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Microsoft word - medication update 2013.doc

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There is no way to predict who will do best on Medication UPDATE
This fact sheet discusses schizophrenia medications and the pros they are now considered by most clinicians as essential first-line and cons of changing from an older antipsychotic medication to treatment for newly-diagnosed patients.
one of the newer “atypical” ones. As always, a note of caution: This is not the last word on the subject. Nothing can replace CLOZAPINE (Clozaril)
talking to a doctor about medications for a specific individual.
Clozapine has been acclaimed because about one-third of
patients with treatment-resistant schizophrenia who have not
“STANDARD” ANTIPSYCHOTICS
responded to other medications show at least some
It’s a good idea to learn some of the technical medication “lingo” improvement on clozapine. It is also recommended for people
that mental health professionals use. Until recently, doctors have who are showing signs of tardive dyskinesia, since it rarely causes called antipsychotic medications neuroleptics because of their tendency to cause neurological side effects. Medications that The major drawback of clozapine is the slight risk (1%) that it will have been around for a few years are now called “standard” cause white blood cells to decrease, subsequently decreasing the antipsychotics. Examples of standard antipsychotics include person’s resistance to infection. Therefore, people taking Thorazine, Modecate, Proloxin, Navane, Stelazine and Haldol.
clozapine must have their blood count monitored regularly.
Trying to understand the bewildering array of medications can be frustrating. A user-friendly reference book, such as Fuller Torrey’s REASONS FOR SWITCHING MEDICATION
Surviving Schizophrenia, is helpful in this regard.
The most common reasons for switching from a standard antipsychotic to an atypical antipsychotic are: SIDE EFFECTS (EPS)
 Persistent positive symptoms (hallucinations, delusions, etc.) Side effects can be a major problem with standard antipsychotic medications. These neurological side effects are called  Persistent negative symptoms (blunted emotions, social “extrapyramidal side effects” (EPS for short) because of the area withdrawal, etc.) despite taking medication of the brain where the drugs cause the side effects. Specific  Severe discomfort from side effects and little or no relief from examples of EPS include akinesia (slowed movement), akathisia (restless limbs), and tardive dyskinesia.
 Severe and persistent tardive dyskinesia In most cases, switching medications can be done at any time.
“ATYPICAL” ANTIPSYCHOTICS
The newer antipsychotic drugs are called atypical antipsychotics.
The person who is ill should take lots of time to think about it and Atypical medications are now used more frequently. They are talk it over with family, friends, and the treatment team. People should also be aware that atypical antipsychotics may have side  They do not have the same chemical profiles as standard effects of their own, such as weight gain and sexual problems.
It’s true that the newer medications tend to produce less side  They seem to work in a different way than standard effects—but they may still cause some. People taking atypical antipsychotics must continue to be monitored for neurological  They appear to cause fewer EPS than standard medications.
“There are many new and exciting treatments for psychotic If someone is considering switching from a standard to an symptoms. Atypical antipsychotics offer consumers choices they atypical antipsychotic, please remember—this article is only a didn’t have even a few years ago. However, new choices also general discussion of some of the issues. Hopefully, having a few present new challenges.to get the most out of the new guidelines will help you begin to ask the right questions.
medications with the least risk possible.” - Peter Weiden, MD At the moment, there are several atypical antipsychotics -Adapted from a consumer handout by Dr. Peter Weiden, St. Luke’s-Roosevelt available in Canada—risperidone, clozapine, olanzapine, and quetiapine, ziprasidone, aripiprazole, asenapine, lurasidone.
NEWER MEDICATIONS: Risperdal* Consta* (risperidone);
Zyprexa* (olanzapine); Seroquel* (quetiapine); Geodon* or Zeldox* (ziprasidone); Abilify* (aripiprazole); Invega (paliperidone); *Saphris (asenapine); Latuda*(lurasidone) Results to date from the above atypical antipsychotic British Columbia Schizophrenia Society
medications are encouraging. While not effective for everyone, www.bcss.org

Source: http://www.bcss.org/wp-content/uploads/Medication-Update-2013.pdf

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