Medication, alcohol and drugs
The purpose of this chapter:
Reduce the risk of psychosis by:
The previous chapter discussed several pieces of advice, including the use of antipsychotic medication and the avoidance of alcohol and drugs. In this chapter, we will discuss the advantages and disadvantages of this advice.
Antipsychotic medication
Antipsychotic medication is used to reduce the symptoms of psychosis. This medication can be helpful in relieving hallucinations, delusions and disorganized thinking. However, antipsychotic medication can also have side effects, such as fatigue, weight gain and movement disorders.
Alcohol and drugs
Alcohol and drugs can worsen the symptoms of psychosis. Alcohol and drugs can also increase the risk of psychosis. Therefore, it is important to avoid alcohol and drugs if you have experienced psychosis.
Careful consideration
Taking antipsychotic medications and avoiding alcohol and drugs are two important pieces of advice for reducing the risk of psychosis. It is important to discuss this advice with your doctor to decide which advice is best for you.
Some questions to think about:
Medications to reduce psychotic experiences have been available since 1952, and many different types of antipsychotic medications have entered the market since then. The purpose of antipsychotic medications is to eliminate or reduce psychotic experiences and prevent relapse. Their effects are explained below. Antipsychotic medication affects the chemical processes of neurotransmitters in nerve pathways and between brain cells. The main "entry points" of these neurotransmitters, dopamine and serotonin, are affected to regulate information transfer in the brain.
These drugs usually do not have an immediate effect, but the action often begins within a few days. It usually takes several weeks before it can be assessed whether psychotic experiences diminish or disappear.
Examples of antipsychotic medications include Leponex, Risperdal, Zyprexa, Haldol, Seroquel, Fluanxol, Cisordinol, Trilafon and Abilify.
The choice of antipsychotic medication type and dosage depends on the individual response to medication. Unfortunately, it is not possible to predict in advance which drug will work best for a particular person. Sometimes it is necessary to experiment with multiple types of medication to find the drug that best suits the person in question.
Unfortunately, no antipsychotic medication exists without potential side effects. It is important to carefully discuss the effects of antipsychotic medication with a physician. Read the package insert and have any ambiguities clarified by a physician. Side effects play a major role when considering whether or not to stop taking antipsychotic medication.
Discuss any side effects well! Measures can be taken to reduce them.
People experiencing psychosis for the first time are generally advised to take antipsychotic medication for at least a year. After that year, it is advisable to consult with the treating psychiatrist about continuing or stopping use. This is because the risk of relapse remains high because the susceptibility to relapse remains present. Of course the triggering factors also play a role, if any were present. The relapse rate after 1 year is 72%, and after two years it is 90%. If you are considering stopping earlier, discuss this with your doctor.
It's important to emphasize that the decision to start or continue taking antipsychotic medication should always be made in consultation with a licensed medical professional. While these medications can be effective in managing negative symptoms of psychosis, they come with potential side effects that can range from mild to severe.
The brain plays a crucial role in processing stimuli from both the external and internal worlds. This processing occurs through electrical currents and chemicals called neurotransmitters. The stimulus transmission takes place in the neural pathways, which consist of interconnected nerve cells.
Within a nerve cell, stimulus transmission occurs electrically, but between the end of one nerve cell and the beginning of the next nerve cell, stimulus transmission occurs chemically. At the end of a nerve cell are neurotransmitters. Examples of these "information carriers" are dopamine, serotonin, histamine and norepinephrine. These substances come into action when there is an electrical signal. When there is an electrical stimulus, they are delivered to the end of the nerve cell and stimulate receptors on the other end, resulting in a new electrical stimulus in the nerve cell.
During the transmission from one nerve cell to another, something can go wrong. Antipsychotic medications act on these receptors.
During psychosis, certain systems, particularly the dopamine system, are overactive and out of balance. The use of antipsychotic medication improves stimulus transmission and restores the old balance. Information can be better transmitted.
The result is better stimulus transmission, more calmness, fewer or no delusions and less or no suffering from the psychosis.
Side effects are unintended and unwanted effects that can occur when taking medication, but they are not necessary and can vary from person to person. In most cases, side effects disappear after about a week. What is an acceptable side effect for one person, such as the disappearance of hallucinations, may be intolerable and unacceptable for another.
It is always advisable to discuss side effects with the psychiatrist or practitioner. The doctor may lower the dosage, adjust the medication or prescribe a drug to reduce the side effects. Often the side effects will then decrease or disappear. It is important to be open about any side effects so the practitioner can take appropriate steps to adjust the treatment plan and ensure the patient's well-being.
It's also crucial for individuals and their loved ones to educate themselves about the risks and benefits of antipsychotic medication, as well as alternative treatment options such as therapy and support groups. By working collaboratively with a healthcare team, people experiencing psychosis can develop personalized treatment plans that address their unique needs and goals for recovery.
Sometimes the prescription of additional anxiety-reducing medication may be necessary when using antipsychotic medications. Medications such as diazepam and lorazepam are often used to reduce the anxiety that can occur during psychotic experiences. Their purpose is to help calm the patient and reduce anxiety symptoms.
However, it is important to note that these medications can be potentially addictive. Therefore, in most cases, the use of these medications is only prescribed for a short period of time. The goal is to relieve acute anxiety and help stabilize the patient during antipsychotic treatment.
The treating physician will carefully weigh the dosage and duration of use of anxiety-reducing medication, taking into account the patient's individual needs and risks. It is essential to follow prescribed guidelines and discuss any concerns or side effects with the physician.
Combining antipsychotic medication with antianxiety medications can be an effective approach to treat both psychotic symptoms and associated anxiety symptoms. The goal is always to provide the patient with the best possible support during the recovery process and to stabilize the psychosis.
Before, during and after psychosis, mood can change significantly. This is often accompanied by feelings of gloom. In some cases, the gloominess may be so severe and persistent that temporary use of an antidepressant may help. In addition, certain antidepressants are also prescribed as an aid against compulsive actions and obsessive thoughts that you cannot let go of. Some examples of antidepressants include Sertraline (brand name Seroxat), Fluoxetine (Prozac), Clomipramine (Anafranil), Venlafaxine (Efexor) and Citalopram (Cipramil).
Psychosis may also be accompanied by intense mood swings, with periods of extreme excitement and bliss alternating with periods of profound gloom. To make these manic and depressive episodes less intense, medication such as lithium, carbamazepine (Tegretol), valproic acid (Depakine) or lamotrigine (Lamictal) may sometimes be prescribed. These drugs help stabilize mood and reduce extremes.
It is important to note that medications that affect mood can also cause side effects. Some examples of side effects include nausea, shaky hands and dry mouth. It is always advisable to discuss any side effects with the prescribing physician, as dosage adjustments, a change of medication or additional medication can reduce or control the side effects.
The use of alcohol and drugs can have several negative effects:
People who are under the influence of alcohol often cannot properly assess what they can and cannot do. Although they feel better, this may be the very reason they use alcohol: to feel better. The same goes for using drugs. People use drugs to feel better, making it seem like they are better able to deal with problems in life.
The effects of alcohol and drugs vary depending on the amount and type of substance used. In addition, the mood a person is in, the social environment present and location also play a role in the effects of alcohol and drug use.
Next to alcohol, cannabis is the most commonly used substance. Research has shown that long-term cannabis use, especially if a person starts at a young age, increases the risk of developing psychosis. In addition, it is known that recovery from psychosis can be slower and less successful if a person continues to use cannabis.
Some people are particularly sensitive to the psychoactive effects of cannabis and can easily become psychotic again by blowing. However, this is not true for everyone and depends on individual vulnerability. Even if cannabis use does not cause psychosis, it is still not recommended. Although it can have a calming effect that makes a person feel good, it also has negative effects on concentration and can lead to passivity and lack of initiative.
In addition, the use of other drugs such as amphetamine (speed) and cocaine also carries significant risks. It can easily lead to a recurrence of psychotic symptoms and, in addition, one can become seriously addicted to these drugs.
Vulnerability to psychosis and the use of drugs and alcohol do not go well together. Among many people who have experienced psychosis, cannabis use plays a role. Unfortunately, many of them continue to blow, which is unfortunate because it can delay their recovery and pick up their lives. Fortunately, most people stop cannabis use when they find that the disadvantages outweigh the benefits.
For example, returning to school or work can be difficult if one continues to blow. Some are able to use so little that it does not adversely affect their lives. However, it is important to discuss the role that drugs and alcohol play in your life with your treatment provider. If you want to quit but can't manage on your own, you can get help.
Discussing your drug and alcohol use with a treatment provider is essential because they can support you in addressing these issues. They can help you set goals and develop strategies to stop or reduce your use. In addition, they can refer you to specialized counseling programs or support groups focused on dealing with addiction.
It is important to remember that quitting drug and alcohol use is a process that takes time and commitment. It can be difficult, but with the right help and support, you can move toward recovery and live a healthier, more balanced life.
It's important for individuals to be honest with their treatment providers about their substance use, as it can greatly impact their mental health and recovery. There are resources available to help people quit or reduce their use, and seeking support can make a significant difference in their overall well-being.
Alcohol and drugs can have different effects related to the treatment of psychosis:
The use of alcohol and drugs can worsen the side effects of antipsychotic medication. This is because both alcohol and drugs can affect the central nervous system and disrupt the chemical balance in the brain. This can worsen side effects such as drowsiness, dizziness, decreased concentration and motor problems, which can interfere with overall treatment.
The use of alcohol and drugs can nullify or diminish the effects of antipsychotic medication. These substances can disrupt the neurotransmitter balance in the brain, which can interfere with the intended effects of the medication. As a result, treatment may be less effective in reducing psychotic symptoms and stabilizing mood.
A major risk of alcohol and drug use in people who have experienced psychosis is the elicitation of relapse. Alcohol and drugs can increase susceptibility to psychotic symptoms and increase the likelihood of developing new psychotic episodes. This can lead to a worsening of symptoms such as hallucinations, delusions and confusion, and can compromise stability and the recovery process
In addition to the specific interactions with medication and the treatment of psychosis, it is important to note that both alcohol and drugs can affect driving ability. Medication can also affect driving ability, and when alcohol or drugs are added, it can have an amplifying effect. This can lead to increased confusion, anxiety, decreased reaction times and problems with motor skills, which can compromise road safety.
It is crucial for people who have experienced psychosis to be aware of these risks and to avoid or severely limit alcohol and drug use. Discussing these issues with a practitioner or psychiatrist is very important, as they can provide appropriate advice and support to reduce the risk of relapse and promote a successful recovery process.