idea? When is the best time to switch? Which medication should I switch to? How do I make the switch? What will happen after I switch? How can I afford the cost of the new antipsychotics? The book also gives clinicians technical details on the new medications and their side effects. For example, eight 'œmedication fact sheets' and seven 'œside effect fact sheets' are included, as well as a discussion of the switching process, assessing the patient's response to the switch, and the long-term issues after switching antipsychotics. A clear and authoritative map for the road to recovery, Breakthroughs in Antipsychotic Medications is a valuable resource for consumers, families, and clinicians.

Author Biography

Peter J. Weiden, M.D., is director of the Neurobiologic Disorders Service in the Department of Psychiatry at St. Luke's-Roosevelt Hospital, New York. Patricia L. Scheifler, M.S.W., is director of Partnership for Recovery, Birmingham, Alabama. Ronald J. Diamond, M.D., is professor at the University of Wisconsin Medical School at Madison. Ruth Ross, M.A., is managing editor of the Journal of Practical Psychiatry and Behavioral Health, and was the science writer of the DSM-IV.

Table of Contents

Foreword	9	(2)
Laurie Flynn
The Keys to Recovery	11	(1)
Acknowledgments	12	(1)
Introduction	13	(6)
Part I. Consumer Guide	19	(72)
What Are Antipsychotic Medications and What Do They Do?	21	(7)
What Kinds of Antipsychotic Medications Are Available and How Are They Different?	28	(7)
How Do I Know If Switching Might Be a Good Idea for Me?	35	(3)
How Do I Know If Switching Might Not Be a Good Idea for Me?	38	(5)
When Is the Best Time to Switch?	43	(3)
Which Medication Should I Switch To?	46	(4)
The Six Steps in Making the Switch	50	(13)
What Will Happen After I Switch?	63	(10)
Getting Better	73	(4)
Getting On with Life	77	(9)
Final Thoughts	86	(5)
Part II. Technical Information	91	(60)
Antipsychotic Medications	93	(13)
Medication Fact Sheet: Conventional Antipsychotics	95	(1)
Medication Fact Sheet: Summary of the Newer Antipsychotic Medications	95	(1)
Medication Fact Sheet: Comparing Conventional and Atypical Antipsychotics	96	(1)
Medication Fact Sheet: Clozapine (Clozaril)	97	(2)
Medication Fact Sheet: Risperidone (Risperdal)	99	(1)
Medication Fact Sheet: Olanzapine (Zyprexa)	100	(1)
Medication Fact Sheet: Quetiapine (Seroquel)	101	(1)
Medication Fact Sheet: Ziprasidone (Zeldox)	102	(1)
Medication Fact Sheet: Medications for Extrapyramidal Side Effects	103	(1)
Medication Fact Sheet: Adjunctive Medications	104	(2)
Common Side Effects	106	(9)
Side Effect Fact Sheet: Extrapyramidal Side Effects (EPS)	107	(2)
Side Effect Fact Sheet: Tardive Dyskinesia and Withdrawal Dyskinesia	109	(1)
Side Effect Fact Sheet: Anticholinergic Side Effects	110	(1)
Side Effect Fact Sheet: Sedation and Insomnia	111	(1)
Side Effect Fact Sheet: Weight Gain	112	(1)
Side Effect Fact Sheet: Sexual Difficulties	113	(1)
Side Effect Fact Sheet: Amenorrhea and Galactorrhea	114	(1)
Switching Medications	115	(15)
Optimizing Current Medications	117	(1)
Indications for Switching Medications	118	(2)
Risks of Switching	120	(1)
The Decision-Making Process	121	(1)
Switching When There Is Illict Drug or Alcohol Use	122	(1)
Switching When the Person Denies Having an Illness	123	(1)
Timing the Switch	124	(1)
Choosing Among the Atypical Antipsychotics	125	(1)
Switching Safely	126	(4)
Assessing the Response to Switching	130	(7)
How to Evaluate the Response	131	(1)
When the New Medication Works Better	132	(1)
Avoiding Unnecessary Polypharmacy	133	(1)
When the New Medication Is Not Working	134	(2)
Postpsychotic Depression and Suicidal Behavior	136	(1)
Long-Term Issues After Switching	137	(9)
Emotional Reactions to Symptom Improvements	138	(2)
Changes in Relationships	140	(1)
Other Problems	141	(1)
Rehabilitation	142	(1)
Academic and Work Functioning	143	(2)
Newer Medications and Life Expectancy	145	(1)
Summary of Technical Information	146	(5)
Part III. Paying for Medications	151	(10)
Part IV. Glossary	161	(22)
Part V. Resources	183	(10)
Part VI. Handouts	193	(2)
Overview of the Treatment of Schizophrenia	195	(4)
Choosing an Antipsychotic	199	(2)
Noncompliance with Antipsychotic Medications	201	(2)
Sample Medication Calendar	203	(1)
Blank Medication Calendar	204	(1)
Knowledge Assessment	205