Indications for Antipsychotic Drugs

A. Antipsychotics (also known as neuroleptics) are indicated for schizophrenia and may be used for other disorders with psychotic features, such as depression.

B. Antipsychotics are the drugs of choice for brief psychotic disorder, schizophreniform disorder and schizophrenia. They also play a prominent role in the treatment of schizoaffective disorder.

C. Antipsychotics may be necessary for patients with mood disorders with psychotic features. Brief to moderate courses are usually used. These agents often improve functioning in patients with dementia or delirium with psychotic features when given in low doses.

D. Antipsychotics are frequently used in the treatment of substance induced psychotic disorders. Low-dose neuroleptics may be useful for the psychotic features of severe personality disorders; however, they should be used with caution and for a brief period of time in these patients.

II. Selection of an Antipsychotic Agent All neuroleptics are equally effective in the treatment of psychosis, with the exception of clozapine, which is more effective for treatment refractory schizophrenia. The newer antipsychotics (risperidone, olanzapine, quetiapine, and ziprasidone) may be more effective than conventional agents.

A. In general, the choice of neuroleptic should be made based on the past history of response to a particular neuroleptic, family history of response, and likelihood of tolerance to side effects.

B. At least two weeks of treatment is required before significant antipsychotic effect is achieved.

C. The use of more than one antipsychotic agent at a time has not been shown to increase efficacy.

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Anxiety and Depression 101

Anxiety and Depression 101

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