Explains what antipsychotics are used for, how the medication works, possible side effects and information about withdrawal.
This page covers the following safety considerations for taking antipsychotics:
Before you decide to take an antipsychotic, or any other medication, you should make sure you have all the facts you need to feel confident about your decision. For guidance on the basic information you might want to know about any drug before you take it, see our pages on:
Before you start taking an antipsychotic, your doctor should do the following tests to assess your physical health:
After you start taking the medication, your mental health team will need to continue to monitor all the above aspects of your physical health regularly. They will also need to monitor and record:
If you're on a high dose of antipsychotics, you should be given an ECG every one to three months because antipsychotics can sometimes cause heart problems as a side effect. The risk is greater with higher doses. Whatever your dose, if you have unexplained blackouts, you should let your doctor know and they should monitor your heart rhythm regularly.
If you've been on the drug for a year and are getting on well with it, your GP can monitor your physical health instead of your mental health team. Your doctor should review your treatment at least once a year to check whether it's still working well for you – but you can ask them for a review whenever you want one.
If you have any of the following conditions, your doctor should use particular caution when prescribing you an antipsychotic. They may also need to monitor you even more regularly to check its effects:
If you have any medical condition at all (even if it's not listed here) make sure that you tell your doctor about it so they can consider it when prescribing your medication.
In some medical circumstances, your doctor may decide it's not safe to prescribe you an antipsychotic at all. For example, you should never be given an antipsychotic if:
If you're an older person, your doctor will need to be particularly cautious when prescribing an antipsychotic, and they may need to adjust your dosage. This is because:
Combining other medication with antipsychotic drugs can sometimes cause unpleasant or dangerous interactions. You should always check with your doctor or pharmacist before taking any drugs together, or closely following one another, in case they could interact with each other badly.
The information below shows the main interaction risks between antipsychotics and:
Anti-Parkinson’s drugs are also antimuscarinic. It's possible that an anti-Parkinson's drug could interact with your antipsychotic to make you delirious, which may be confused with your psychotic symptoms.
Certain sleeping pills and minor tranquillisers can increase the sedative action of all antipsychotics, so they will make you feel even more drowsy. This is particularly true of:
If your doctor decides to prescribe an antipsychotic alongside lithium, they should start it at a lower dose than usual.
Taking a tricyclic antidepressant at the same time as antipsychotic medication increases the risk of causing dangerous disturbances to your heart rhythm. This especially applies to fluphenazine, haloperidol, risperidone and sulpiride.
You should get advice from the pharmacist or another qualified professional before taking any non-prescription medicine – including complementary or alternative medicines – with your antipsychotic, so they can can tell you about any potential risks.
Drinking alcohol can increase the sedative action of all antipsychotics, so it will make you feel even more drowsy. You might want to ask your doctor or pharmacist whether it’s safe to drink with the drug you've been prescribed, and take extra care to know your limits.
It's possible that street drugs may interact with antipsychotics. For example, if you take amphetamines with chlorpromazine, the effects of one or both can be reduced. See our pages on the mental health effects of street drugs for more information. You can also visit the FRANK website for confidential advice on street drugs.
This information was published in 2016. We will revise it in 2019.
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