medication / neuroleptics / injectables
Slow release injectable neuroleptics
and long-acting
Directions ​
Physical health issues
Porphyria (disturbance of pigment metabolism)
Nausea, severe vomiting
Nausea, vomiting before chemotherapy for cancer
Irrepressible hiccups
Mental health problems
To relieve agitation, hallucinations, delusions and inconsistencies of thought in psychotic people
Tourette syndrome (motor tics, uncontrollable movements, growling and licentious language)
Schizophrenic disorders and related disorders such as:
> Brief reactive psychoses
> Schizophreniform disorders
> Schizoaffective disorders
Managing manic episodes or preventing them
People with an autism diagnosis
Depression, psychotic depression
Generalized anxiety
Obsessive Compulsive Disorder
Hostile impulses
Personality disorders
Alcoholism
Contraindications ​
Physical health issues
Allergic reaction to antipsychotics
Severe heart abnormality
Poorly controlled epilepsy
Angle-closure glaucoma (a disease of the eye characterized by an increase in intraocular pressure which increases the hardness of the globe)
Problem related to urinary retention
Precaution for people with liver disease
Signs of dyskinesia
Consumption of substances likely to induce cholinergic delirium, such as scopolamine
History of neuroleptic malignant syndrome
Seniors
Lower doses than adults
May increase mortality in dementia
Pregnancy and breast feeding
Abstain during the first trimester and while breastfeeding, but haloperidol is considered safe.
Children
Not recommended, but used by experts
Others
Coffee, tea, hallucinogenic drugs can trigger symptoms of psychosis
Excessive dose of amphetamines (speed, ecstasy)
Drugs interactions​
Be careful not to take any medication, with or without a prescription, without consulting a doctor or pharmacist to identify the risks of interaction.
Psychiatric drugs
Anticonvulsants
> May increase the toxicity of phenytoin (Dilantin)
> Barbiturates which act as anticonvulsants may affect the metabolism of antipsychotics and in decrease therapeutic effects while increasing sedation
Antidepressants and antiparkinsonians
> Taken together, increased sedative and anticholinergic effects of tricyclic antidepressants and antipsychotics
Sleeping pills, tranquilizers, anesthetics, narcotics and antihistamines
> Increase the sedative effects of these substances
> Increase the risk of confusion, dry mouth, blurring of vision, decrease in sweating and retention of urine
Lithium
> Slightly increases the side effects of antipsychotics
Other drugs
Painkillers
> Can cause deep drowsiness
Medications that lower blood pressure
> Antipsychotics increase hypotension
Drugs used for resuscitation
> Avoid epinephrine at all costs, use norepinephrine instead
Substances used to treat certain heart problems
> Antipsychotics may increase the risk of cardiac arrhythmia
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Others
caffeine
> Regular coffee intake can, in some cases, reduce the effect of antipsychotics and, unfortunately, the doses are then increased
> More than 2 to 3 cups of coffee: can sometimes lead to intoxication which results in symptoms of motor and verbal restlessness resembling a mild psychotic crisis (per DSM-IV)
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Side effects​
They depend on the dosage and duration of treatment, the metabolism of the individual and the context in which he lives.
Neurological side effects
Head
Odd facial expressions (dystonia)
Rapid but mild tremors of the lower lip (rabbit syndrome)
Repetitive and involuntary rhythmic movements of the tongue, lips and eyes, by grimacing, chewing, twitching of the nose,
sniffling and jerking of the neck (tardive dyskinesia)
Convulsions (if high doses or if dose escalation is rapid)
Members
Exaggerated contraction of muscles, involuntary movements, strange postures (dystonia)
Muscle rigidity, jerky movements, shuffling gait, hunched back, tremors (parkinsonism)
Absence of certain movements (akinesia)
Irrepressible urge to move, which turns into motor restlessness (akathisia)
Others
Affects the body's temperature regulation mechanism (loss of hot and cold perceptions)
Blood problems: decrease in white blood cells
Jerky movements of the fingers, arms, legs, pelvis and trunk (tardy dyskinesia)
Intense muscle rigidity (neuroleptic malignant syndrome: very rare)
Sleep
Sedation (low potency antipsychotics)
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Other side effects
Head
Dry mouth
Dilation of the pupils
Blurring of vision
Appearance of spots on the retina of the eye and even blindness: large dose of thiodazine (Mellaril, etc.). Reversible
Pupil dilation (reversible)
Heart
Acceleration of heart beats ​
To be monitored in case of overdose
Abdomen
Anticholinergic effects:
> Constipation
> Urinary retention
> Nausea
> Vomiting
Decreased pulmonary secretions
Liver problems: hepatitis
Sexuality
Hormonal problems:
> Breast swelling
> Cessation of menstruation
> Disappearance of orgasm
> Milk production
> Decreased sexual desire
> Impotence
Anticholinergic effects:
> ejaculation problems
Skin
Exfoliative dermatitis
Light sensitivity
Severe sunburn
Weight
Weight increase
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Overdose Risks
Rarely fatal unless combined with other drugs or alcohol
Symptoms of overdose are:
Hustle
Deep sedation
Coma
Acceleration of heart beats
Cardiac arrythmia
Tremors
Involuntary contraction of muscles
Seizures
Drop in blood pressure when getting up
Hypothermia
Hyperthermia (sometimes)
Respiratory distress
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Withdrawal symptoms
Psychotropic drugs act in the brain just as they do in the rest of the body; and as we have seen, each person reacts differently. It's the same with weaning; the person's metabolism, the type of drug, the dose as well as the duration of the intake and its half-life, explain that the withdrawal effects are varied. We have listed the potential and main withdrawal symptoms of each class of psychotropic drugs. This list is incomplete, as not all withdrawal effects are listed; moreover, knowledge is rapidly evolving in this field. A person may have no withdrawal symptoms or experience one, a few, or even many. The medication reduction journey is specific to each person, just as each process is unique. For example, a person can take the same medicine twice at the same dose and the effects will be different. Gradual reduction, like removing 10 % of dose per week/month, reduces the frequency or intensity of withdrawal symptoms and the incidence of rapid relapses. It is very important to undertake this process with the collaboration of your doctor. The pharmacist also plays a key role and can provide guidance to monitor withdrawal effects for each medication. Most people who will have withdrawal symptoms will tolerate them without problems for the short duration of these symptoms.
Common and frequent withdrawal symptoms for all classes: anxiety, nervousness, restlessness, sleep problems, greater need to rest, sleep, irritability, fatigue.
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Withdrawal symptoms for neuroleptics :
Withdrawal symptoms appear a few days after the dose is reduced. In the process of progressive reduction according to the method of 10 %, the last step can be particularly difficult. It can be lengthened or split to reduce withdrawal symptoms.
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Main psychological withdrawal symptoms:
Withdrawal psychosis
Nervousness or restlessness
Insomnia
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Main physical withdrawal symptoms:
Muscle stiffness; body aches (sore all over)
Tremors
Sweat
Runny nose
Nausea, vomiting
Cramps, abdominal pain
Diarrhea
Salivation
Headaches (headaches)
Nightmares
Palpitations
Hypertension
Discovery of tardive dyskinesia (Definition: abnormal and involuntary movements of the tongue, jaw, trunk or extremities whose appearance is related to the taking of neuroleptic drugs. tardive dyskinesia may become irreversible.)
Clozaril carries a higher risk in relation to withdrawal psychosis because its duration of action is short.
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