Changing antipsychotics – how to choose the best treatment
A new article published in Australian Prescriber today reminds patients, their families and health professionals that antipsychotic medicines have their place in treating long-term, serious psychiatric illnesses, but swapping antipsychotics might be necessary for some people if they haven't responded well to the medicine or if they are having unwanted side effects.
Professor Nicholas Keks, Director at the Centre for Mental Health Education and Research in Victoria, and his co-authors warn that specialist advice should be sought when considering switching antipsychotics.
"Antipsychotics can cause a range of side effects like shaking and balance problems, weight gain and blurred vision. If a side effect is intolerable, it may be better to switch to a different antipsychotic medicine," says Professor Keks.
"For serious psychiatric illnesses like schizophrenia and bipolar mood disorder, stopping an antipsychotic can lead to a return of the illness, sometimes more severe than before treatment. That's why we recommend that stopping or switching antipsychotics is done by a psychiatrist. How fast this can be done depends on the patient's condition and the antipsychotic medicines being switched," he says.
"If the antipsychotic medicine is being used to help with insomnia, or behavioural disturbances associated with dementia, it may be possible to reduce the dose or stop the medicine completely. This should, however, only be done under medical supervision."
Australian Prescriber has developed a tool for health professionals to guide switching from one antipsychotic to another.
For advice relating to your own circumstances, talk to your GP or specialist.
For general information on prescription, over-the-counter and complementary medicines (herbal, 'natural', vitamins and minerals) from a health professional, call NPS Medicines Line on 1300 MEDICINE (1300 633 424) for the cost of a local call (calls from mobiles may cost more). Hours of operation are Monday–Friday 9am–5pm AEST (excluding public holidays).
