Antipsychotics: Proceed with Caution


Dr. Richard A. Friedman, professor of psychiatry at Weill Cornell Medical College in Manhattan, recently wrote an article published in the New York Times entitled A Call for Caution on Antipsychotic Drugs.

Dr. Friedman explains that antipsychotics are used to treat such serious psychiatric disorders as schizophrenia, bipolar disorder and severe major depression because of the mood-stabilizing effects. But the rates of these disorders have been stable in the adult population for years, and antipsychotics have been around for a long time (starting in the 1950’s). So why did these and other antipsychotics get to be so popular?

Starting in 1993, newer, more powerful antipsychotics were introduced that generally had fewer neurological side effects than the first-generation drugs. Therefore, doctors were prescribing them more, and for conditions other than serious psychiatric disorders.

Atypical antipsychotics prescribed for other disorders

In the article, Dr. Friedman discusses the 3.1 million Americans prescribed antipsychotics each year. The number of annual prescriptions for atypical antipsychotics rose 93 percent over the past 10 years, according to IMS Health. One reason for this is that the drug is being prescribed to more than just those individuals suffering from bipolar and schizophrenia disorders. Examples include prescribing antipsychotics to those with depression, and more recently, anxiety. Few of these patients, unfortunately, were not educated about the potential long-term risks of taking these drugs.

Potential side effects of antipsychotics

Examples of the side effects include a risk of increased blood sugar, elevated lipids and cholesterol, and weight gain. They can also cause a movement disorder called tardive dyskinesia, though the risk of this is thought to be significantly lower.

Are atypical antipsychotics effective?

Presently there is little evidence that atypical antipsychotic drugs are effective outside of a small number of serious psychiatric disorders, namely schizophrenia, bipolar disorder and treatment-resistant depression.

Dr. Friedman writes,

“Atypical antipsychotics can be lifesaving for people who have schizophrenia, bipolar disorder or severe depression. But patients should think twice — and then some — before using these drugs to deal with the low-grade unhappiness, anxiety and insomnia that comes with modern life.”


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