Most of the psychotic disorders are treated with the combination of medication and psychotherapy.
The main medications used in the treatment of psychotic disorders are the antipsychotics. These drugs do not cure the disorder but help to control the symptoms such as delusions, hallucinations and the exaggerated behavior. Generally speaking, the antipsychotics are divided into 2 categories depending on their pharmacological mechanism; the typical (aloperidol,thioridazine) which are the older but equally efficient and the atypical (risperidone, olanzapine, quetiapine, ziprasidone, aripiprazole) thought to cause less side effects and to be more efficient in improving symptoms such as avolition, social alienation, flattening of affect. The controversy is that the atypical ones are blamed to cause metabolic side effects (weight increase, diabetes, high cholesterol levels).
Typical antipsychotics help to control symptoms such as:
- Disorganised thought and speech
Moderate adverse effects can include:
- Dry mouth
- Blurred vision
More serious side effects are:
- Difficulty in controlling muscles with involuntary contractions
- Erectile dysfunction
But there are new medications, often called atypical or new generation antipsychotics, such as Risperidone (Risperdal), olanzapine (Zyprexa), quetiapine (Seroquel), Ziprasidone (Geodon), Clozapine (Leponex), Sertindol (Serdolect), Aripiprazole (Abilify), paliperidone (Invega). The later drugs are now used at the forefront of pharmacotherapy because they are considered to have fewer and more tolerable side effects. Plus, they target to symptoms such as:
- Social isolation
- Blunted affect
These medications can cause weight gain and raise the risk for diabetes and high cholesterol.
In psychotic disorders some types of psychotherapies can be used. The most common of them are the individual, the group and even the family therapy. The individual therapy has a supportive and counseling character and can be implemented with psychoeducation and cultivation of social skills. The majority of the psychotic patients are treated on outpatients basis. But patients with severe symptoms, those who are in danger of harming themselves or others, may need to be admitted in a clinic up until their state stabilize.