Anti-psychotic medications are very useful
and have helped many people with schizophrenia
to lead healthy and productive lives by taking
care of some of the symptoms, including delusions,
hallucinations, disorganized thinking, disorganized
behavior, and negative symptoms, or lack of
motivation that may come with schizophrenia.
However, they don't come without side effects.
I'm going to talk with you about four different
categories of side effects that seem to be
very common.
One is what we call extrapyramidal symptoms.
Those are motor or movement side effects of
these medications.
The older anti-psychotics tend to have more
of these side effects.
They include feeling stiff in your muscles,
having tremor in your hands or in your body,
feeling restless and unable to sit still,
or having what we call tardive dyskynesia.
That occurs over time, where you might have
movements of your mouth or of your limbs that
are repetitive and that appear after a period
of treatment.
Those are the extrapyramidal symptoms, or
EPS.
They're more common with the older medications.
With the newer medications, the more common
side effects tend to be what we call the metabolic
side effects, or cardiometabolic side effects.
Those include weight gain, an increased blood
sugar or risk for diabetes, and an increased
cholesterol.
Initially, we were really excited about all
of the new anti-psychotic medications.
Then, when we saw how people gained weight
and got more heart disease, partly related
to the medications, we started to see that
there was a big risk there, because really,
it's heart disease and diabetes that tend
to be the things that lead to early mortality
in people with schizophrenia.
So, that's the second category of side effects.
There's also anticholinergic side effects.
Those include dry mouth, feeling flushed or
hot, having constipation.
Those are things that tend to happen with
the anticholinergic side effects.
Different medications, both old and new, have
more or less anticholinergic side effects.
One last category that I'll mention is prolactin.
Prolactin is a body hormone that you have.
For some of our anti-psychotic medications,
in particular Risperidone, is probably the
biggest culprit, increase prolactin production.
What happens, then, is that women especially
may not have their periods, they may have
difficulty conceiving a child.
And, for some people, there's breast enlargement
and even lactation, both men and women.
That can be a very disruptive side effect,
obviously, and needs to be addressed.
If you have side effects with anti-psychotic
medications, definitely, there's many choices
of anti-psychotic medication, and so you should
speak with your doctor or psychiatrist about
it, because they can try different things
to see what works best for you and causes
the least burden of side effects to you.
Many people have no side effects at all from
anti-psychotic medications, thank goodness.
If you have schizophrenia and you're thinking
about medications, find a treatment provider
you trust so you can work on finding the right
medication for you.
