Anti-psychotic medication

Many people in America today are taking psychotropic medications to help reduce psychiatric symptoms. Family practice doctors and psychiatrists are using stronger medications for psychiatric complaints. For example, doctors are giving Abilifyfor mood stabilization. (Before this was approved by  the FDA.) Abilify is an anti-psychotic drug. Another example is that many doctors are giving anti-psychotic medications for sleep.

Doctors are giving the general population these strong drugs because they are effective. These drugs come with a side effect panel that you need to be aware of before you take the first pill. 

Examples of this medication category are: Haldol, Thorazine, Sparine, Prolixin, Mellaril, Serentil, Trilafon, Stelazine, Taractan, Navane, Moban, and Loxitane. These medications are about 40 years old. Some of these medications are still used today, mostly in emergencies instead of long term treatment due to their heavy and dangerous side effect panel.

Examples of Atypical Antipsychotics are Clozaril approved by the FDA in 1990, Risperdal approved by the FDA in 1994, Zyprexa was approved by the FDA in 1996, Seroquel was approved by the FDA in 1997, Geodon was approved by the FDA about 8 years ago, and Abilify was placed on the market about 5 years ago. While some side effects to these newer drugs can be severe they are generally better tolerated for long term care.

Here is a list of the side effects in the anti-psychotic medication category:

Photo-sensitivity.  Use sun block and wear a big floppy hat. You can get a sun burn very easily while on an antipsychotic. That coupled with the inability to perspire you got yourself a death stew. Plan outside events carefully. Protect your eyes by wearing sun glasses.

Decreased perspiration. Stay cool in the summer time. Drink plenty of fluids. This can be a very dangerous side effect which can lead to heat exhaustion or heat stroke. Note while on anti-psychotic medication the body does not cool itself properly. You must keep this in mind while planning outdoor activities

WARNING As stated above if you are on an anti-psychotic you are more susceptible for heat exhaustion and heat stroke. You have to be doubly careful during hot summer days.

Heat exhaustion happens if you get too hot and hydration is not adequate. The symptoms of heat exhaustion are: heavy sweating, loss of color in your face, lethargy, weakness, muscle cramps, nausea and vomiting, and fainting. The skin will be cool and moist. The pulse will be elevated and breathing will be fast and shallow.

Treatment for heat exhaustion is to cool the body. Drink water or any fluid other than alcohol. (Alcohol can dehydrate)Get into some shade or air conditioning. The immediate goal is to cool the body. Rest after an episode of heat exhaustion. If this condition is left untreated one can progress into heat stroke which is completely life threatening.

Heat stroke is an elevated body temperature with accompanying physical and neurological symptoms. Put in simple terms, the body is unable to cool itself.  Heat stroke is a true medical emergency that can be fatal if not properly and promptly treated.

Common signs and symptoms of heat stroke include: high body temperature, the absence of sweating, with hot red or flushed dry skin, rapid pulse, problems breathing, strange behavior, hallucinations, agitation, disorientation, seizure, and coma.

People who experience heat stroke must receive immediate treatment to avoid permanent damage to the internal organs. First and foremost, cool the person. Get the person to a shady area, remove or loosen clothing, apply cool water to the skin for example, you may spray the person with cool water from a garden hose. Fan the person to help promote sweating and evaporation. Place ice packs under armpits and on the upper thighs close to the groin. Monitor body temperature with a thermometer and continue cooling efforts until the body temperature drops to 101-102 degrees. Notify emergency services (911) immediately. They can give you further instructions for treatment of the person.

 Measures to prevent heat strokes are to avoid becoming dehydrated and to avoid vigorous physical activities in hot  humid weather. If you have to perform physical activities in hot weather, drink plenty of fluids such as, water and Gatorade, but avoid alcohol, coffee, and tea which may lead to dehydration. Take frequent breaks to hydrate yourself. Wear hats, light colored and loose fitting  clothing.

Let’s get back to other side effects associated with anti-psychotics.

Drowsiness.  This side effect will go away once your body acclimates to the drug especially if you are placed on this medication long term. Rest or sleep when your body tells you to.

Orthostatic hypotension which means your blood pressure will drop sometimes to severe numbers when you stand up from a sitting or lying position. Perform all position changes slowly. Remember to drink plenty of fluids throughout the day.

Dry mouth. Suck on sugar free lemon drops or lemon wedges!

Fast heart rate. Tell your doctor for possible medication adjustments.

Blurred vision and an aggravation of glaucoma.  Tell your psychiatrist AND your eye doctor what medications you are on for possible medication adjustments. Too much pressure inside your eyeball can cause blindness. Take good care of your eyes.

Constipation.  Drink plenty of water and other fluids throughout the day, eat a balanced diet including fiber, and walk. That should get things going naturally.

The retention of urine.  Tell your doctor for possible medication adjustments. Urinary track infections become common when retaining urine.

Inhibition of ejaculation. Tell your psychiatrist and your urologist for possible medication adjustments.

Weight gain. Learn to love your body no matter what. Eat well balanced meals. Try to snack on low calorie food items like celery. This is hard to do but keeping your weight gain to a minimum can be done with a little planning and determination.

Swelling.  Take a rest with your feet elevated. This will help reduce the swelling in your ankles. Report swelling to you psychiatrist for a possible medication adjustment. If you swell due to cardiac problems make sure your cardiologist knows what medications you are taking. Try to keep all of your doctors informed of changes in your condition.

Menstrual disorders. Tell your psychiatrist and your OBGYN for possible medication adjustments.

Rash.  Tell your Doctor ASAP! A rash can indicate an allergic reaction to a medication.

Blood disorders. Make sure your blood is tested at least every 6 months for an evaluation as to how your body is handling the psych medications. If on Clozaril blood tests are done monthly. Make sure you have these test done as they are extremely important and give essential information to the doctor so that he or she can deliver excellent care to you.

Here is the list of severe side effects called EPS, (Extra-Pyramidal Symptoms):

Psuedo-parkinsonian symptoms: face tremors or twitching, grimacing, rigidity, shuffling gait, and excess salivation which can cause drooling.

Dystonia: is a neurological movement disorder. Muscle contractions cause repetitive movements and abnormal postures. Twisting is frequently observed. This is a painful side effect and can affect any part of the body. Sometimes people will experience locked eye balls. The eye balls are rolled upwards and the person can not voluntarily move them. This condition is an emergency. Call the medics! The medics will give a shot of a muscle relaxant and the ocular crisis will soon resolve.

Akathesia: which is internal and external restlessness or the inability to sit or stand still. This brings on extreme mental discomfort. The urge to move is profound.

Tardive Dyskinesia: usually caused by long term use of anti-psychotic medication. Even after the medication is stopped the involuntary movements typically do not go away. The bizarre movements usually affect the face and upper body. This symptom can be irreversible.

Neuroleptic malignant syndrome: is a life-threatening, neurological disorder most often caused by an adverse reaction to anti-psychotic medication. It generally presents with muscle rigidity, high fever, autonomic instability (vital signs are unstable), and cognitive changes such as delirium. People with this condition are very sick. They will be in the hospital usually on the ICU.

As with all medications, the doctors have to weigh the benefits of the drug to the adverse side effects to the drug before giving it to a patient.

You can see from the side effect profile anti-psychotic medications are very strong, they can help a lot, but they can hurt as well. If you are placed on an anti-psychotic medication it becomes essential for you to be followed closely by a doctor. You, as the consumer of health care, must take an active part in your own care. You or your health care advocate will need to report adverse side effects promptly.  The side effects can be treated with good outcomes.

You need to know what medication you are taking. Why are you taking the med? How often do you take the med? What dose are you to take? How will the medication help? What are the side effects? When should I alert the doctor of adverse side effects? What should I do if side effects occur? Do I have dietary restrictions with the prescribed medicine? Should I stay out of the sun? How long will it take for the medication to become helpful? In short, know your meds like you know the back side of your hand.

There is a time and a place for all medications. This group of medicine definitely helps more than it hurts. Be informed. Ask questions. Be an active member in your own health care team. Have a wonderful summer and stay cool! Literally!  

Tags: antipsychotics, danger, heat, summer