There are many types of psychotic disorders, including schizophrenia, which affect the day-to-day lives of many people.
In this lesson, we’ll look at the treatments commonly used for psychotic disorders, including the difference in types of antipsychotic drugs.
Imagine that you are enjoying a sunny day in the park. You sit on a bench and enjoy the sunshine and the trees and flowers. Other people play with their dogs, take a walk or play Frisbee with their friends. It’s a typical, enjoyable afternoon. Suddenly, a man begins to yell crazy things. He’s not making much sense, because his speech is garbled, but you can kind of tell that he seems to be talking to someone who is not there.
He says something about aliens listening in on his thoughts. You’d probably think he was crazy.Between 1% and 3% of people suffer from a psychotic disorder, or a mental illness that involves a break from reality.
Often, this break involves hallucinations, or seeing and hearing things that aren’t there, and delusions, or believing something even with lots of evidence that it’s not true. There are many types of psychotic disorders, including schizophrenia, schizoaffective disorder, delusional disorder and brief psychotic disorder, among others. In addition, bipolar disorder, a mood disorder, sometimes comes with psychotic symptoms.
For centuries, not much could be done for people suffering from a psychotic disorder. They were often thrown into mental institutions and spent their entire lives there. Some of the conditions of the institutions were horrible: Patients would be chained up and sometimes even abused by the staff.But for most of history, there wasn’t really an alternative. After all, most people with psychotic disorders weren’t able to live and work in society without harming themselves or others. And there weren’t any treatments that made it possible for them to be rid of the psychoses that haunted them.All that changed in 1954, when the first antipsychotic drug was introduced on the market.
Antipsychotic drugs reduce the worst of the symptoms of psychosis, like hallucinations and delusions. They make it possible for people to function normally in society, and made it possible for many psychotic patients to be released from mental institutions.Many psychotic disorders, including schizophrenia, include an active phase and a recovery, or residual phase.
During the residual phase of the disorder, the symptoms are greatly reduced. A patient on antipsychotic medication, likewise, takes a lower dosage of antipsychotics during the residual phase, and a higher dosage during the active phase.How do antipsychotics work? Well, there’s a chemical in the brain called dopamine, which sends messages from one brain cell to the next. The message moves from cell to cell, and therefore, from one end of the brain to another. Think of dopamine kind of like telephone wires, sending communications from one part of the brain to the other. Psychotic symptoms are a result of too much dopamine activity in the brain. Antipsychotic drugs work to slow dopamine down, making it harder for it to send communications around the brain.
There are some issues with antipsychotics, though. They have very serious side effects, which cause some people to stop taking the drugs. Side effects include tremors and difficulty moving, intense dreams or nightmares and even seizures. Furthermore, studies have shown that antipsychotics can actually cause people to lose brain tissue. So even though antipsychotics help people live in society instead of being locked up in mental institutions, there are serious drawbacks.
After the first wave of antipsychotic drugs was put on the market in the 1950s and 1960s, a new type of antipsychotic was developed in the 1980s and 1990s. This second generation of antipsychotic drugs is called atypical antipsychotics.
Like the first generation antipsychotics, atypical antipsychotics reduce psychotic symptoms by working on dopamine levels in the brain. However, atypical antipsychotics also work on another chemical in the brain, serotonin.One advantage of atypical antipsychotics is that the side effects are not as bad. Seizures and movement disorders are more rare, though tremors and loss of brain tissue are still problematic side effects of the drugs. In addition, atypical antipsychotics are still relatively new, and there isn’t enough data to see what long-term side effects might be a result of taking atypical antipsychotics.
Drugs alone are not a great option for people who suffer from psychotic disorders.
For one thing, many of the patients do not believe that they have a problem, and therefore, don’t stick to their treatment. They might stop taking drugs, and then end up with psychotic symptoms again.Combining drugs and therapy has had a better chance of working, because the therapist can monitor the patient’s progress and make sure that he is sticking to the treatment plan. Therapy can also help psychotic patients deal with depression and figure out how to function better in society.In severe situations, hospitalization might be needed for a period of time. In the past, treatments have involved electroconvulsive therapy, sometimes called electroshock therapy, which involves sending electrical shocks to the brain. Another treatment common in the past was lobotomy, or surgically removing part of the brain.
Both of these treatments are very rare today.
Psychotic disorders are mental illnesses that involve a break from reality. They are usually treated with a combination of drugs and therapy. There are two types of drugs used: traditional antipsychotics and atypical antipsychotics.
Both work by changing the chemistry of the brain, and both have severe side effects.
After viewing this video, students should be able to:
- Understand how psychotic disorders are treated
- Define antipsychotic drugs and atypical antipsychotic drugs and compare their side effects
- Recall severe treatments of the past that are rarely used today