An Overview of Psychotic Disorders and Treatment

 

The typical antipsychotics are categorized as either low potency, medium potency, or high potency based on their affinity to the dopamine receptors. All antipsychotics generally have five side effect profiles that one needs to be aware of when it comes to their selection. This includes: sedation, anticholinergic effects, extrapyramidal effects, weight gain, and metabolic effects.5

The typical antipsychotics which block dopamine receptors are more likely to cause extrapyramidal side effects (Parkinson’s-like side effects, akathesia, acute dystonias, and tardive dyskinesia), whereas weight gain and metabolic side effects are more likely to be observed with the atypical antipsychotics.

Additionally, before an antipsychotic is administered, an assessment of the individual’s mood state must be performed to identify any marked agitation which may require the use of an antipsychotic with a greater sedation property or the use of an antipsychotic with less sedation if there is psychomotor retardation and withdrawal.5 

The use of antipsychotics have served as a breakthrough for the treatment of psychotic disorders because they can reduce the risk of relapse with continuation of therapy and allow an individual to possess some level of appropriate functioning despite the presence of  a chronic disease state.

Antipsychotics have been able to restore some level of functionality in thought processes, behavioral patterns, and interactions in people with psychotic disorders. And rather than spending the rest of their lives in institutions, those suffering from psychotic conditions are given the opportunity to lead more active lives.

Abimbola Farinde, PharmD, MS, is a clinical staff pharmacist at Bayshore Medical Center in Pasadena, Texas, with a specialization in psychopharmacology and geriatrics.

References

  1. Hersen M, Turner  S  and Beidel D (Eds.). Adult Psychopathology and Diagnosis. (5th ed.) Hoboken, N.J.: John Wiley & Sons. 2007.
  2. Hahn RK, Albers LJ and Reist C. Psychiatry. Blue Jay, Calif.: Current Clinical Strategies Publishing. 2008.
  3. Dipiro J,  et al. Pharmacotherapy: A Pathophysiologic Approach. (5th ed.) New York: The McGraw-Hill Companies, Inc. 2005.
  4. Schatzberg, AF, Cole, JO and DeBattista, C. Manual of Clinical Psychopharmacology (7th ed.). Washington, DC: American Psychiatric Publishing, Inc. 2010.
  5. Preston J and Johnson J. Clinical Psychopharmacology. (6th ed.) Miami, Fla: MedMaster Inc. 2011.