Medication

IF YOUR DOCTOR PRESCRIBES A PSYCHIATRIC DRUG IT IS IMPORTANT THAT YOU UNDERSTAND WHAT THE DRUG IS, HOW YOU SHOULD TAKE IT AND WHAT EFFECTS IT WILL HAVE ON YOU.

You may wish to discuss with your Doctor about alternative treatments to the proposed drugs.

In addition, you may wish to ask about counseling or psychotherapy (‘Talking Treatments’) or some other form of psychological treatment. This may help alongside the drug treatment or be a possible alternative to the drugs. It may be that psychological treatment could help you recover sooner.

The following list of questions may be useful when meeting your Doctor and help you get the most out of your drug treatment.

What and How?

  • What kind of medicine is it?
  • How can it help me?
  • How and when should I take it?
  • What should I do if I miss a dose?
  • How long will it take to work?
  • How will I know that it works?

How important is it?

  • How important is it that I take it?
  • What may happen if I do not take it?
  • What should I do if I miss a dose?

What about side effects?

  • What are the side effects?
  • How likely is it that I will experience these side effects?
  • Does taking it for a long time have any risks or dangers?
  • Can I drive whilst taking it?
  • Can I drink alcohol while taking it?
  • Is it safe to take other medicines whilst taking it?
  • Are there any foods I should avoid whilst taking it?

How long?

  • How long should I continue taking it?
  • When will I need to see you again?
  • What will you need to know when I see you again?

Drug Types

The following is a list of some of the drugs that can be prescribed. For each drug there is a pharmacy name and a brand name (in brackets). Each physician tends to have their own prescribing preferences. Generic names do not have capital letters, trade names do. ALWAYS CHECK WITH YOUR DOCTOR BEFORE STARTING OR STOPPING ANY MEDICATIONS! WE ARE NOT MEDICAL PROFESSIONALS, SO PLEASE TALK TO SOMEONE WHO IS ABOUT YOUR SITUATION!

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1) Anti-psychotic drugs

(also referred to as ‘Major Tranquilizers)

Olanzapine (Zyprexa), quetiapine (Seroquel), risperidone (Risperdol), amisulpride (Solian) and clozapine (Clozaril) are more commonly prescribed anti-psychotics. These are newer drugs, which can have fewer side-effects for some people, although clozapine can have an effect on the blood. For this reason, people taking clozapine need to have regular blood tests.

Alternatively, you may be prescribed: Chlopromazine (Largactil), flupentixol (Depixol), fluphenazine decanoate (Modecate), haloperidol (Haldol, Dozic, Serenace), sulpiride (Dolmatil), trifluoperazine (Stelazine), zuclopentixol dihydrochloride (Clopixol), pimozide (Orap)

Thioridazine (Melleril) may only be prescribed to people with schizophrenia under specialist supervision (consultant psychiatrist).

2) Anti-depressant drugs

There are four main types of anti-depressants: Tri-cyclics (and related), MAOI’s, SSRI’s and Other (types which don’t fit into any category).

Tri-cyclics: Amitryptilline (Tryptizol), clomipramine (Anafranil), dothiepin (Prothiedin), lofepramine (Gamanil), trazodone (Molipaxin), imipramine (Tofranil)

MAOI’s: Moclobemide (Manerix), phenelzine (Nardil) (NB – MAOI’s have particular interactions with certain foods)

SSRI’s: fluoxetine (Prozac), paroxetine (Seroxat), , fluvoxamine (Faverin), citalopram (Cipramil), sertraline (Lustral)

Other: Venlafaxine (Efexor), mirtazapine (Zispin), nefazodone (Dutonin),

3) Anti-manic drugs

Lithium carbonate (Camcolit or Priadel), carbemazepine (Tegretol), valproic acid (Depakote) NB – carbemazepine and valproic acid are primarily anti-epileptic drugs, which are found helpful as mood stabalisers and so are used to treat manic depression, especially for people who cannot tolerate lithium.

4) Anti-anxiety drugs

Buspirone hydrochloride (Buspar), chlordiazepoxide (Librium), diazepam (Valium), lorazepam (Ativan), Oxazepam

5) Drugs for sleep problems

You may be given tablets to help you sleep. This treatment has only short-term effects. If taken long-term it could have the opposite effect of causing anxiety and further sleep difficulties, and it can be difficult to come off the tablets. If you are concerned about taking medication for sleep problems, or coming off the tablets, speak with your doctor, nurse or pharmacist.

The following are all ‘sleeping tablets’:
Zopiclone (Zimovane), chlormethiazole (Hemineverin), chloral hydrate (Welldorm)

The following are benzodiazepines, another type of sleeping tablet:
Nitrazepam (Mogadon), temazepam, flurazepam (Dalmane)

Stopping medication

All psychiatric drugs should be withdrawn (stopped) slowly. Withdrawal effects can occur particularly with tricyclic anti-depressants, SSRIs (especially paroxetine) and many anti-psychotics.

If you want to come off of medication, you need to cut down the dose gradually over a period of time, as your body will need time to adjust to the change. If you are concerned about taking or coming off of any medication for sleep problems, speak with your doctor, nurse or pharmacist.

Effects of medication

Listed below are the most common side-effects that can be experienced whilst on medication. Not everyone experiences side-effects, and those that do experience them to varying degrees. Some side-effects are dependent on the level of the dose you are taking, so the smaller the dose, the less likely you are to experience any side-effects.

Also listed are some suggestions as to how to alleviate these side-effects, but please note that, with some symptoms, you must seek medical advice immediately. With other symptoms, there may be ways of alleviating them, but if they persist you should contact your doctor. Please note that some symptoms (particularly blurred vision, dizziness and drowsiness) are made worse if you drink alcohol.

The list of drugs is not complete. Your particular drugs may not be included here. Please consult your doctor if you are experiencing any side-effects which are worrying you.

Outside of hospital, there is a legal obligation for you to be given information on your drugs, such as an information leaflet. As an in-patient, there is no obligation to give you information unless you ask for it.

If you are concerned about any aspect or effects of your medication, speak with your doctor, nurse or pharmacist, who may also be able to offer information leaflets.

Possible side-effects

Symptom
Suggestion
Drug Type

Blurred vision:
Consult your doctor. Avoid driving or using machinery.
Occurs sometimes with anti-psychotic drugs (1) and anti-depressant drugs (2)

Confusion:
Consult your doctor.
Occurs sometimes with anti-anxiety drugs (4) and drugs for sleep problems (5)

Constipation:
Consider a high fibre diet or laxatives. Drink plenty of fluids – not alcohol. If this persists, consult your doctor.
Occurs often with anti-depressants (2), and some anti-psychotics (1)

Dizziness:
Consult your doctor. Avoid driving or using machinery.
Occurs sometimes with anti-psychotic drugs (1) and drugs for sleep problems (5)

Drowsiness:
Consult your doctor. Avoid driving or using machinery.
Occurs often with anti-depressants (2), anti-anxiety drugs (4) and drugs for sleep problems (5)

Dry mouth:
Suck an ice-cube or a boiled sweet. Drink plenty of fluids – not alcohol. Occurs often with anti-psychotics (2), anti-depressants (1) and anti-anxiety drugs (4)

Headaches:
Take painkillers. Tell chemist what medication you are currently taking. Occurs sometimes with anti-psychotics (1), anti-anxiety drugs (4), drugs for sleep problems (5) and anti-depressants (2)

Light-headedness:
Consult your doctor. Avoid driving or using machinery. Occurs sometimes with drugs for sleep problems (5) and some anti-psychotics (1)

Nausea and / or vomiting:
Try taking your medication after meals. Otherwise consult your doctor. Occurs often with anti-psychotics (1), anti-depressants (2) and almost any other drugs

Rashes:
See your doctor immediately before taking your next dose.
Occurs sometimes with all drugs

Sexual problems:
Speak with your doctor.
Can occur with anti-psychotics (1) and anti-depressants (2)

Sensitivity to sunlight:
Use sun protection products. Cover up well. Wear sun-glasses.
Occurs often with anti-psychotics (1)

Stiffness in limbs or face:
Consult your doctor immediately.
Occurs sometimes with anti-psychotics (1)

Sweating:
See your doctor immediately before taking your next dose.
Occurs sometimes with anti-anxiety drugs (4)

Tremors (shakes):
See your doctor immediately before taking your next dose.
Occurs sometimes with anti-depressants (2), almost always with older anti-psychotics (1) and lithium. Can also occur with valproic acid.

Weight gain:
Speak with your doctor.
Can occur with anti-psychotics, lithium, some anti-depressants and other drugs

NB – older anti-psychotic medication can have significantly higher incidence of side-effects. If you have concerns about side-effects or any other aspect of medication, speak with your doctor, nurse or pharmacist.