Academic literature on the topic 'Psychosis-like effects'

Many mental health professionals view medicines to be of utmost importance in the treatment of psychosis. The main types of medicines used to treat psychosis are antipsychotics, which are most effective for what are referred to as “positive symptoms” like hallucinations and delusions. Antipsychotics work by binding to dopamine (and, in some cases, serotonin) receptors in the brain, which affects the ways certain neurons communicate with one another. The length of time the medicine should be taken is based on the types of symptoms one experiences and how long the symptoms last. Sometimes antipsychotics cause side effects. It is important to discuss possible side effects from specific medicines with the psychiatrist, so that the person with psychosis and their families know which side effects to expect and how to handle them if they happen. Doctors usually try to find the lowest effective dose in order to minimize side effects, while still being effective in treating symptoms.

Psychotic symptoms are more common in older people than in any other age. The most frequent psychotic disorders in older people are juvenile-onset schizophrenia in ageing patients, psychosis in Alzheimer’s disease, and the late- and very late-onset schizophrenia-like psychosis. Drug treatment of all types of psychosis is essential and often achieves similar levels of efficacy than in younger adults. The treatment of choice for any psychotic condition is atypical antipsychotics. Rather than being based on specific diagnosis, the choice of drug must be highly personalized, depending on the efficacy for the particular patient, drug’s profile of adverse effects, medical comorbidities, and concomitant medications. Attention should be paid to the emergence of adverse effects that are in general more frequently found with conventional than with atypical antipsychotics. Clinical and psychological management includes the need to establish a therapeutic alliance with the patient and ensure adherence to treatment in the long term.

Mental health professionals treat nearly all psychiatric illnesses using two types of treatments: medicines and psychosocial treatments. This is true for psychosis as well. We describe medicines used to treat psychosis in this chapter and psychosocial treatments for psychosis in Chapter 7. Medicines are a crucial part of the treatment plan for people who experience a first episode of psychosis. In fact, many mental health professionals view medicines to be the most important aspect of the treatment of psychosis. This is because psychosocial treatments are usually more effective when medicines help to adequately control symptoms. We discuss a number of medicines in this chapter. When a specific medicine is mentioned, two names are given. The first is the generic name and the second (in parentheses) is the trade name in the United States. For example, Tylenol is the trade name of the generic pain medicine called acetaminophen. Anyone taking medicine should be familiar with both the generic and trade names of the medicine, even though the generic names are sometimes more difficult to spell or pronounce. This chapter begins with an overview of the class of medicines used to treat psychosis, called antipsychotic medicines, or just “antipsychotics.” Before explaining antipsychotics in further detail, we set the stage by defining how antipsychotics work and some side effects and other serious problems called adverse events that may occur when taking antipsychotics. We then describe in more detail the two main types of medicines used to treat psychosis, the so-called “conventional” antipsychotics, and the “atypical” antipsychotics. Some mental health professionals refer to these as “first-generation” and “second-generation” antipsychotics, respectively. Then, we discuss the sometimes difficult task of finding the right medicine. We end by addressing two commonly asked questions about antipsychotic medicines: “Why is it important to take the medicine?” and “How long should the medicine be taken?” As mentioned earlier, the main types of medicines used to treat psychosis are the antipsychotics. These medicines are “antipsychotics” because they fight against (“anti-”) psychotic symptoms. As discussed in Chapter 1 (What Is Psychosis?) and Chapter 2 (What Are the Symptoms of Psychosis?), psychosis is a state of not being well-grounded in reality, due to symptoms like hallucinations or delusions.

There are about 400,000 species of plants in this world. Only a small fraction, perhaps 100 in number, contain hallucinogenic chemicals. Nearly a century ago, Lewis Lewin, professor of pharmacology at the University of Berlin, in speaking of drugs he called phantasticants, said “The passionate desire which . . . leads man to flee from the monotony of daily life . . . has made him discover strange substances (which) have been integral to human evolution both societal and cultural for thousands of years.” An unusual problem presents itself to me in writing about these drugs: They straddle the worlds of science and mysticism. The Encyclopedia Britannica defines mysticism as the practice of religious ecstasies (religious experiences during alternate states of consciousness), together with whatever ideologies, ethics, rites, myths, legends, and magic may be related to them. Science I am comfortable with; mysticism not so much. Yet in our exploration of the agents found in this chapter, we will encounter many persons speaking of drug-induced mystical experiences. I have attempted to get around my unease by first providing the history and the pharmacology of these agents and then touching only lightly on mysticism, allowing readers to draw their own conclusions. What shall we call these chemicals? Hallucinogen, a substance that induces perception of objects with no reality, is the term most commonly encountered and the one that I have settled on for the title of this chapter. However, it comes with a caveat. Albert Hofmann, the discoverer of LSD, our prototypic hallucinogen, has pointed out that a true hallucination has the force of reality, but the effects of LSD only rarely include this feature. Two additional terms that we will find useful are psychotomimetic and psychedelic. We have already considered the former, an ability to mimic psychosis, in our discussion of amphetamine-induced paranoid psychosis in chapter 4 and the effects of phencyclidine in chapter 6. A psychedelic was defined in 1957 by Humphrey Osmond, inventor of the word, as a drug like LSD “which enriches the mind and enlarges the vision.”