Table of Contents (hide)
This page is still being worked on.
Antipsychotics: They’re not just for Schizophrenia Anymore!
Like all crazy meds, antipsychotics (APs) are used for conditions other than what they are usually associated with. Or what they were originally developed for. Thorazine (chlorpromazine) was originally developed and used as an add-on to anesthesia: to calm people down prior to surgery, to keep them from puking, and to lower body temperature1. Even reserpine, the original antipsychotic, was developed in Europe as a blood pressure med a couple years ahead of Thorazine, and it was first synthesized in India almost 20 years prior to that and used as an antipsychotic. Oh, and the root of plant from which it was synthesized, Rauwolfia serpentina (AKA Indian Snake root) has been used in India since forever to treat mental illness. But who cares if crazies had to suffer an extra couple of decades until Whitey caught up2.
So, what are antipsychotics, or, to use the application-neutral monicker, neuroleptics these days…
Older first-generation meds like Thorazine (chlorpromazine) and Haldol (haloperidol) are used right along side the newer second-generation and third-generation neuroleptics to treat schizophrenia and related conditions. Invega (paliperidone) is currently the only med with official approval to treat schizoaffective disorder.
Just as most new antiepileptic drugs (AEDs) are being pushed to treat migraines and/or neuropathic pain, most new antipsychotics are being pushed as mood stabilizers, and for the same reason. Just as there is more money in treating pain than there is in treating epilepsy and bipolar disorder, there is more money in treating bipolar disorder than there is in treating schizophrenia.
Adding an antipsychotic to an antidepressant (AD) to boost the efficacy of the antidepressant has been around for about 30 years. Symbyax (olanzapine and fluoxetine) wasn’t the first combination of the two in one pill, Etrafon/Triavil is a combination of the tricyclic antidepressant Elavil (amitriptyline) and the standard antipsychotic Trilafon (perphenazine). Symbyax was just the first drug to hit the market with an approval for bipolar disorder and nothing else, even if it is a combination of two existing meds.
What’s different is the amount of research that’s been done on the AP & AD cocktail, for both bipolar and unipolar depression. And while there’s more money in depression than bipolar disorder, the AD market is over-saturated with meds that are mostly generic. Even the few that are still on-patent, like Cymbalta, are often being sold for applications unrelated to depression, such as neuropathic pain. So the drug companies have seized the opportunity by getting approvals for their expensive APs to be paired with anyone’s generic ADs, or still profitable on-patent meds like Lexapro. It’s a lot cheaper doing it that way than making one pill the way Lilly did with Symbyax. Plus it’s better for the consumer, as you can now mix and match Abilify and various ADs and have your insurance cover it, instead of being stuck with only Prozac and Zyprexa, which is all Symbyax is.
Additionally some APs, such as Seroquel, are approved to treat bipolar depression and not just bipolar mania, which is how most approvals for bipolar work.
Although second-generation APs are frequently prescribed for anxiety disorders, none is approved to treat them. Many of the first-generation APs have been approved to treat generalized anxiety disorder (GAD) or just non-specific “anxiety.” Several FGAs have been approved to treat tic disorders, mainly Tourette Syndrome. Many APs, old and new, are approved to treat “agitation,” which has usually meant, “Keeping grandma in her bed,” or “Make. that. damn. kid. shut. the. fuck. up. already!” (many FGAs carry an approval for “behavioral problems” as well). Fortunately they aren’t used for this nearly as often as they used to be.
Now considered a second- or third-line application, as this was the original purpose for some FGAs, they are still used to handle severe vomiting that doesn’t respond to the drugs that are usually used in hospitals for this, and are in the same or similar chemical class as the APs.
||Keep Crazymeds on the air.
Donate some spare electronic currency
you have floating around The Cloud
1 Ask an anesthesiologist, I have no idea why cooling you down makes their lives easier. For all I know phrases like "chill out" originated with anesthesiologists.
2 This is one of several specific reasons as to why I get really pissed off when people equate racism with mental illness. For some reason those in the so-called "liberal media" are especially fond of doing this. I'm looking at you NPR and Keith Olbermann.
Common Uses of Antipsychotic Drugs (APs) by Jerod Poore is copyright © 2010
Page created by: Jerod Poore. Date created: 12 July 2011 Last edited by: JerodPoore on 2016–04–18
Page design and explanatory material by Jerod Poore, copyright © 2003 - 2016. All rights reserved.
Keep up with Crazymeds and and/or my
slow descent into irreparable madness boring life. Pick your preferred social media target(s):
Follow me for site updates
and research & pharm news.
|Wear my Straitjacket||Batshit Crazy Blog|
Crazymeds | Promote Your Page Too||
Follow for site updates and
high weirdness to distract you.
|Crazymeds’ Tumblr||Crazymeds: The Blog|
Almost all of the material on this site is by Jerod Poore and is copyright © 2003, 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014, 2015, and 2016 Jerod Poore. Except, of course, the PI sheets - those are the property of the drug companies who developed the drugs the sheets are about - and any documents that are written by other people which may be posted to this site will remain the property of the original authors. You cannot reproduce this page or any other material on this site outside of the boundaries of fair use copying without the express permission of the copyright holder. That’s usually me, so just ask first. That means if want to print out a few pages to take to your doctor, therapist, counselor, support group, non-understanding family members or something like that - then that’s OK to just do. Go for it! Please. As long as you include this copyright notice and something along the lines of following disclaimer, I’m usually cool with it.
All rights reserved. No warranty is expressed or implied in this information. Consult one or more doctors and/or pharmacists before taking, or changing how you take any neurological and/or psychiatric medication. Your mileage may vary. What happened to us won’t necessarily happen to you. If you still have questions about a medication or condition that were not answered on any of the pages you read, please ask them on Crazy Talk: the Crazymeds Forum.
The information on Crazymeds pertains to and is intended for adults. While some information about children and adolescents is occasionally presented (e.g. US FDA approvals), pediatric-specific data such as dosages, side effects, off-label applications, etc. are rarely included in the articles on drugs or discussed on the forum. If you are looking for information regarding meds for children you’ll have to go somewhere else. Plus we are big pottymouths and talk about S-E-X a lot.
Know your sources!
Nobody on this site is a doctor, a therapist, or a pharmacist. We don’t portray them either here or on TV. Only doctors can diagnose and treat an illness. While it’s not as bad as it used to be, some doctors still get pissed off by patients who know too much about medications, so tread lightly when and where appropriate. Diagnosing yourself from a website is like defending yourself in court, you suddenly have a fool for a doctor. Don’t be a cyberchondriac, thinking you have every disease you see a website about, or that you’ll get every side effect from every medication1. Self-prescribing is as dangerous as buying meds from fraudulent online pharmacies that promise you medications without prescriptions.
All information on this site has been obtained from the medications’ product information / summary of product characteristic (PI/SPC) sheets and/or medication guides - which is all you get from sites like WebMD, RxList,
NAMBLA NAMI, etc., the sources that are referenced throughout the site, our personal experience and the experiences family, friends, and what people have reported on various reputable sites all over teh intergoogles. As such the information presented here is not intended as a substitute for real medical advice from your real doctor, just a compliment to it. You should never, ever, replace what a real doctor tells you with something from a website on the Internet. The farthest you should ever take it is getting a second opinion from another real doctor. Educate yourself - always read the PI/SPC sheet or medication guide/patient information leaflet (PIL) that comes with your medications and never ever throw them away. OK, you can throw away duplicate copies, but keep at least one, as that’s your proof of purchase of having taken a med in case a doctor doubts your medical history. Plus they take up less space than a bottle, although keeping one inside of a pill bottle is even better.
Crazymeds is not responsible for the content of sites we provide links to. We like them, or they’re paid advertisements, or they’re something else we think you should read to help you make an informed decision about a particular med. Sometimes they’re more than one of those things. But what’s on those sites is their business, not ours.
Crazymeds is optimized for ridiculously large screens and browsers that don’t block ads. I use Firefox and Chrome, running under Windows 72. On a computer that sits on top of my desk. With a 23 inch monitor. Hey, at least you can make the text larger or smaller by clicking on the + or - buttons in the upper right hand corner. If you have Java enabled. Like 99% of the websites on the planet, Crazymeds is hosted on domain running an open source operating system with a variety of open source applications, including the software used to display what you’ve been reading. As such Crazymeds is not responsible for whatever weird shit your browser does or does not do when you read this site3.
Crazymeds now uses a secure server, but it is not so secure that you can discuss anything having to do with nuclear power facilities, air traffic control systems, aircraft navigation systems, weapons control systems, or any other system requiring failsafe operation whose failure could lead to injury, death or environmental damage. Just so you know. So if you’re mentally interesting and have a job that deals with that sort of thing, talk about said job elsewhere. Otherwise feel free to discuss your meds and brain cooties.
No neurologists, psychiatrists, therapists or pharmacists were harmed in the production of this website. Use only as directed. Void where prohibited. Contains nuts. Certain restrictions may apply. All data are subject to availability. Not available on all mobile devices, in the 12 Galaxies Guiltied to a Zegnatronic Rocket Society, or in all dimensions of reality. Hail Xenu!
‘Everything is true, nothing is permitted.’ - Jerod Poore
1 While there are plenty of books to help you with hypochondria, for some reason there’s not much in the way of websites. Then again, staying off of the Internet is a large part of curing/managing the disorder.
2 Remember kids, Microsloth operating systems are like TOS Star Trek movies with in that every other one sucks way, way more. With TOS Star Trek movies you don’t want to bother watching the odd-numbered ones. With Microsloth OS you don’t want to buy and install the even-numbered ones. Anyone who remembers ME and Vista knows what I mean.
3 Have I mentioned how open source operating systems for commercial applications is one of the dumbest ideas in the history of dumb ideas?* I don’t even need my big-ass rant any more. Heartbleed has made my case for me. And that’s just the one that got all the media attention. The very nature of an open source operating system makes security as much of an illusion as anonymity on teh Intergoogles. Before you flip out too much: the domain Crazymeds is hosted on uses a version of SSL that is not affected by the Heartbleed bug. That’s one of the many reasons why I pay a lot of money and keep this site on Lunarpages.
* Yes, I know I’m using open source browsers. I also test the site using the now-defunct IE and Safari browsers. Their popularity - and superiority - killed IE and Safari, so that’s why I rely on the open source browsers. It’s like brand vs. generic meds. Sometimes the generic is better than the brand.
Author: Jerod Poore Date Modified: 2017–03–25 Date Published: 2011–07–12