[When and how prescribe antipsychotics?]

Rev Med Interne. 2017 May;38(5):328-336. doi: 10.1016/j.revmed.2016.12.007. Epub 2017 Feb 10.
[Article in French]

Abstract

Antipsychotics are commonly prescribed in the general population since they have many indications. They can be used in acute care such as agitation or behavior disorders, or to treat more characterized psychiatric disorders like psychotic or mood disorders. Consequently, any practitioner will have to prescribe or renew a prescription of antipsychotics. These treatments require a benefit/risk balance assessment taking into account the specific context of each patient. Indeed, antipsychotics have many side effects, mainly neurological (extrapyramidal syndrome, dyskinesia, akathisia), metabolic and cardiac. If these complications are poorly controlled, they could dramatically increase the morbidity and the mortality. Second-generation antipsychotics should be preferred to first-generation antipsychotics because of their better safety profile, especially in case of prolonged prescribing. Treatment monitoring, including effectiveness on the targeted symptoms, tolerance and observance, are major issues in the management of patients treated with antipsychotics.

Keywords: Antipsychotic; Antipsychotique; Effets indésirables; Indication; Monitoring; Neuroleptic; Neuroleptique; Prescription; Side effects; Surveillance.

MeSH terms

  • Adolescent
  • Adult
  • Antipsychotic Agents / adverse effects
  • Antipsychotic Agents / pharmacokinetics
  • Antipsychotic Agents / therapeutic use*
  • Child
  • Drug Monitoring / methods
  • Drug Monitoring / standards
  • France / epidemiology
  • Humans
  • Long-Term Care / standards
  • Practice Patterns, Physicians' / standards*
  • Practice Patterns, Physicians' / statistics & numerical data
  • Psychotic Disorders / drug therapy
  • Psychotic Disorders / epidemiology

Substances

  • Antipsychotic Agents