Potential Risks of Antipsychotic Medications

Antipsychotic medications are mainly prescribed to individuals with schizophrenia and bipolar disorder. However, these medications are also becoming popular for treating autism and ADHD. Learn some of the potential serious side effects of these medications.

Antipsychotic medications have been around since the 1950's (referred to as typical antipsychotics), though a newer generation of medications were developed in the 1990's (called atypical antipsychotics). The older drugs include: chlorpromazine (Thorazine), haloperidol (Haldol), Perphenazine (no brand name available), and Fluphenazine (no brand name available).

The newer generation includes: Risperidone (Risperdal), Olanzapine (Zyprexa), Quetiapine (Seroquel)

Ziprasidone (Geodon), Aripiprazole (Abilify), and Paliperidone (Invega).

Antipsychotic medications can be essential for helping some individuals have functional and enjoyable lives. For others, these medications may just be used to help with insomnia, behavior issues, anxiety or mood swings. The potential benefit will always need to be weighed against the potential risk, as with any medication.

The mild side effects of antipsychotics are similar to those of many other drugs. These include: drowsiness; dizziness when changing positions; blurred vision; heart palpitations (rapid heartbeat); sensitivity to the sun; skin rashes and menstrual problems for women. Some of these side effects will subside on their own once a person has been on a medication for a few days. Some may persist, but they may not be bothersome enough to cause a person to switch medications.

The more serious side effects are what you'll really need to consider when weighing risk vs. benefit. The serious side effects for antipsychotics include: major weight gain; changes in metabolism; increased risk of getting diabetes and high cholesterol (due to the weight gain); tardive dyskinesia and neuroleptic malignant syndrome. Since these conditions greatly affect a person's long term health and impact their quality of life they should be given serious consideration. To reduce the risks associated with weight gain, diabetes and high cholesterol, a strict diet should be adhered to. This can be difficult with children or individuals with certain disabilities, but it is well worth the effort.

For individuals who take antipsychotic medicine for help with insomnia or difficulty staying asleep at night, there are many less risky medicines and supplements that can be tried. Melatonin and valerian root are over the counter supplements that have been reported to help some people fall asleep and stay asleep. Sleep medicines such as Ambien and Lunesta work well for occasional difficulty sleeping, but a tolerance can be built to the drugs if taken on a nightly basis. Some blood pressure medications are prescribed to be taken at bedtime because they induce drowsiness.

Don't be afraid to do your own research in addition to the information your doctor gives you. Since it is you or your loved one taking the medication you are your best advocate.

Through my experience searching for a medication to help my daughters sleep I've had plenty of experience both advocating for them and weighing risks and benefits. Both of my daughters have autism and have suffered from sleeping problems almost their entire lives. For a couple of years they took Risperdal, and it worked wonderfully. Unfortunately we were left in a situation where we didn't have a doctor to prescribe it for them (the pediatrician wouldn't prescribe it as she said it was a highly controlled substance and our specialist who originally prescribed it had moved). At that point I decided to just let them be medicine free and see what happened.

We had about one and a half to two years of pretty good sleeping habits. As time progressed during this period the dysfunctional sleeping patterns slowly began recurring. For the following two years we had a few decent months (meaning sleeping at least 5-6 consecutive hours most nights of the week) followed by a few bad months (meaning 2-3 solid nights of sleep interspersed with nights of 1-2 hours of sleep or sporadic 1-2 hour periods of sleep throughout the night followed by 1-2 hours awake). At this point I sought medical help again and in about three months we tried Neurontin, Depakote, Clonidine and Ambien. None of them helped the girls sleep for more than a week or two, if at all. Neurontin made them gain weight and stay swollen all the time.

After that I gave up on medicine again for a while. At the suggestion of a doctor and a nurse practitioner I tried Benadryl for a while. It helped initially, but then they developed a resistance to it as well.

We've recently started on Seroquel, and it seems to be working for now. However, early blood work shows that one of my daughters already has slightly elevated cholesterol levels. This means I have to become strict with her diet and cut out the snack foods that she likes. Still, that is probably in her best interest anyway, since nobody really needs to eat chips and chocolates.

Sources:
National Institutes of Health, Mental Health Medications, http://www.nimh.nih.gov/health/publications/mental-health-medications/complete-index.shtml
Drugs.com, Atypical Antipsychotics, http://www.drugs.com/drug-class/atypical-antipsychotics.html