What is the choice of medication based on? How do typical and atypical antipsychotics differ?

In which situation which drug is best suited cannot be said in general. Different doctors recommend different medications. This is also due to the fact that in most studies no great differences in the effectiveness of the individual agents were observed. But, yes, there are some common antipsychotics for schizophrenia. In any case, it must always be checked individually how someone responds to a medication. The aim is to find the most effective dose with the fewest side effects. If a drug does not work well enough, the dose can be increased or the active ingredient changed.

Doctors usually start with common meds for schizophrenia lower dose and then increase it step by step. Acute psychosis sometimes starts with a high dose to quickly relieve symptoms. Medicines are often combined. However, it is unclear whether this will bring any benefits – especially since the risk of interactions increases with each additional drug.

What are the side effects of antipsychotics if not taken properly?

Possible side effects of antipsychotics are –

• Movement disorders (tremors, muscle stiffness, lack of movement).
• Involuntary movements such as smacking, grimacing and head movements.
• Dysphagia, metabolic problems, inner unrest, and an increase in weight.
• Increased diabetes –Risk, dry mouth, bladder dysfunction, visual disturbances, dizziness, and headache.
• Fatigue and lack of drive, rarely, cardiac arrhythmias, and serious problems with blood formation.
• Some movement disorders only develop after prolonged use, sometimes only after years.

Whether side effects occur, depends on the active ingredient, and the dose. There are various common antipsychotics for schizophrenia, but you must not consume them without consulting the doctor. The consequences of long-term use of antipsychotics have not been sufficiently researched.

How do high-potency, and low-potency antipsychotics differ?

A distinction is made within the typical antipsychotics – highly potent antipsychotics, and low potency antipsychotics. Both groups are similarly effective but differ in dosage and side effects – with high-potency antipsychotics, a lower dosage is sufficient to achieve the same effect as low-potency agents. Low-potency common meds for schizophrenia tend to make you tired and have a calming effect. They are also more likely to lead to disorders of the autonomic nervous system with dry mouth and indigestion.

Are antipsychotics always useful for schizophrenia?

Antipsychotics can alleviate the symptoms, and consequences of schizophrenia. However, their side effects can be uncomfortable, and it is not always necessary to take them. It is therefore important to carefully weigh up their advantages, and disadvantages. The following questions play a role –

• What is the treatment goal?
• How severe are the symptoms?
• Which phase of the disease is it?
• What would be the consequences of another acute psychosis?
• What would be the consequences of changing medication?
• What would be the consequences of not using medication?
• How severe are the side effects?
• Can the dose be adjusted so that the side effects are tolerable?
• How effective have previous treatments been?
• What other treatments and support options are there?

Conclusion: doctors usually see antipsychotics as necessary

If the symptoms are only mild, medication can sometimes be avoided, or treated with very low doses. It is important that people with schizophrenia are involved in the planning of their treatment. However, this is often not the case, and can also be difficult in an acute phase. It can be easier when the acute symptoms have resolved. After a while, it can also be discussed whether the intake can be stopped at some point. To be able to make an informed decision together with the doctors, comprehensive information about the consequences of taking common antipsychotics for schizophrenia is necessary. This also helps to be clear about the personal treatment goals.

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