Complementary therapies I take in addition to my
medication:
GNC Triple
Strength Fish Oil
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Serving Size: 1 Softgel Servings Per Container: 60
Calories: 15 Total Fat: 1.5g
EPA: 647mg DHA: 253mg
GNC Mega Men Sport Multi-Vitamins
(Bonus Size)
$34.99
Other Cool Stuff:
Tablet/Pill Splitter
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GoFit Yoga Mat
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Homedics LCD Digital Scale $39.99
Attention:
This
website is probably more suitable for people whom are 18
years of age or older. I use vulgarity from time to time,
and I sometimes talk about things that are generally
inappropriate. Sorry you 1st graders. Beat it.
Acute phase (of illness) -
A worsening of a person's positive (psychotic) symptoms, often
leading to bizarre out-of-control behavior. Antipsychotic
medications are given to eliminate or reduce these symptoms.
It often takes 4-6 weeks for the antipsychotic medications to work.
The newer and older medications take about the same amount of time
to work. Frequently the patient needs to be hospitalized for
safety issues during the acute phase.
Top
Adjuvant medication -
A second (or third) medication that is added onto another
medication. The purpose of the second medication is not to
replace the first medication, but to boost its benefits. The
first medication is still the cornerstone medication and is
considered the primary medication. It is considered to be an
adjunctive treatment. The same medication might be used as an
adjuvant for one person while being a primary medication for someone
else. Top
Affinity (for receptors) -
Affinity means how strongly a medication attaches itself to a
receptor on the nerve cell. Stronger affinities produce
stronger effects. Medications that attach to a receptor in a
way that keeps the neurotransmitter away are known as antagonists.
Conventional antipsychotics have strongaffinities to the
dopamine receptor and completely block the dopamine from reach the
nerve cell. Atypical antipsychotics have weaker affinities
that allow some of the dopamine to reach the receptor.
Top
Agonist - A drug or psychiatric medication
that works by resembling the neurotransmitter itself. The
brain cells behave as if there were more of that neurotransmitter
around. An agonist is the opposite of an antagonist.
Top Agoraphobia - The phobia most likely
to drive people to seek professional help. An agoraphobic has
in intense fear of being in a situation from which immediate escape
is not possible or in which help would not be available if she or he
should become overwhelmed by anxiety or experience a panic attack or
panic-like symptoms. An agoraphobic often will not leave home
unless accompanied by a friend or family member, and, in severe
cases, not even then. Women are four times more likely than
men to be diagnosed with agoraphobia. Top
Agranulocytosis - A potentially
dangerous side effect of Clozapine that causes people to stop making
the white blood cells needed to fight infections.
Agranulocytosis occurs in about 1% of people taking Clozapine.
Agranulocytosis usually occurs in the first 6 months of clozapine
treatment, which is why patients starting clozapine have their blood
monitored every week for the first 6 months.
Top
Akathisia - A kind of restlessness or
inability to sit still that is caused by medication. Akathisia
can cause people to pace, to repeatedly get up and down from a
chair, and to have fidgety legs. People describe akathisia as
"feeling like I'm jumping out of my skin." Sometimes people
have trouble communicating their distress and may not mention
akathisia symptoms without being asked. The restless sensation
is usually most intense in the upper legs and the trunk.
Akathisia waxes and wanes. It may get better when the person
is busy or distracted and worse when the person is left alone.
Many psychiatric conditions cause symptoms that are just like
akathisia. This can make it difficult to know with certainty
whether the problem is due to akathisia or is caused by psychosis, a
manic anxiety or state, or drug alcohol use. See also
extrapyrmidal side effects. Top
Akinesia (also referred to as "bradykinesia")
- A slowing down of movements ("kinesis is a Latin word for
movement"). A person with akinesia may be listless or
lifeless. The person's face may lose its usual expressions.
Akinesia can sometimes be more of an internal, subjective feeling
than actual slowed down movements. A common complaint with
akinesia is "I feel like a zombie." Akinesia can closely
resemble the negative symptoms of schizophrenia or depressive
symptoms. It can be difficult, if not impossible at times, to
tell the difference between these conditions. See also
extrapyramidal side effects.
Top
Alcohol - It is well known that alcohol
can worsen mood symptoms such as depression. Alcohol can
worsen psychotic symptoms. Continued alcohol use cab be an
explanation when a new medication does not work as well as expected.
See also dual diagnosis. Top
Allergy - While there can be allergic
reactions to any medication, allergic reactions to antipsychotic
medications are uncommon. When patients report having had an
"allergy" to an antipsychotic medication, it is usually a dystonic
reaction that is interpreted as an allergy. There is no
evidence that schizophrenia or other psychotic conditions are caused
by food allergies or other allergic reactions. See also
dystonia.
Top
Alpha Receptors - One of
several subtypes of receptors that are receiving sites for the
neurotransmitter norepinephrine. Some antipsychotics block the
alpha receptor. The psychiatric effects of blocking alpha
receptors are not fully understood. However, blocking of alpha
receptors is the major cause of dizziness during the first few days
of starting a new medication. See also orthostatic
hypotension. Top
Amenorrhea - To miss several
menstrual periods. Some of the antipsychotic medications can
cause an elevation of the hormone prolactin. High prolactin
levels fool a woman's hormonal system into "believing" she is
pregnant. This side effect of medication can also cause
irregular periods and abnormal leakage of breast milk, which is
called galactorrhea. Amenorrhea in premenopausal in women is
often a side of the medication, but don't forget that amenorrhea
also happens during real pregnancies.
Top
Amotivation - Literally "no
motivation." Amotivation can be a negative symptom of
schizophrenia, a part of kinesia, or the result of depression.
Doctors tend to use this term when they are describing someone's
negative symptoms. See also apathy. Top
Ancillary Symptoms -
Symptoms that are not always found in schizophrenia, or happen to
other people without a diagnosis of schizophrenia. For
example, insomnia is considered an ancillary symptom because it is
not really a specific feature of schizophrenia, but it a common and
distressing problem for many people with schizophrenia.
Top
Anergia - Literally "no energy."
In psychiatry, anergia is used to describe the lack of energy that
is one of the negative symptoms of schizophrenia. It may be
very hard for doctors to tell the difference between anergia, which
is a negative symptom, and akinesia, which is an extrapyramidal side
effect.
Top
Antagonist - A drug that blocks the
actions of a neurotransmitter. The antagonist drug blocks the
place on the receptor where the neurotransmitter usually lands.
The receptor is "fooled" into believing there is less
neurotransmitter around, and that message is then conveyed to the
receptor's nerve cell. Top
Antianxiety medications
- Medications that are most commonly used to treat anxiety, whatever
the cause. Most antianxiety medications are in the class of
medications known as benzodiazepines. These include Ativan (lorazepam)
and Valium (diazepam). A related category of medications are
the triazolam medications such as Xanex (alprazolam) and Klonopin (clonazepam).
Buspar (buspirone) is another kind of antianxiety medication.
See also adjuvant medication, akathisia, anxiety, insomnia.
Top
Anticholinergic medications
- Medications that counteract many of the extrapyramidal side
effects (EPS), especially dystonia, tremor, and rigidity.
Anticholinergic medications can sometimes help with akathisia and
akiniesia, but they are not effective for dyskensia.
Anticholinergics are frequently given along with the conventional
antipsychotics, either to treat EPS that are there or to prevent EPS
from happening. Examples of commonly used anticholinergic
medications include Cogentin (benztropine), Akineton (biperidan),
and Artane (trihexyphenidyl). Unfortunately, anticholinergic
medications have side effects of their own. Fortunately,
because they cause far fewer EPS, anticholinergics are not needed
nearly as often with atypical antipsychotics. See also
anticholnergic side effects.
Top
Anticholinergic side
effects - Choline is a chemical that nerve cells use to
communicate. Many of the medications used to treat the side
effects of antipsychotics have strong antcholinergic effects.
Some antipsychotics are also very anticholinergic, including
Mellaril (thioridazine), Thorazine (chlorpromazine), and Clozaril (clozapine).
Common anticholinergic side effects include dry mouth, blurry
vision, constipation, and difficulty urinating (urinary retention).
These problems don't always come from anticholinergics, but if a
person is taking an anticholinergic medication, chances are good
that such problems are due to the medication. Anticholinergic
problems can be treated in several different ways. Nothing is
needed if the problem is mild and not bothersome. Sometimes
the passage of time helps resolve the anticholinergic problem on its
own. If the problem persists and is bothersome or dangerous,
medication adjustments may be needed. These include adding a
medication to reverse the anticholinergic effects, decreasing the
anticholinergic medication, switching to a less anticholinergic
medication, or switching to an antipsychotic medication that is less
likely to require an extra anticholinergic side-effect medication.
Top
Antidepressant medications
- Medications that work on relieving symptoms of depression.
They are given as primary medications for people with a diagnosis of
major depression. Many of the antidepressant medications are
serotonin inhibitors such as Paxil (paroxetine), Prozac (fluoxetine),
and Zoloft (sertraline). For patients with schizophrenia or
schizoaffective disorder, antidepressant medications may be added to
the antipsychotic to help relieve depressive symptoms.
Antidepressant medication should not be taken alone by patients with
schizophrenia or schizoaffective disorder. See also
postpsychotic depression.
Top
Antiobsessive medications
- Medications that are most commonly used to treat obsessions and
compulsions, whatever the cause. Many of the antiobsessive
medications are serotonin reuptake inhibitors such as Luvox (fluvoxamine),
Paxil (paroxetine), Prozac (fluoxetine), and Zoloft (sertraline).
Anafranil (clomipramine) is another antiobsessive medication.
In general, antiobsessive medications are safe to take with
antipsychotics, although there may be drug-drug interactions,
especially when Luvox is given with Clozaril (clozapine). See
also obsessive and compulsive symptoms. Top
Anxiety - A normal mood that can also
be a symptom in just about any psychiatric condition. As one
would imagine, anxiety is a very common symptom when someone has
psychotic symptoms--delusions and hallucinations can be terrifying;
having paranoid fears means always feeling like you are under
attack. Akathisia is a side effect that often causes anxiety.
Treatment of anxiety depends on the cause and may include
reassurance, adding an antianxiety medication, increasing the dose
of the antipsychotic, or treating the akathisia. See also
paranoia. Top
Anxiety disorders -
Psychological disorder characterized by frequent, fearful thoughts
about what might happen in the future. Anxiety disorders are
the most common category of mental disorders and account for more
than 4 million visits to doctor's offices each year in the United
States. Top
Apathy - An indifference to one's
environment. There is a kind of dullness to the person's
reactions and a sense that the person just doesn't care. Often
apathy goes hand-in-hand with having a very low physical energy (anergia).
Withdrawal from sadness or depression is not apathy; rather, apathy
is lack of any feeling. Apathy is a common negative symptom.
Sometimes extrapyramidal side effects and severe sedation from
antipsychotics can also cause apathy. Sometimes problems with
drugs or alcohol cause apathy. Families and friends may
mistake apathy or laziness. See also laziness, substance
abuse.
Top
Asociality - Literally "no social
functioning." In psychiatry, it is used to mean the poor
social functioning that is due to the negative symptoms of
schizophrenia.
Top
Atypical antipsychotics
- The newer antipsychotic medications. The newer medications
are also sometimes called "novel" or simply "newer." The word
"atypical" will soon be outdated, as the atypical medications
continue to replace the older medications for the first-line use
(just like the "New" in New York is outdated). The term
"atypical" means that the medication belongs to a class of newer
medications. If you feel confused about this word, you're not
alone. There is disagreement in the medical community about
the exact meaning of the word. Sometimes "atypical" refers to
the medication's side-effect profile, sometimes to what the
medication does in the test tube or in animal models, and sometimes
to whether or not the medication affects the neurotransmitter
serotonin. Medications considered to be atypical
antipsychotics that are currently available in the United States
include Clozaril (clozapine), Risperdal (risperidone), Zyprexa (olanzapine),
Seroquel (quetiapine), Geodon (ziprasidone), and Abilify (Aripiprazole).
At least two other other atypical antipsychotics--sertindole and
zotepine--are available in other countries but probably will not be
available in the United States in the foreseeable future.
Top
Avolition - Lack of volition or will
power. This term is used to describe one of the negative
symptoms of schizophrenia. See also akinesia, negative
symptoms. Top
"Awakenings" - Term borrowed from a
book of the same title by Oliver Sacks. In this book, we use
the term to refer to the psychological challenges and changes after
a patient with persistent symptoms of schizophrenia responds to one
of the newer antipsychotic medications. See also atypical
antipsychotics, postpsychotic depression. Top
Baseline - When used by mental healthy
clinicians, "baseline" refers to the state in which a person with
persistent symptoms is no better or worse than usual ("The patient's
symptoms were at his usual baseline until he changed apartments.")
See also acute phase, maintenance treatment.
Top
B.I.D. - Technical term meaning that a
medication should be taken twice a day. See also Q.D., Q.I.D.,
T.I.D.
Top
Bipolar disorder - Psychiatric
disorder related to problems regulating mood. Also referred to
as manic-depression. Patients with bipolar disorder have mood
swings characterized by periods of depression and mania. Many,
but not all, patients experience psychotic symptoms. Although
bipolar disorder differs from schizophrenia, doctors often need to
distinguish bipolar disorder from schizophrenia when there are
psychotic symptoms. Accurate diagnosis is important because
mood stabilizers (lithium, Depakote, Tegretol) are the primary
medications for people with bipolar disorder. Antipsychotics
are often also used during the acute (manic) phase either as
adjunctive treatments with the mood stabilizers or alone for
patients who cannot tolerate mood stabilizers. Patients with
mood disorders are often more likely to get extrapyramidal side
effects (EPS) from conventional antipsychotics. The atypical
antipsychotics, therefore, seem to be better adjunctive medications
for bipolar disorder because of their better side-effect profile.
Also, the atypical antipsychotics seem to have mood stabilizing
properties and can be helpful for patients who do not respond to, or
cannot tolerate, mood stabilizers. Top
Blurry vision - Possible side
effect of medications that have anticholinergic properties.
This side effect often happens early on, when the medication is
started or the dosage is raised. The blurry vision will often
get better by itself, so it is usually best to wait a few weeks to
see if the problem goes away on its own. Other treatments
include medication adjustments discussed under anticholinergic side
effects. See also anticholinergic side effects.
Top
Caffeine - Caffeine from any source
(coffee, cola, "pep pills") can counteract the benefits of
antipsychotic medications. Excessive caffeine intake can
sometimes be the reason a new medication does not work as well as
expected.
Top
Cataracts - Clouding of the cornea
(outer layer) of the eye. Some psychiatric medications,
including Thorazine, Mellaril, and Tegretol, have been reported to
cause cataracts as a very rare side effect. During animal
testing, the atypical antipsychotic quetiapine (Seroquel) cause
cataracts in dogs. Although there is no evidence that Seroquel
causes cataracts in people, there is precaution concerning this in
the label for Seroquel.
Top
Catatonia - A condition in which the
person is immobile and extremely withdrawn. Catatonia can be a
psychotic symptom and may also be a part of a mood disorder or
schizophrenia. However, catatonia can also be a rare but
serious side effect of antipsychotic medications. Just as is
the case for EPS, the conventional antipsychotics are more likely to
cause catatonia than the atypical antipsychotics.
Top
Causes (of psychosis) -
Research has conclusively shown that psychosis from schizophrenia
and bipolar disorders is caused by a brain disorder that ultimately
leads to an imbalance in the neurotransmitters responsible for the
control of thoughts and moods. It is important to know that
psychosis is not caused by "bad parenting" or other childhood
problems. Also, stress seems to trigger psychosis but not to
cause it, just like the physical exercise might trigger a heart
attack but not actually cause it. Substance abuse or alcohol
abuse can cause psychosis or can trigger a psychotic episode in
someone with a psychiatric disorder. The timing of substance
abuse or alcohol abuse and the psychiatric symptoms often needs to
be carefully sorted out before doctors can make an accurate
diagnosis. See also stigma.
Top
CBC (complete
blood count) monitoring - Periodic blood tests that are
needed for patients taking clozapine. The blood is checked for
the number of white blood cells that are available to fight
infection. Blood tests are done once a week for the first 6
months of taking clozapine and then usually every other week after
that. See also agranulocytosis, clozapine.
Top
Clozapine (Clozaril) - The
first of the atypical antipsychotics to be introduced and the only
one that has been proven to be more effective than the conventional
antipsychotics. Clozapine has many drawbacks, including the
need for ongoing blood tests, so that its use is limited to patients
who have not done well on other antipsychotic medications.
Clozapine comes in 25 and 100 mg tablets. See also
agranulocytosis, hypersalivation, myoclonus, seizure.
Top
Cocaine - A substance of abuse that is
a dopamine agonist and worsens positive (psychotic) symptoms.
Cocaine use counteracts the protective effects of antipsychotic
medications. See also dual diagnosis, substance abuse.
Top
Cognitive problems - Many
patients with schizophrenia have cognitive problems such as trouble
concentrating, focusing, or paying attention. With some
exceptions, cognitive problems are thought to be caused by the
psychiatric condition rather than the medications used to treat the
disorder. It is hoped--but not proven--that the typical
antipsychotics may be more effective than the older conventional
antipsychotics for these kinds of cognitive problems. See also
memory problems. Top
Constipation - A possible side
effect of anticholinergic medications, which slow down bowel
movements. The person may get constipated and have fewer bowel
movements and hard stools. This problem can be annoying for
some people. When constipation is severe or happens in an
older person, it can be medically dangerous. Mild constipation
can be helped by drinking plenty of fluids and eating foods that are
high in fiber, such as bran. If the problem is severe or
persists, other possible treatments include using laxatives or the
medication adjustments discussed under anticholinergic side effects.
Clozapine is an antipsychotic that can cause constipation.
Top
Contraindication - A medical
word meaning a reason not to go ahead with a treatment. For
example, a recent heart attack is a contraindication for elective
surgery. Most of the time, contraindication are weighed
against indications. An example of a contraindication for
switching from an older to a newer antipsychotic medication is when
the person needs a long-acting depot antipsychotic medication
because he or she has a hard time taking oral medications a
prescribed. None of the newer medications are available in a
long-acting form. Before switching antipsychotic medications,
it is important to consider possible contraindications.
Top
Conventional antipsychotics
- The group of antipsychotic medications developed between the 1950s
and 1970s; also referred to as "neuroleptics" or "traditional" or
"classic" antipsychotics. These medications include
haloperidol (Haldol), fluphenazine (Prolixin), chlorpramazine (Thorazine),
thioridazine (Mellaril), and perphanazine (Trilafon). They
work by blocking the nerve cells that receive the neurotransmitter
dopamine. In general, they are effective for positive
(psychotic) symptoms and less effective for negative symptoms of
schizophrenia. Top
Conversion disorder - A
somatoform disorder in which a person suffers a loss of motor or
sensory functioning in some part of the body; the loss has no
physical cause but solves some psychological problem. A person
may become blind, deaf, or unable to speak or may develop a
paralysis in some part of the body. Top
Crossover - Used to refer to the
process of switching from on antipsychotic to another. This
process may involve a period of time during which the old
antipsychotic medication and the newer antipsychotic medication are
prescribed simultaneously.
Top
Delusions - Believing things that no
one else believes, such as an unshakable belief that the CIA is
following you when no one else thinks this is happening or believing
that you are Jesus. See also positive symptoms.
Top
Denial of illness - A term
used to mean that the person is not aware of (or does not
acknowledge) having a psychiatric condition. Not surprisingly,
patients who deny their illness are less likely to take recommend
medication as prescribed. Denial of illness can be a vexing
problem for family members of patients with schizophrenia,
especially when the person does much better on medication. For
patients who tend to deny their illness all the time, switching
medications does not seem to change the person's point of view.
Top
Depot therapy (also referred to
as "depot route") - A long-acting form of antipsychotic medication
that is given by an injection into a muscle approximately every 2-4
weeks. It is called "depot" because the medication is stored
in the muscle for several weeks, just as a bus depot stores buses.
Other types of medications such as hormones and antibiotics also
come in depot forms. Only two long-acting depot antipsychotic
medications are available in the United States today: Prolixin (fluphenazine)
and Haldol (haloperidol). both are older, high-potency,
conventional antipsychotics. None of the newer atypical
antipsychotics are currently available in long-acting depot form.
It seems likely that some of the newer medications will eventually
come in long-acting forms, but this won't happen anytime soon.
Some antipsychotic medications can also be given in short-acting
injections, but those are not depot medications.
Top
Depression - A very common
psychiatric disorder. When a depressive disorder occurs by
itself without other psychiatric disorders, it is called "unipolar
depression." Treatment for unipolar depressive disorders
includes antidepressant medications and/or certain kinds of
psychotherapy. Unless the depression is very severe or the
person has psychotic symptoms, antipsychotics are not needed.
Patients with schizophrenia also have very high rates of depression.
Depression in schizophrenia has to be treated very differently from
unipolar depression. In evaluating depressive symptoms in
schizophrenia, the doctors need to evaluate the patient's positive
symptoms and side effects before making a final diagnosis of
depression. One common form of depression in schizophrenia is
called postpsychotic depression.
Top
Diagnosis - A doctor makes a
psychiatric diagnosis by evaluating the person's current psychiatric
symptoms and past history of symptoms. The doctor also
examines the results of laboratory tests and the physical
examination to rule out medical problems that might be causing the
symptoms. The doctor then uses the information to give a name
to the person's symptoms (a diagnosis). To do this, the doctor
often compares the person's problems with the diagnostic criteria
for disorders that are listed in DSM-IV. Much of the time,
there is no lab test or x-ray that pinpoints the diagnosis, so that
the accuracy of the diagnosis depends to a great extent on the
accuracy of the information the doctor gathers. Therefore, the
doctor will want to interview the family as well as the patient.
One of the hardest parts of accurate diagnosis is figuring out
whether the problems could be caused by substance abuse; therefore,
it is important to be truthful about drug and alcohol habits.
Top
Dietary precautions - There
are no dietary restrictions for patients taking antipsychotic
medications (however, there are dietary restrictions for people
taking a rarely used type of antidepressant known as monoamine
oxidase inhibitors [MAOIs]). Most of the newer medications
(with the exception of Geodon) can be taken either with food or on
an empty stomach. Weight gain can happen after switching to
one of the newer atypical antipsychotics. If this is a
concern, it is a good idea to be very careful about maintaining a
healthy diet during the switching period. See also weight
gain. Top
Dissociative amnesia - A
dissociative disorder in which there is a complete or partial loss
of the ability to recall personal information or identify past
experiences. It is often caused by a traumatic experience--a
psychological blow, so to speak--or a situation that creates
unbearable anxiety causing the person to escape by "forgetting."
Top
Dissociative disorder -
Disorders in which, under unbearable stress, consciousness becomes
dissociated from a person's identity of her or his memories of
important personal events, or both. Their consciousness
becomes dissociated from their identity of their memories of
important personal events, or both. Top
Dissociative fugue - In a
fugue state, people not only forget their identity, but they also
travel away from home. Some take on an a new identity that is
usually more outgoing and uninhibited than their former identity.
Top
Dopamine - A neurotransmitter in the
brain. Both conventional and atypical antipsychotics slow down
(antagonize) dopamine's ability to transmit messages between nerve
cells in the brain. See also antagonist.
Top
Drug-drug interactions -
Changes in the metabolism or blood levels of one drug when a second
drug is added. Most drug interactions in psychiatry are safe
for medically healthy adults, but there are exceptions. This
is a very complicated area.
Top
Dry mouth - A common anticholinergic
side effect. People with persistent dry mouth are more likely
to have dental problems. One way to help mild dry mouth is to
chew sugarless gum or suck on sugar-free candy.
Top
DSM-IV - Diagnostic and Statistical
Manual of Mental Disorders, 4th Edition, published by the
American Psychiatric Press, Washington DC, in 1994. DSM-IV
contains the major diagnostic system that is used by psychiatrists
in the United States. In DSM-IV, all major psychiatric
conditions are described and the clinical criteria used to make the
diagnosis are outlined for each condition. Top
Dual diagnosis - Literally the
presence of two diagnosis at the same time. When one is
speaking of psychotic disorders, the term is usually used to mean a
person who has both a major psychiatric disorder, such as
schizophrenia, and a substance abuse or alcohol problem.
Top
Dyskinesia - Abnormal muscle
movements that are most common in the face, mouth, tongue, and
hands. The movements usually look like writhing or wriggling
and tend to come and go. The person is often not aware of
these movements, which are often discovered by other people who
spend time with the person. There are many different types and
causes of dyskinesia. Two types of dyskinesia are commonly
caused by antipsychotic medications. Withdrawal dyskinesia - A
temporary dyskinesia that occurs when antipsychotic medication is
stopped. Top Tardive dyskinesia - A
dyskinesia that persists over a long period of time.
Top
It is impossible to identify the type of dyskinesia simply by
observing the abnormal movement. The exact diagnosis is
usually based on information about all the medications the person is
taking or has recently taken. Top
Dystonia - An uncontrollable muscle
spasm. Anyone who has had writer's cramp has actually
experienced dystonia. Patients starting medication may
experience a dystonia, which could look like a neck or jaw spasm or
cause a rolling up of the eyes. Anxiety tends to trigger
dystonic reactions. Dystonic reactions come and go, so that
they may not actually be witnessed by any mental health
professional. Sometimes acute dystonia is misdiagnosed as part
of the psychiatric condition, especially when the person is
psychotic or has trouble describing his or her symptoms accurately.
Top
Early side effects - Side
effects that happen within days to weeks after starting a new
medication. Early side effects tend to go away on their own
over time. For example, sedation can be an early side effect
of starting a new medication but often goes away in a few weeks.
Top
Early warning signs -
Symptoms or behaviors that happen before a person has an acute
psychotic episode (relapse). Many people have a telltale
pattern of early warning signs, which can help alert them and their
families and clinicians that a crisis may be coming. In such
situations, the hope it to rapidly treat the symptoms ("heading them
off at the pass") so that a full-blown relapse can be avoided.
Top
Ejaculatory problems -
Difficulties with ejaculation as part of normal male sexual
functioning. Ejaculation may be too rapid or too delayed.
Top
Erectile problems -
Difficulty or inability to achieve or maintain an erect penis as
part of normal male sexual functioning.
Top
Extrapyramidal side
effects (EPS) - A series of neurological side effects of
antipsychotics that involve a disruption of the part of the brain
known as the extrapyramidal system. The disruption involves
the neurotransmitter dopamine. Disruption of dopamine in this
brain area can cause disorders that affect normal movement.
EPS include akathisia, dystonia, tremors, muscle rigidity, and
akinesia. Taken together, EPS are one of the most serious
problems with the older conventional antipsychotics. One of
the major breakthroughs with the newer atypical antipsychotics is
that they are much less likely to cause EPS.
Top
Formulary - Most insurance plans have
a list of preferred medications. This list is called a
"formulary." Doctors are encouraged to prescribe medicines
that are "on formulary" and discouraged from prescribing medications
that are "off formulary." Medications that are "off formulary"
are much harder for the doctor to prescribe and may not be covered.
(Many Veterans' Administration Medical Centers still have
restricted formularies that do not include all of the newer
antipsychotics.) Some plans have not included all of the newer
medications in their formularies and/or make it harder for the
doctor to prescribe one of the newer medications. because we
do not know ahead of time who will do best on which medication,
these formulary restrictions lead to lost opportunities for many
patients. See also medicaid. Top
Galactorrhea - Abnormal leakage of
breast milk. See also amenorrhea. Top
Gender identity disorder
- Chracterized by a problem accepting one's identity as a male or
female; children either express a desire to be or insist that they
are the other gender. They show a strong preference for the
clothes, games, pastimes, and playmates of the opposite sex.
Top
Generalized anxiety
disorder - An anxiety disorder in which people experience
chronic, excessive worry for 6 months or more. These people
expect the worst; their worrying is either unfounded or greatly
exaggerated and, thus, difficult to control.
Top
Half-life - The length of time a drug
will stay in the blood stream. It refers to the amount of time
it takes for half (50%) of the drug to be eliminated from the body.
A medication with a short half-life (for example, under 12 hours)
needs to be taken more frequently than a medication with a longer
half-life (for example, longer than 24 hours).
Top
Hallucinations - Changes in your
senses, such as hearing voices or seeing unusual things that are not
there. See also positive symptoms. Top
Herbal therapies - Herbal
remedies have become increasingly popular in the United States for
many emotional and medical problems. For example, the extract
of a plant called St. John's Wort is used as a home remedy for
depression and a plant called Valerian is used for insomnia.
People sometimes believe that herbal therapies are always safe or
don't have side effects. This is not true; herbal treatments
do have side effects. Many of these herbs can make psychotic
symptoms worse. Unlike prescription medications that are
carefully tested and approved by the FDA, herbs are not regulated
and are sold without careful testing or research. It is very
important for patients to be truthful about the herbal treatments
they are taking. They should also discuss their issue with
their doctor before starting a herbal treatment. In general,
people with major psychiatric disorders such as schizophrenia or
bipolar disorder should avoid herbal therapies. See also
megavitamin therapy.
Top
Histaminic receptors -
Receiving sites for the neurotransmitter histamine. Some of
the antipsychotics block histaminic receptors. The psychiatric
effects of blocking histaminic receptors are not fully understood.
However, like antihistamines taken for colds, antipsychotics with
antihistaminic effects can cause sedation. Top
Hypersalivation - Increased
salivation, drooling. Hypersalivation is a common side effect
of clozapine.
Top
Hypochondriasis - A somatoform
disorder in which persons are preoccupied with their health and fear
that their physical symptoms are a sign of some serious disease,
despite reassurrance from doctors to the contrary.
Top
Indication - A reason to go ahead
with a treatment. For example, appendicitis is an indication
for abdominal surgery. Most of the time, indications are
weighed against contraindications. In the context of switching
antipsychotic medications, an example of an indication for switching
from an older to a newer antipsychotic is when the person continues
to have persistent extrapyramidal side effects despite efforts at
treating them with side-effect medications. Before switching
antipsychotic medications, it is important to consider the
indications for switching. Often, this includes reviewing with
the doctor the "target symptoms" for the newer medication. The
checklist on page 35 reviews some of the reasons to switch
medications. See also contraindications.
Top
Insomnia - Trouble getting to sleep, a
common symptom of many many psychiatric problems. For patients
with psychotic disorders, insomnia can be a symptom of paranoia,
which makes the person afraid of being killed or harmed while
asleep. Insomnia can also be a sign of too much caffeine or
can be caused by akathisia at bedtime. Waking up too early in
the morning can be a symptom of depression, especially if the person
wakes up feeling very depressed. Top
Laziness - Persistent negative
symptoms can be confused with laziness. Generally speaking,
people need to be very cautious about judging a person with
schizophrenia as "lazy." Most of the time, this person is
incapacitated by the illness and/or side effects. See also
akinesia, apathy. Top
Loneliness - A normal emotion that
comes from the distressing sensation of being disconnected to, or
isolated from, other people. People with schizophrenia can be
lonely because of the consequences of their symptoms or because of
stigma. However, there can be a surprising lack of loneliness
among some people with schizophrenia who remain isolated but not
lonely. This lack of connection between someone's life
circumstances and their internal experience is probably a result of
negative symptoms, especially indifference. The negative
symptom factor may explain why some patients experience more
loneliness after their negative symptoms get better.
Top
Maintenance treatment - A
phase of treatment during which medication is used to control
ongoing symptoms and to prevent or delay relapse. For patients
with schizophrenia, ongoing antipsychotics are needed to prevent or
delay recurrence of acute symptoms, even when the person has been
free of any symptoms for a long time. Top
Major depressive disorder
- An overwhelming feeling of sadness, despair, and hopelessness, and
they usually lose their ability to experience pleasure. They
may have changes in appetite, weight, or sleep patterns; loss of
energy; and difficulty thinking or concentrating. Key symptoms
of major depressive disorder are psychomotor disturbances such as
body movements, reaction time, and slower speech.
Top
Mania - A period of abnormally elevated,
expansive, or irritable mood. The person may have an inflated
sense of self-esteem or grandiose ideas, feel a decreased need to
sleep, be more talkative than usual, feel that his or her thoughts
are racing, be easily distracted, start a series of new projects,
and become involved in risky activities (such as unrestrained
shopping sprees or sexually indiscrete behavior). See also
bipolar disorder.
Top
Manic episode - Episodes marked by
excessive euphoria, inflated self-esteem, wild optimism, and
hyperactivity. People in a manic state have temporarily lost
touch with reality and frequently have delusions of grandeur along
with their euphoric highs They may waste large sums of money
on get-rich-quick schemes then become irritable, enraged, or
dangerous when family members or friends try to stop them.
Top
Medicaid - A healthy insurance program
that is federally funded by the United States government. it
is available to citizens of the United States with low incomes who
are disabled by a medical or physical illness. Most
individuals suffering from severe mental illness are disabled by
their illness and are eligible for Medicaid. Medicaid almost
always pays for the newer medications. See also formulary,
Medicare.
Top
Medicare - Like Medicaid, Medicare is
a federally funded healthy program. It is for people who have
worked in the past or whose spouses have worked. Most elderly,
retired people are in the Medicare program, but people with
schizophrenia who once worked may also receive Medicare.
Although Medicaid and Medicare sound similar, the way they cover
prescription medications is very different. Unlike Medicaid,
Medicare does NOT pay for prescription medications. See also
formulary.
Top
Medication noncompliance
- Not following a doctor's recommendation. Noncompliance is
very common among patients who are supposed to be taking
antipsychotic medications. In part, this isn't any different
from other medical conditions, such as high blood pressure, where
noncompliance is also very, very common. There are some
additional factors that make noncompliance very common among
patients with schizophrenia. First of all, many of the
symptoms of psychosis make it impossible for the person to know that
treatment is needed. For example, by definition, patients are
not aware that paranoia is a symptom of their illness. Another
common reason that patients may not take their medication is the
distress caused by extrapyramidal side effects, especially from the
older conventional antipsychotics. Finally, taking medications
for a mental illness is very stigmatizing. It is therefore
hardly a surprise that it is very different for many people to
accept such a stigmatizing diagnosis. One approach that can
help patients who are not compliant with their antipsychotic
medication is trying a long-acting depot antipsychotic.
Unfortunately, none of the newer antipsychotics come in long-acting
forms. The only depot medications now available are older
conventional antipsychotics. Another approach is to minimize
distressing side effects by routinely using the newer atypical
antipsychotics. Doctors often have to balance the pros and
cons of these options to try and come up with the best plan for the
individual. See also denial of illness, depot therapy, stigma.
Top
Megavitamin therapy - A
minority of mental healthy practitioners believe that schizophrenia
should be treated with very high doses of vitamins or minerals, but
most psychiatrists do not find megavitamin treatment helpful.
Whatever else, megavitamin therapy is not a substitute for
antipsychotic medication in the treatment of psychosis.
Rather, such treatments might supplement antipsychotic medications.
See also herbal therapies. Top
Memory problems - Some
medications can cause memory problems. In particular,
anticholinergic medications and lithium have been shown to cause
memory difficulties for some people, even at "normal" therapeutic
doses. See also cognitive problems.
Top
Mood disorders - A set of
psychiatric diagnosis in which the major problem is mood regulation.
Mood may be too low (depression), too high (mania), or too high at
some times and too low at others (bipolar disorder, which is also
referred to as manic-depression). For a patient with a mood
disorder, mood symptoms are the primary symptoms.
Top
Mood stabilizers - A class of
medications that reduce mood swings (the "highs and lows" associated
with bipolar disorder). Examples include lithium, Depakote (divalproex),
and Tegretol (carbamazepine). The last two medications were
initially marketed as anticonvulsants for seizure patients, but were
accidentally discovered to have mood stabilizing properties.
Mood stabilizers are also used to boost the effects of antipsychotic
medications in patients with schizophrenia or schizoaffective
disorder. See also adjuvant medications.
Top
Muscarinic receptors - A
subtype of cholinergic receptor (the other subtype are nicotinic
receptors). Anticholinergic medications reduce extrapyramidal
side effects (EPS) by blocking the muscarinic receptors in the basal
ganglia part of the brain. However, anticholinergic
medications have their own side effects which are caused by their
ability to block muscarinic receptors in other parts of the body.
See also anticholinergic side effects, extrapyramidal side effects.
Top
Muscle spasm - See dystonia,
extrapyramidal side effects, myoclonus. Top
Myoclonus - A sudden jerky movement
of the arms that often happens right before falling asleep (which is
normal). However, if myoclonus happens during the day in a
person taking clozapine, it may be a warning that there may soon be
a seizure. See also clozapine. Top
National
Alliance for Mentally Ill (NAMI) - A grassroots advocacy
organization whose goal is to improve the lives of those suffering
from schizophrenia. For further information call
1-800-950-NAMI. Top
Negative symptoms - The
abilities and motivation that people lose when they have a mental
illness. They are called "negative" because the person has
lost abilities and interests they once had. People with
negative symptoms may have less energy, lose interest in things they
once enjoyed, withdraw socially, and have difficulty concentrating.
There is no single negative symptom, and some patients have more of
one type of negative symptom than another. Sometimes it can be
difficult or impossible to distinguish negative symptoms from
internal preoccupation, depression, or an extrapyramidal side effect
known as akinesia. While not a cure, the atypical
antipsychotics are often more effective than the conventional
antipsychotics for treating persistent negative symptoms. See
also avolition, apathy, asociality, laziness.
Top
Neuroleptic
Malignant Syndrome (NMS) - A rare but very serious condition
caused by antipsychotics. Signs of NMS include severe ridigity
and elevated levels on a blood test called CPK. The main
treatment for NMS is to stop the antipsychotic medication for at
least 2 weeks. The atypical antipsychotics are not as likely
as the conventional antipsychotics to cause NMS, but it is still a
possibility. See also catatonia, extrapyramidal side effects.
Top
Neuroleptics - A term sometimes
used to refer to conventional antipsychotic medications because they
cause neurological (extrapyramidal) side effects. Because the
newer atypical antipsychotics are much less likely to cause EPS,
this term is not usually used to refer to the newer medications.
Top
Neurotransmitter - A chemical
that is used to transmit a message between nerve cells in the brain.
Nerve cells store neurotransmitters in nerve endings. When a
nerve impulse is sent to the nerve ending, neurotransmitters are
released into the space between the cells. The
neurotransmitter then attaches itself to a part of a nearby nerve
cell that is designed to receive that specific chemical. The
part of the nerve cell that receives the neurotransmitter is called
a receptor. These receptors can figure out the concentration
of that neurotransmitter and help translate this message back into a
new nerve impulse. There are many different kinds of
neurotransmitters. Two neurotransmitters that are very
important in the treatment of schizophrenia are dopamine and
serotonin. Antipsychotics can work by blocking the receptors
that measure the concentration of neurotransmitters. All
antipsychotics block dopamine receptors to some extent. All
the atypical antipsychotics (and some of the conventional
antipsychotics) also block serotonin receptors. In addition,
some antipsychotics block other neurotransmitter receptors,
including alpha, histaminic, muscarinic, and nicotinic receptors.
Top
Nicotine and nicotinic
receptors - Nicotine is the psychoactive component of
cigarettes. There are neurotransmitters in the brain that
receive nicotine. It seems that stimulating nicotine receptors
actually helps normalize some of the brain abnormalities in
schizophrenia and also helps antipsychotics work better. In
other words, nicotine from cigarettes may help alleviate some of the
symptoms of psychosis. This may partly explain why so many
patients with psychosis smoke cigarettes. Top
Nonresponse to medication
- The medication has not worked for the person's symptoms.
What is considered nonresponse depends on what benefits the doctor
expected from the medication. Nonresponse is used to mean that
the medication did not work, not that something else was interfering
with the medication's effectiveness. Several other things can
interfere with a medication working. The person may not take
the medication as prescribed or may be using alcohol or drugs.
The dose may be too low, or enough time may not have been allowed
for the medication to take full effect. When someone is not
doing well on a new medication, it is very important to distinguish
between nonresponse (that medication is not working for that person)
and these other factors. See also partial response.
Top
Nutrition - Many people with
psychotic disorder have poor nutrition, living on junk foods and
fast foods. Only under extreme circumstances will poor
nutrition cause psychosis, but poor nutrition probably makes it
harder for the antipsychotic medications to work properly.
Patients should try to avoid "junk food" diets; if that is
unrealistic, the diet should be supplemented with one-a-day
multivitamins Top.
Obsessive and
compulsive symptoms - predominant symptoms in a psychiatric
disorder known as obsessive-compulsive disorder (OCD).
Antiobsessive medications, such as Anafranil, Luvox, Paxil, Prozac,
or Zoloft, are the primary treatment for a person with OCD.
Patients with schizophrenia or schizoaffective disorder may also
have secondary OC symptoms sometimes in addition to positive or
negative symptoms. These OC symptoms sometimes improve when an
antiobsessive medication is added to an antipsychotic. One
puzzling observation is that the newer medications help decrease OC
symptoms in some patients, but may actually worsen them in others.
Top
Obsessive-compulsive disorder (OCD)- An anxiety disorder in
which a person suffers from recurrent obsessions or compulsions, or
both. Obsessions are persistent, involuntary thoughts, images,
or impulses that invade consciousness and cause a person great
distress. People with obsessions might worry about
contamination by germs or about whether they performed a certain
act, such as turning off the stove or locking the door.
Top
Olanzapine (Zyprexa) - One
of the newer atypical antipsychotics. It is made by Eli Lilly
and was approved by the FDA in the fall of 1996. Olanzapine
comes in 2.5, 5, 7.5, and 10 mg tablets. Top
Orthostatic hypotension
- A drop in blood pressure upon sitting or standing. Symptoms
of orthostatic hypotension can range from severe to mild. Mild
symptoms include dizziness and lightheadedness when standing; Severe
symptoms include loss of consciousness and falling. Some
antipsychotics cause more orthostatic hypotension than others; the
amount of orthostatic hypertension a medication causes seems to
depend on how strongly it blocks alpha receptors. Orthostatic
hypotension is usually an early side effect. For medically
healthy adults, early orthostatic hypotension can be a nuisance but
is usually not dangerous. For older people, or patients with
other medical (especially cardiac) problems, orthostatic hypotension
can be a serious healthy risk because of the medical consequences of
sudden drops in blood pressure and the danger of sudden falls.
Top
Panic attack - An episode of
overwhelming, anxiety, fear, or terror. People commonly report
a pounding heart, uncontrollable trembling or shaking, and
sensations of choking or smothering. Some say they believe
they are going to die or are "going crazy."
Top
Panic disorder - A diagnosis
given to people who suffer from recurring panic attacks. Panic
disorder sufferers must cope both with repeated attacks and with
anxiety about the occurrence and consequences of further attacks.
Top
Paranoia - Unfounded belief or fear
that others are trying to cause harm. Often paranoid thoughts
are a part of a person's delusion(s). Paranoid symptoms can
cause overwhelming anxiety or can lead to harmful actions. See
also positive symptoms.
Top
Paraphilias - Disorders in which a person
experiences recurrent sexual urges, fantasies, or behaviors
involving children, other nonconsenting persons, nonhuman objects,
or the suffering or humiliation of the individual or his or her
partner.
Top
Parkinsonism - Extrapyramidal
symptoms (tremors, muscle rigidity, and akinesia) resemble the
symptoms of Parkinson's disease. See also extrapyramidal side
effects, rigidity, tremor. Top
Partial response - The person
is showing some signs of improvement on a new medication, but the
doctor considers the degree of improvement inadequate. Like
nonresponse, partial response is a relative concept and depends on
the doctor's expectations. It can sometimes be difficult to
distinguish between nonresponse and partial response. However,
this distinction is very important because the doctor is more likely
to recommend that someone with a partial response remain on the new
medication for an extended period of time. See also
nonresponse to medication.
Top
Personality disorder - A
long-standing, inflexible, maladaptive pattern of behaving and
relating to others, which usually begins early in childhood or
adolescence. Personality disorders are the most common of
mental disorders. 10-15% of North Americans have personality
disorders. Top
Phobia - A persistent, irrational fear
of some specific object, situation, or activity that poses little or
no real danger. Phobics realize their fears are irrational,
but they nevertheless feel compelled to avoid the feared situations
or objects. Top
Polypharmacy - The use of more
than one drug to treat a patient. Many patients taking
psychiatric medications are prescribed more than one medication at a
time. The term "polypharmacy" is also used in a more narrow
sense to mean the long-term use of two or more antipsychotic
medications at once. Top
Positive symptoms - Changes
that mental illness makes in a person's perceptions (five sense),
thoughts, feelings, and behavior. Positive symptoms are often
called "psychotic symptoms." They are called "positive"
because they mean that the person has behaviors and experiences that
one would not normally expect them to have. Positive symptoms
include delusions, hallucinations, paranoia, and thought disorder.
Top
Postpsychotic depression
- Depression that occurs shortly after a psychotic episode gets
better. The person's psychotic symptoms may be gone or much
better. However, in postpsychotic depression, the person gets
increasingly depressed and may report feeling despondent, hopeless,
or worthless. Suicidal thoughts and even suicide may happen
during this phase. The first step in the treatment of
postpsychotic depression is to recognize it for what it is.
Postpsychotic depression often appears after other "improvements"
have occured, so that the doctor and family are caught off guard.
Suicidal ideas should be taken seriously during this time.
Medication treatment includes adding an antidepressant to the
antipsychotic medication. The antidepressants used to treat
postpsychotic depression are exactly the same as those used to treat
other kinds of depression. See also antidepressant
medications, depression.
Top
Potency (of medication)
- The number of milligrams of medication needed to achieve a certain
amount of antipsychotic effectiveness. The fewer the
milligrams needed to achieve a certain effectiveness, the higher the
potency of the drug. As an example, let's compare two
antipsychotic medications. It has been shown that 100 mg of
Thorazine (chlorpromazine) has, on average, the same effectiveness
as 2 mg of Haldol (haloperidol). Because it takes a smaller
amount of Haldol to get the same effect, Haldol is an example of a
high-potency medication and Thorazine is a low-potency medication.
It is easy mix up potency with how well the drug works (which is
called its efficacy). People often get worried or frightened
when they switch to an antipsychotic medication with a different
potency. When a person goes from a high-potency medication to
a low-potency medication, they sometimes worry that too much is
being prescribed. On the other hand, going from a low-potency
to a high-potency medication can cause concern that the dose of the
new medication is way too low.
Top
Primary medication - The
medication or medication class that is most important for an
individual. Patients often receive more than one class of
psychiatric medication at once. For example, a person who is
taking an antipsychotic, antidepressant, and an antianxiety
medication at the same time is taking three different classes of
medication. For patients with schizophrenia or schizoaffective
disorder, the antipsychotic medications are usually the primary
treatment and other medications are the adjunctive, or secondary,
treatments. For a person with bipolar disorder, a mood
stabilizer such as lithium or Depakote would be the primary
treatment and an antipsychotic might be considered adjunctive.
See also adjuvant medication. Top
Primary symptoms - The
symptoms that are most relevant to making a psychiatric diagnosis.
For the diagnosis of schizophrenia, positive and negative symptoms
are the primary symptoms. Notice that primary symptoms aren't
necessarily the worst symptoms. For example, someone with
schizophrenia may be more distressed by anxiety or depressive
symptoms, even though they are not primary for the diagnosis.
Top
Prolactin elevation - An
increase in the levels of the hormone prolactin. Prolactin is
a hormone that is released from the pituitary gland into the
bloodstream. Its normal role is to start milk production and
stop menses in women who have just given birth. Some
antipsychotics cause the pituitary gland to release more prolactin,
which can cause prolactin elevations in some people. This
prolactin elevation can cause menstruation to stop or lead to milk
leakage in the breasts. Prolactin elevation is detected by a
blood test. It is not medically dangerous, and high prolactin
levels return to normal when the medication is stopped, or the
person switches to an antipsychotic medication that does not elevate
prolactin. See also amenorrhea, galactorrhea.
Top
Psychiatric diagnosis and antipsychotic therapy -
Antipsychotics work to control psychotic symptoms regardless of
cause. Improvement on antipsychotic medications does not tell
you the underlying cause of the psychosis. Antipsychotics are
most often used for patients who have a psychiatric diagnosis of
schizophrenia, schizoaffective disorder, or bipolar disorder.
Antipsychotics are also used in some kinds of depressive disorders,
especially when psychotic symptoms are present. In addition,
antipsychotics are often used to help control behavioral problems
that occur in dementia or developmental disabilities. See also
DSM-IV, mood disorders. Top
Psychological disorders
- Mental processes and/or behavior patterns that cause emotional
distress and/or substantial impairment in functioning.
Top
Quetiapine (Seroquel) -
One of the newer antipsychotics made by Zeneca. It comes in 25
mg, 100 mg, 200 mg, and 300 mg tablets (other dose strengths are
expected to be available soon). Top
Q.D. - Technical term meaning that a
medication that should be taken once a day. See also B.I.D.,
Q.I.D., T.I.D. Top
Q.I.D. - Technical term meaning that a
medication that should be taken four times a day. See also
B.I.D., Q.D., T.I.D. Top
Receptor - A protein lying on the
membrane layer of a nerve cell. Receptors are designed to
receive neurotransmitters. Each receptor receives a specific
neurotransmitter. Receptors are very sensitive to the
concentration of the specific neurotransmitter they receive, while
at the same time they ignore other neurotransmitters.
Medications often work by changing the sensitivity of a receptor to
its specific neurotransmitter. See also receptor profile.
Top
Receptor profile - A
particular pattern of receptor binding. Many of the
psychiatric medications have effects on more than one
neurotransmitter receptor. In fact, some antipsychotics bind
to (block) more than five neurotransmitters. No two
medications have the exact same pattern of receptor binding.
In fact, each medication has a unique "fingerprint" of specific
binding patterns. See also affinity, dopamine, serotonin.
Top
Refractory positive
symptoms - Positive symptoms that have not responded to a
number of different treatments. See also nonresponse to
medication, positive symptoms. Top
Rehabilitation - Just as
patients regain heart conditions regain functioning with cardiac
rehabilitation, patients recovering from psychosis often need
psychiatric rehabilitation to regain work and social functioning.
The newer atypical antipsychotics seem to help many patients enter
rehabilitation. Top
Residual symptoms - Any
symptoms that remain after the person has been stable on a
medication for a long period of time. Residual symptoms are
sometimes called baseline symptoms. Top
Rigidity - An increase in the general
tenseness of muscles that is not caused by anxiety or exercise.
This rigidity causes muscles to tire more easily and can also make
it more difficult to perform repetitive movements precisely.
Muscle rigidity can occur as part of the extrapyramidal side effects
(EPS) of certain antipsychotics. A reliable sign that muscle
rigidity is due to EPS is a decreased arm swing while walking.
Top
Risperidone (Risperdal)
- The second atypical antipsychotic introduced after clozapine.
It is made by Jannsen and comes in 1, 2, 3, and 4 mg pills, as well
as in liquid form. Top
Schizoaffective disorder
- A disorder in which the person has the symptoms of both a major
mood disorder, such as major depression or bipolar
(manic-depressive) illness and schizophrenia. Sometimes, the
person has the symptoms of schizophrenia when mood symptoms are not
present. The pharmacologic treatment of schizoaffective
disorder is usually very similar to that of schizophrenia--that is,
antipsychotics are the primary medication for schizoaffective
disorder. All the advantages of the atypical antipsychotics
are the same for patients who have a diagnosis of schizoaffective
disorder. Top
Schizophrenia - Schizophrenia
usually begins during adolescence or young adulthood. It is
rare for schizophrenia to begin "out of the blue" after age 30.
To make a diagnosis of schizophrenia, the person has to have had
positive (psychotic) symptoms (such as delusions or hallucinations)
