Harms versus benefits of antipsychotics in the prevention of delirium.

Relationship between Delirium and Dementia

It is essential to differentiate between dementia and delirium before prescribing antipsychotics as they are separate disorders, but sometimes they seem similar. Cognition is present in both, but the following helps in distinguishing them.

Delirium mainly affects attention and occurs due to acute illness or toxicity after using a particular drug that sometimes becomes life-threatening but often is reversible.

Dementia occurs because of the anatomic changes affecting the brain and mainly affects memory after a slower onset. It is irreversible.

What Are Antipsychotics

These are a group of medicine that physicians prescribe for treating mental health illnesses including those that occur due to a bipolar disorder such as mania that causes persons suffering from it to feel that they are in a state of elation or high. They also help to treat severe anxiety and depression. Antipsychotics are at times known as major tranquillizers. Antipsychotics are sold in form of capsules, tablets, depot injections (long-acting) and liquids. Pharmacists stock antipsychotics in various brand names. Antipsychotics are in two main types:

Older antipsychotics: these are the well-established types also known as the first generation. They have been in use since the 1950s and until now, they are still in the market. The brands fitting to the older antipsychotics include:

Atypical or newer antipsychotics- these are the types of antipsychotic that manufacturers developed in the recent years compared to older forms. Although they are more modern, their shelf life is long since developers began manufacturing them in the 1970s. The purpose of developing them was to create products with fewer effects than the older type. However, they still have a few side effects. Some call them second-generation antipsychotics and they include these brands:

The choice of antipsychotic that a physician prescribes depend on the severity of the symptoms that require treatment and if the person has other health issues. Antipsychotic medicine has some differences. For instance, some have more sedating capabilities and might be better for individuals in dire need of relaxation. A specialist usually offers advice on the best type to take use for every case. It is difficult to tell the antipsychotics that will work in a manner that favors a person without the advice of a doctor. It helps to try another type if the first that a patient uses does not work well.

There is a general observation that both older and newer antipsychotics work similarly. Some brands like clozapine are exceptional in producing better results than others. Unfortunate their strength can trigger various possible side effects, especially on the blood cells. It means that people who are taking this prescription require regular blood tests.

In some cases, doctors can decide to use an injection of long-acting medicine (depot injection) after easing of the symptoms. The drug in depot injection releases slowly into the body. A patient should get it every 2-4 weeks. The injections help to prevent recurrence of symptoms and they are an advantage to the patients because they do have to memorize taking of tablets every day.

Benefits of Antipsychotics in Prevention of Delirium

Some people have reservations about the use of antipsychotics, but they benefit patients with delirium by doing the following;

1. Altering the effect of certain body chemicals

Antipsychotics change the functioning of certain substances that cause reactions that cause disorientation. They alter the effect of particular chemicals in the brain called serotonin, dopamine, acetylcholine and noradrenaline. These are the chemicals that cause an effect that changes the mood, emotions and behavior. Dopamine is the primary chemical that antipsychotics direct their force. An alteration of the effects by these chemicals in the brain helps to prevent or suppress the following from occurring:

Antipsychotic medications are a short-term treatment for bipolar disorders to help also help in controlling mania symptoms alongside delusions and hallucinations. These are the symptoms that occur during a severe depression or acute mania. Some even help in the treatment of bipolar depression and some of them have demonstrated their long-term ability to prevent future episodes or depression or mania that occurs due to bipolar disorder. General practitioners usually refrain from prescribing antipsychotics before consulting a psychiatry specialist.

2.Creates a Calming effect

Antipsychotics are off-label sedatives for the patients with bipolar disorders to manage insomnia, agitation or anxiety. Doctors prescribe them to stabilize the mood and decrease symptoms of mania until the full effect of mood stabilizers. Some antipsychotics can help to stabilize the moods, and as a result, patients can solely rely on them for long-term treatment if they so do not respond to or tolerate to anticonvulsants and lithium.