Okay, folks, let’s talk about antipsychotic meds. Remember, I’m a psychologist and not a psychiatrist. However, many of my clients over the years have taken these medications, so I think I have more than a passing knowledge of them.

Antipsychotic medications are primarily used to treat psychotic disorders. Makes sense, eh? Specifically, these medications help with the hallucinations and delusions experienced during many psychoses. I have sent patients to psychiatrists when it’s clear they’re suffering from a psychotic disorder. There are two basic types: the older “typical” antipsychotics and the newer “atypical” antipsychotics. The typical antipsychotic include Chlorpromazine (Thorazine) and Haloperidol (Haldol). The “atypicals” include:Risperidone (Risperdal), Olanzapine (Zyprexa), Quetiapine (Seroquel),Ziprasidone (Geodon), Aripiprazole (Abilify), Paliperidone (Invega), and Lurasidone (Latuda).

In recent years (say the past 10 or so), I’ve seen antipsychotics also being used as sleep aids and to help when patients are highly agitated. I’m not sure I really agree with this, particularly because of all the side effects. But I have seen it. BTW, the use of antipsychotics for agitation has been something I’ve seen in hospitals and is usually administered by injection (at least in my experience).

The side effects are numerous and can be very serious. Here’s what the NIMH (National Institute of Mental Health) has to say:

Most side effects go away after a few days and often can be managed successfully. People who are taking antipsychotics should not drive until they adjust to their new medication. Side effects of many antipsychotics include:

• Drowsiness
• Dizziness when changing positions
• Blurred vision
• Rapid heartbeat
• Sensitivity to the sun
• Skin rashes
• Menstrual problems for women.

Atypical antipsychotic medications can cause major weight gain and changes in a person’s metabolism. This may increase a person’s risk of getting diabetes and high cholesterol.

In addition they note:

Typical antipsychotic medications can cause side effects related to physical movement, such as:

• Rigidity
• Persistent muscle spasms
• Tremors
• Restlessness.

Long-term use of typical antipsychotic medications may lead to a condition called tardive dyskinesia (TD). TD causes muscle movements a person can’t control. The movements commonly happen around the mouth. TD can range from mild to severe, and in some people the problem cannot be cured. Sometimes people with TD recover partially or fully after they stop taking the medication.

These other side effects are not as common with the atypicals.

The next question is whether or not a person on any of these medications should be flying. Unequivocally I can say: NO! No matter what the reason for the use of the meds. My opinion. I don’t think a person on antipsychotics should be using heavy machinery either. Should they drive a car? Not at first, not until they know how it’s going to affect them. I can tell you, though, that most of those clients of mine in the past who were on antipsychotics *did* drive. To the best of my knowledge, psychiatrists are not required to contact the Department of Motor Vehicles (DMV) when they prescribe antipsychotics. They probably don’t contact the FAA either if the patient happens to be a pilot. Is this a loophole that should be plugged? I don’t know.

For you writers: consider having a character who is taking Seroquel for sleep (i.e. she’s not psychotic) and struggling with the side effects of that medication. A number of the soldiers I’ve worked with had been prescribed this med for sleep and they had a horrible time showing up on time for formation at zero-dark-thirty. So, now they were getting in trouble for that!