“Antipsychotics may contribute to dementia via modulation and degeneration of the mesocortical dopaminergic circuit, the same circuit underlying cognitive decline in dementia and Parkinson's disease,” they write.
Psychosocial side effects
You may experience agitation or episodes of high anxiety. Mental fog. You might have a hard time thinking clearly or focusing on a task. You might also have difficulty recalling information.
It's common to experience these side-effects while taking antipsychotics: Stiffness and shakiness. Feeling sluggish and slow in your thinking.
Antipsychotic medications work by altering brain chemistry to help reduce psychotic symptoms like hallucinations, delusions and disordered thinking. They can also help prevent those symptoms from returning.
Sedation, or sleepiness, is a common side effect of many antipsychotics. It is more common with certain antipsychotics than others, such as chlorpromazine and olanzapine. Sedation can happen during the day as well as at night.
The use of antipsychotics might be considered counterintuitive, since all of these drugs are known to cause confusion or delirium as an adverse effect.
Thus, early exposure to antipsychotic drugs may permanently alter neuronal development with a lasting impact on behavior.
“I was particularly interested in how antipsychotics affect people's sense of themselves because although antipsychotics can reduce symptoms of psychosis, they also dampen down emotions, motivation, and sexual function, which are such important parts of what makes us what we are.”
When people who are prescribed antipsychotics for psychotic disorders stop taking them, some relapse, meaning that their psychosis returns. However, some patients are able to sustain a psychosis-free existence after the cessation of antipsychotics.
So while treatment with some antipsychotics seems to increase intelligence, others reduce symptoms without that effect. Other medications that are known to cause improved cognitive functioning had no effect when combined with those antipsychotics.
Antipsychotic drugs are harmful if you do not need them. For someone with dementia, antipsychotic drugs can make everyday activities more difficult. They also have dangerous side effects such as more anxiety, restlessness, loss of hunger or thirst, excessive sleeping and even death.
Seroquel use may also be directly implicated in memory issues for some patients. This likely has to do with the mechanism by which it works to affect dopamine regulation. The rewarding, accomplished feeling dopamine produces is believed to be central to learning and memorization.
We know that antipsychotics shrink the brain in a dose-dependent manner (4) and benzodiazepines, antidepressants and ADHD drugs also seem to cause permanent brain damage (5).
Agitation and sedation: Some people feel “wired” and unable to stop moving when taking antipsychotics. This effect may be mistaken for a worsening of illness rather than a side-effect of the medication. These same drugs can also have the opposite effect, making people feel tired.
Causes of Apathy
Excessive doses of antipsychotics can contribute to apathy.
Boredom relates to the experience of meaning, which itself encompasses relationships, roles and a sense of control. Furthermore, medication, particularly antipsychotics that block dopamine (which is important for experiencing motivation, pleasure and reward), may contribute to it.
People who have psychotic episodes are often totally unaware their behaviour is in any way strange or that their delusions or hallucinations are not real. They may recognise delusional or bizarre behaviour in others, but lack the self-awareness to recognise it in themselves.
“Antipsychotics may contribute to dementia via modulation and degeneration of the mesocortical dopaminergic circuit, the same circuit underlying cognitive decline in dementia and Parkinson's disease,” they write.
Some people need to keep taking it long term. If you have only had one psychotic episode and you have recovered well, you would normally need to continue treatment for 1–2 years after recovery. If you have another psychotic episode, you may need to take antipsychotic medication for longer, up to 5 years.
While not a certainty, long‐term antipsychotic treatment is a very common outcome for people with schizophrenia.
Clozapine and olanzapine have the safest therapeutic effect, while the side effect of neutropenia must be controlled by 3 weekly blood controls. If schizophrenia has remitted and if patients show a good compliance, the adverse effects can be controlled.
Possible negative effects of antipsychotics include: drowsiness or confusion. shaking, unsteadiness and reduced mobility. worse than usual dementia symptoms, such as problems with thinking and memory.
You may not feel better straight away. Everyone responds to antipsychotics differently. It can take several days or weeks to reduce symptoms such as hallucinations or delusional thoughts. The effects of antipsychotics can take several weeks or months to work.