Medical Treatment

In acutely psychotic episodes where someone is obviously a danger to himself or herself and others, antipsychotic medications and sedation are the treatments of choice. Restraints in the Emergency Department may be necessary during the time it takes medications to take effect. Hospitalization is a must.

• Examples of antipsychotic drugs used in the emergency setting include haloperidol (Haldol), or less likely chlorpromazine (Thorazine), which is an old medication not often prescribed because it has too many side effects when used over time. These two drugs may also be used as outpatient medications outside of an acute attack.

• Long-term treatment with antipsychotics or neuroleptics often requires medications such as fluphenazine (Prolixin), thiothixene (Navane), trifluoperazine (Stelazine), perphenazine (Trilafon), and thioridazine (Mellaril). Newer antipsychotic drugs with much fewer side effects have appeared and include clozapine (Clozaril), olanzapine (Zyprexa), risperidone (Risperdal), quetiapine fumarate (Seroquel), ziprasidone (Zeldox), and aripiprazole (Abilify).

• Most of these medications take between 2-4 weeks to take effect. Patience from a standpoint of changing dosage, medication, or adding medications is required.