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Some people use counselling, such as cognitive-behavioural therapy, to treat panic disorder. It can help you to:

• Deal with problems you are having right now.
• Learn how to deal with future anxiety and panic attacks.

Other treatments include support groups and exercises that help you relax, such as progressive muscle relaxation or meditation.

WHY MIGHT YOUR DOCTOR RECOMMEND TAKING MEDICINE:

Your doctor might advise you to take medicines if:

• You have not been able to control your symptoms with other treatment, such as counselling with cognitive-behavioural therapy.
• You have other problems linked to panic disorder that could benefit from medicine, such asdepression or problems with drugs or alcohol.

Mental Health Assessment

Test Overview

A mental health assessment gives your doctor an overall picture of how well you feel emotionally and how well you are able to think, reason, and remember (cognitive functioning). Your doctor will ask you questions and examine you. You might answer some of the doctor’s questions in writing. Your doctor will pay attention to how you look and your mood, behaviour, thinking, reasoning, memory, and ability to express yourself. Your doctor will also ask questions about how you get along with other people, including your family and friends. Sometimes the assessment includes lab tests, such as blood or urine tests.
A mental health assessment may be done by your family doctor or general practitioner, or by a psychiatrist, psychologist, or social worker.
A mental health assessment for a child is geared to the child’s age and stage of development.

Why It Is Done

A mental health assessment is done to:

• Find out about and check on mental health problems, such as anxiety,depression, schizophrenia, Alzheimer’s disease, and anorexia nervosa.
• Help tell the difference between mental and physical health problems.
• Evaluate a person who has been referred for mental health treatment because of problems at school, work, or home. For example, a mental health assessment may be used to find out if a child has learning disabilities or behaviour disorders such as attention deficit hyperactivity disorder (ADHD),conduct disorder (CD), or obsessive-compulsive disorder (OCD).
• Check the mental health of a person who has been hospitalized or arrested for a crime, such as drunken driving or physical abuse.

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How To Prepare

If you are having a mental health assessment because you have specific symptoms, you may be asked to keep a diary or journal for a few days before your appointment. For some assessments, you may be asked to bring a family member or friend with you, someone who can describe your symptoms from their view.
If your child is being checked for behaviour problems, you may be asked to keep a diary or journal of how he or she acts for a couple of days. Your child’s teacher may need to answer questions about how your child acts at school.
Many medicines can cause changes in your ability to think, reason, and remember. Be sure to tell your doctor about all the non-prescription and prescription medicines you take.
Talk with your doctor about any concerns you have regarding the need for the test, its risks, how it will be done, or what the results will mean. To help you understand the importance of this test, fill out the medical test information form(What is a [size=11]PDF document?) [/size].

How It Is Done

Health professionals often do a brief mental health assessment during regular checkups. If you are having symptoms of a mental health problem, your doctor may do a more complete assessment or refer you to another doctor, such as a psychologist or psychiatrist.
A mental health assessment includes an interview with a doctor and may also involve a physical examination and written or verbal tests.

Interview

During the interview, your doctor pays attention to how you look, how you move, what type of mood you seem to be in, and how you behave. You will be asked to talk about your symptoms and complaints. Be as detailed as possible. If you have kept a diary or journal of your symptoms, share this with your doctor.
Your doctor may ask you questions to check how well you think, reason, and remember (your cognitive functioning). He or she may ask you questions to find out how you think, how you feel about life, and whether you are likely to consider suicide.

Physical examination

A mental health assessment may include a physical examination. Your doctor will review your past medical history, as well as that of your family members, and the medicines you currently take.
Your doctor may test your reflexes, balance, and senses, such as hearing, taste, sight, smell, and touch.

Lab tests

The mental health assessment sometimes includes lab tests on a blood or urine sample. If a nervous system problem is suspected, tests such asmagnetic resonance imaging (MRI), electroencephalogram (EEG), orcomputed tomography (CT) may be done. Lab tests to detect other problems may include thyroid function tests, electrolyte levels, or toxicology screening (to look for drug or alcohol problems).

Written or verbal tests

A mental health assessment may include one or more verbal or written tests. You will be asked some questions and will either answer out loud or write your answer on a piece of paper. Your answers are then rated and scored by your doctor.
Written questionnaires generally contain 20 to 30 questions that can be answered quickly, often in a “yes” or “no” format. They usually don’t take long to finish, and you can do them by yourself at a regular office visit.
Many mental health questionnaires are available. They look at:
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• Specific problems. For example, for depression, the Hamilton Rating Scale for Depression, the Beck Depression Inventory, or the Geriatric Depression Scale can be used to evaluate your symptoms.
• How well you are able to think, reason, and remember (cognitive function). The Mini Mental State Examination can be used to check your cognitive function.
• How well you are able to carry out routine activities, such as eating, dressing, shopping, or banking.

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Sometimes a more extensive mental health test, such as the Wechsler Adult Intelligence Scale, may be needed. The test may need to be given by a specialist such as a psychologist.

Children

How a child’s mental health is assessed varies depending on the age of the child and the suspected problem. Young children may be asked to draw pictures to express their feelings, or they may be asked to look at pictures or images of common subjects and talk about how the pictures make them feel. Parents or teachers may be asked to answer questions about a child using a checklist.

How long does it take?

The time it takes for a mental health assessment varies depending on the reason for the assessment. An interview with written or verbal tests may last 30 to 90 minutes, or longer if several different tests are done. An in-depth test such as the Wechsler Adult Intelligence Scale may take 1 to 2 hours.

How It Feels

A mental health assessment is used to find out how you think and feel.
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• If you are being checked for a problem, such as alcohol dependence, you may feel resentment, anger, or hostility and may not want to have the assessment.
• If you are being evaluated for a health condition, such as Alzheimer’s disease, you may be afraid.
• Because some mental health problems are hard to diagnose, you may worry or become upset if your condition is not quickly or easily identified.

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Lab tests do not usually cause much discomfort. A blood sample will be taken from a vein in your arm. An elastic band is wrapped around your upper arm and may feel tight. You may feel nothing at all from the needle, or you may feel a quick sting or pinch. Collecting a urine sample does not cause pain.[/size]

Risks

Your doctor may not be able to find the cause of your symptoms, because some mental health problems are hard to diagnose. Also, more than one mental health assessment or other tests may be needed to accurately diagnose your problem.

Results

A mental health assessment gives your doctor an overall picture of how well you feel emotionally and how well you are able to think, reason, and remember (cognitive functioning). Your doctor may discuss some results of the mental health assessment with you right after the assessment. Complete results may not be available for several days.
Many conditions can change the results of a mental health assessment. Your doctor will talk with you about how your results relate to your symptoms and past health.
A mental health assessment can help diagnose:
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• Mental health problems, such as anxiety disorders, depression, schizophrenia,attention deficit hyperactivity disorder, conduct disorder, bipolar disorders, andeating disorders.
• Developmental problems, such as learning disabilities, intellectual disability, and autism.
• Substance use problems, including alcohol and drug use and dependence.
• Diseases of the nervous system, such as Alzheimer’s disease,Huntington’s disease, Parkinson’s disease, and epilepsy.
• Other problems, such as thyroid disease and brain tumours.

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What Affects the Test

You may not be able to have the test or the results may not be helpful if you:
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• Are not able to co-operate with and trust your doctor.
• Are not willing to have a mental health assessment.
• Have physical or emotional problems that interfere with your ability to complete a written test. In most cases, other testing instruments and tools are used if this is a problem for you.
• Use some medicines, alcohol, or illegal drugs.
• Have trouble reading, writing, or understanding the English language.

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What To Think About

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• Some mental health problems can be hard to diagnose. You may need more than one mental health assessment and other tests to accurately diagnose your problem.
• What your family and friends see or think about your symptoms can sometimes help your doctor diagnose a mental health problem. Consider having a family member or friend come with you to your appointment.
• Contact your human resources department or local health unit to find out what support services are available in your area.

DSM
The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the standard classification of mental disorders used by mental health professionals in the United States. It is intended to be applicable in a wide array of contexts and used by clinicians and researchers of many different orientations (e.g., biological, psychodynamic, cognitive, behavioral, interpersonal, family/systems). The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) is the current edition and has been designed for use across clinical settings (inpatient, outpatient, partial hospital, consultation-liaison, clinic, private practice, and primary care), with community populations. It can be used by a wide range of health and mental health professionals, including psychiatrists and other physicians, psychologists, social workers, nurses, occupational and rehabilitation therapists, and counselors. It is also a necessary tool for collecting and communicating accurate public health statistics.

The DSM consists of three major components: the diagnostic classification, the diagnostic criteria sets, and the descriptive text.

Diagnostic Classification
The diagnostic classification is the list of the mental disorders that are officially part of the DSM system. “Making a DSM diagnosis” consists of selecting those disorders from the classification that best reflect the signs and symptoms that are exhibited by the individual being evaluated. Associated with each diagnostic label is a diagnostic code, which is typically used by institutions and agencies for data collection and billing purposes. These diagnostic codes are derived from the coding system used by all health care professionals in the United States, known as the International Classification of Diseases, Ninth Edition, Clinical Modification (ICD-9-CM).

Diagnostic Criteria Sets
For each disorder included in DSM, a set of diagnostic criteria indicate what symptoms must be present (and for how long) as well as symptoms, disorders, and conditions that must not be present in order to qualify for a particular diagnosis. Many users of DSM find these diagnostic criteria particularly useful because they provide a concise description of each disorder. Furthermore, use of diagnostic criteria has been shown to increase diagnostic reliability (i.e., likelihood that different users will assign the same diagnosis to an individual). However, it is important to remember that these criteria are meant to be used as guidelines informed by clinical judgment and are not meant to be used in a cookbook fashion.

Descriptive Text
Finally, the third component of DSM is the descriptive text that accompanies each disorder. The text of DSM-5 systematically describes each disorder under the following headings: “Diagnostic Features”; “Associated Features Supporting Diagnosis”; “Subtypes and/or Specifiers”; “Prevalence”; “Development and Course”; “Risk and Prognostic Factors”; “Diagnostic Measures”; “Functional Consequences

DSM: History of the Manual

The need for a classification of mental disorders has been clear throughout the history of medicine, but until recently there was little agreement on which disorders should be included and the optimal method for their organization. The many different classification systems that were developed over the past two millennia have differed in their relative emphasis on phenomenology, etiology, and course as defining features. Some systems included only a handful of diagnostic categories; others included thousands. Moreover, the various systems for categorizing mental disorders have differed with respect to whether their principle objective was for use in clinical, research, or statistical settings. Because the history of classification is too extensive to be summarized here, this summary focuses briefly only on those aspects that have led directly to the development of the Diagnostic and Statistical Manual of Mental Disorders (DSM) and to the “Mental Disorders” sections in the various editions of the

International Classification of Diseases (ICD).

Pre-World War II
In the United States, the initial stimulus for developing a classification of mental disorders was the need to collect statistical information. What might be considered the first official attempt to gather information about mental health in the United States was the recording of the frequency of “idiocy/insanity” in the 1840 census. By the 1880 census, seven categories of mental health were distinguished: mania, melancholia, monomania, paresis, dementia, dipsomania, and epilepsy.

In 1917, the American Medico-Psychological Association, together with the National Commission on Mental Hygiene, formulated a plan that was adopted by the Bureau of the Census for gathering uniform statistics across mental hospitals. Although this system devoted more attention to clinical utility than did previous systems, it was still primarily a statistical classification. The American Psychiatric Association subsequently collaborated with the New York Academy of Medicine to develop a nationally acceptable psychiatric nomenclature that would be incorporated within the first edition of the American Medical Association’s Standard Classified Nomenclature of Disease. This nomenclature was designed primarily for diagnosing inpatients with severe psychiatric and neurological disorders.

In 1921, the American Medico-Psychological Association changed its name to the American Psychiatric Association.
Post-World War II

A much broader nomenclature was later developed by the U.S. Army (and modified by the Veterans Administration) in order to better incorporate the outpatient presentations of World War II servicemen and veterans (e.g., psychophysiological, personality, and acute disorders). Concurrently, the World Health Organization (WHO) published the sixth edition of International Classification of Diseases (ICD), which, for the first time, included a section for mental disorders. ICD-6 was heavily influenced by the Veterans Administration nomenclature and included 10 categories for psychoses and psychoneuroses and seven categories for disorders of character, behavior, and intelligence.

The American Psychiatric Association Committee on Nomenclature and Statistics developed a variant of the ICD-6 that was published in 1952 as the first edition of Diagnostic and

Statistical
Manual: Mental Disorders (DSM-I). DSM-I contained a glossary of descriptions of the diagnostic categories and was the first official manual of mental disorders to focus on clinical utility. The use of the term “reaction” throughout DSM-I reflected the influence of Adolf Meyer’s psychobiological view that mental disorders represented reactions of the personality to psychological, social, and biological factors.

In part because of the lack of widespread acceptance of the mental disorder taxonomy contained in ICD-6 and ICD-7, WHO sponsored a comprehensive review of diagnostic issues, which was conducted by the British psychiatrist Erwin Stengel. His report can be credited with having inspired many advances in diagnostic methodology–most especially the need for explicit definitions of disorders as a means of promoting reliable clinical diagnoses. However, the next round of diagnostic revisions, which led to DSM-II and ICD-8, did not follow Stengel’s recommendations to any great degree. DSM-II was similar to DSM-I but eliminated the term “reaction.”

Development of DSM-III
As had been the case for the Diagnostic and Statistical Manual of Mental Disorders, First Edition and Second Edition (DSM-I) and (DSM-II), the development of the Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III) was coordinated with the development of the next version of the International Classification of Diseases (ICD), ICD-9, which was published in 1975 and implemented in 1978. Work began on DSM-III in 1974, with publication in 1980.

DSM-III introduced a number of important methodological innovations, including explicit diagnostic criteria, a multiaxial system, and a descriptive approach that attempted to be neutral with respect to theories of etiology. This effort was facilitated by extensive empirical work on the construction and validation of explicit diagnostic criteria and the development of semistructured interviews.

ICD-9 did not include diagnostic criteria or a multiaxial system largely because the primary function of this international system was to outline categories for the collection of basic health statistics. In contrast, DSM-III was developed with the additional goal of providing a medical nomenclature for clinicians and researchers. Because of dissatisfaction across all of medicine with the lack of specificity in ICD-9, a decision was made to modify it for use in the United States, resulting in ICD-9-CM (for Clinical Modification). The ICD-9-CM is still in use today.

DSM-III-R and DSM-IV
Experience with Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III) revealed a number of inconsistencies in the system and a number of instances in which the criteria were not entirely clear. Therefore, the American Psychiatric Association appointed a work group to revise DSM-III, which developed the revisions and corrections that led to the publication of DSM-III-R in 1987.

Several years later, in 1994, the last major revision of DSM, DSM-IV, was published. It was the culmination of a six-year effort that involved more than 1000 individuals and numerous professional organizations. Much of the effort involved conducting a comprehensive review of the literature to establish a firm empirical basis for making modifications. Numerous changes were made to the classification (e.g., disorders were added, deleted, and reorganized), to the diagnostic criteria sets, and to the descriptive text based on a careful consideration of the available research about the various mental disorders.

Developers of DSM-IV and the 10th Edition of the International Classification of Diseases (ICD-10) worked closely to coordinate their efforts, resulting in increased congruence between the two systems and fewer meaningless differences in wording. ICD-10 was published in 1992.

The definition of attention-deficit/hyperactivity disorder (ADHD) has been updated in the fifth edition
of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to more accurately characterize
the experience of affected adults. This revision is based on nearly two decades of research showing that
ADHD, although a disorder that begins in childhood, can continue through adulthood for some people.

Previous editions of DSM did not provide appropriate guidance to clinicians in diagnosing adults with
the condition. By adapting criteria for adults, DSM-5 aims to ensure that children with ADHD can continue
to get care throughout their lives if needed.
Changes to the Disorder
ADHD is characterized by a pattern of behavior, present in multiple settings (e.g., school and home),
that can result in performance issues in social, educational, or work settings. As in DSM-IV, symptoms
will be divided into two categories of inattention and hyperactivity and impulsivity that include behaviors
like failure to pay close attention to details, difficulty organizing tasks and activities, excessive talking,
fidgeting, or an inability to remain seated in appropriate situations.

Children must have at least six symptoms from either (or both) the inattention group of criteria and
the hyperactivity and impulsivity criteria, while older adolescents and adults (over age 17 years) must
present with five. While the criteria have not changed from DSM-IV, examples have been included to
illustrate the types of behavior children, older adolescents, and adults with ADHD might exhibit. The
descriptions will help clinicians better identify typical ADHD symptoms at each stage of patients’ lives.

Using DSM-5, several of the individual’s ADHD symptoms must be present prior to age 12 years, compared
to 7 years as the age of onset in DSM-IV. This change is supported by substantial research published
since 1994 that found no clinical differences between children identified by 7 years versus later
in terms of course, severity, outcome, or treatment response.

DSM-5 includes no exclusion criteria for people with autism spectrum disorder, since symptoms of both
disorders co-occur. However, ADHD symptoms must not occur exclusively during the course of schizophrenia
or another psychotic disorder and must not be better explained by another mental disorder,
such as a depressive or bipolar disorder, anxiety disorder, dissociative disorder, personality disorder, or
substance intoxication or withdrawal.

Care Beyond Childhood
The ADHD diagnosis in previous editions of DSM was written to help clinicians identify the disorder in
children. Almost two decades of research conclusively show that a significant number of individuals
diagnosed with ADHD as children continue to experience the disorder as adults. Evidence of this came
from studies in which individuals were tracked for years or even decades after their initial childhood
diagnosis. The results showed that ADHD does not fade at a specific age.
Studies also showed that the DSM-IV criteria worked as well for adults as they did for children but that
a lower threshold of symptoms (five instead of six) was sufficient for a reliable diagnosis.

2 • DSM-5 Attention Deficit/Hyperactivity Disorder Fact Sheet
In light of the research findings, DSM-5 makes a special effort to address adults affected by ADHD to
ensure that they are able to get care when needed.

DSM is the manual used by clinicians and researchers to diagnose and classify mental disorders. The American Psychiatric
Association (APA) will publish DSM-5 in 2013, culminating a 14-year revision process.

The upcoming fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) will include
a new chapter on Obsessive-Compulsive and Related Disorders to reflect the increasing evidence
of these disorders’ relatedness to one another and distinction from other anxiety disorders, as well as
to help clinicians better identify and treat individuals suffering from these disorders.

Disorders grouped in this new chapter have features in common such as an obsessive preoccupation
and repetitive behaviors. The disorders included in this new chapter have enough similarities to group
them together in the same diagnostic classification but enough important differences between them to
exist as distinct disorders.

Disorders in this chapter include obsessive-compulsive disorder, body dysmorphic disorder and trichotillomania
(hair-pulling disorder), as well as two new disorders: hoarding disorder and excoriation (skinpicking)
disorder.

Hoarding Disorder
Hoarding disorder is characterized by the persistent difficulty discarding or parting with possessions,
regardless of the value others may attribute to these possessions. The behavior usually has harmful effects—emotional,
physical, social, financial, and even legal—for the person suffering from the disorder
and family members. For individuals who hoard, the quantity of their collected items sets them apart
from people with normal collecting behaviors. They accumulate a large number of possessions that
often fill up or clutter active living areas of the home or workplace to the extent that their intended use
is no longer possible.

Symptoms of the disorder cause clinically significant distress or impairment in social, occupational
or other important areas of functioning including maintaining an environment for self and/or others.
While some people who hoard may not be particularly distressed by their behavior, their behavior can
be distressing to other people, such as family members or landlords.

Hoarding disorder is included in DSM-5 because research shows that it is a distinct disorder with distinct
treatments. Using DSM-IV, individuals with pathological hoarding behaviors could receive a diagnosis
of obsessive-compulsive disorder (OCD), obsessive-compulsive personality disorder, anxiety
disorder not otherwise specified or no diagnosis at all, since many severe cases of hoarding are not
accompanied by obsessive or compulsive behavior. Creating a unique diagnosis in DSM-5 will increase
public awareness, improve identification of cases, and stimulate both research and the development of
specific treatments for hoarding disorder.

This is particularly important as studies show that the prevalence of hoarding disorder is estimated at
approximately two to five percent of the population. These behaviors can often be quite severe and
even threatening. Beyond the mental impact of the disorder, the accumulation of clutter can create a
public health issue by completely filling people’s homes and creating fall and fire hazards.
2 • Obsessive Compulsive and Related Disorders
Excoriation (Skin-Picking) Disorder
Excoriation (skin-picking) disorder is characterized by recurrent skin picking resulting in skin lesions.

Individuals with excoriation disorder must have made repeated attempts to decrease or stop the skin
picking, which must cause clinically significant distress or impairment in social, occupational or other
important areas of functioning. The symptoms must not be better explained by symptoms of another
mental disorder.

This disorder is included in DSM-5 because of substantial scientific literature on excoriation’s prevalence,
diagnostic validators and treatment. Studies show that the prevalence of excoriation is estimated
at approximately two to four percent of the population. Resulting problems may include medical issues
such as infections, skin lesions, scarring and physical disfigurement.

Process for a New Diagnosis
New diagnoses were included in DSM-5 only after a comprehensive review of the scientific literature;
full discussion by Work Group members; review by the DSM-5 Task Force, Scientific Review Committee,
and Clinical and Public Health Committee; and, finally, evaluation by the American Psychiatric Association’s
Board of Trustees. Trustees approved the final diagnostic criteria for DSM-5 in December 2012.
DSM is the manual used by clinicians and researchers to diagnose and classify mental disorders. The American
Psychiatric
Association (APA) will publish DSM-5 in 2013, culminating a 14-year revision process.

http://www.healthyclassmate.com/the-top-celebrities-with-mental-illness/2/

New Medicines:

Questions to ask the Doctor?

Ask the following questions if your doctor recommends a new medicine for your health condition.

General Questions:

What is the name of the medicine?_______________________________________________________________________ Brand name (trade name) Generic name (chemical name)?

What will the medicine do (for example, decrease blood pressure)? ____________________________________________

Why do I need this medicine? ____________________________________________________________________________

Are there any other medicine or treatment options? _________________________________________________________

Is medicine covered by my provincial health plan? __________________________________________________________

Is a generic form of the medicine available and appropriate for me? ___________________________________________

Can I start with a prescription for a few days to make sure the medicine agrees with me? _________________________

Questions to ask about taking this Medicine?

How is the medicine taken (for example, orally [by mouth] or through a skin patch)? _____________________________

What amount do I take each time (dose)? __________________________________________________________________

How often should it be taken (for example, 3 times a day)? ___________________________________________________

When? ________________________________________________________________________________________________

1 Should I take it with or without food? _____________________________________________________________________

What should I avoid while taking it (for example, certain foods, activities, other medicines, or alcohol)? ______________

Will it interact with other medicines I am currently taking or other medical conditions? ____________________________

Yes No If yes, what might occur? _________________________________________________________________________

What are the common side effects (those that do not usually cause problems)? ___________________________________

What side effects should I report if I experience them? _______________________________________________________

What do I do if I miss a dose? ____________________________________________________________________________

How long will I need to take this medicine (days, weeks, months)? _____________________________________________

How will I know that the medicine is helping? _______________________________________________________________

What is the next step if this medicine doesn’t work? __________________________________________________________

Reminders

• Be sure you understand your doctor’s instructions. _________________________________________________________

• State any concerns you have about taking the medicine. ____________________________________________________

For example, ask if “4 doses daily” means taking a dose every 6 hours around the clock or just during regular waking hours. _______________________________________________________________________________________________

Anti Psychotics for the Treatment of Bipolar Disorder

Examples

First-generation, or typical, anti psychotic medicine
[th]Generic Name[/th]

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Second-generation, or atypical, anti psychotic medicines
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These medicines are available in liquid, tablet, or injectable form.

How It Works

These medicines balance certain chemicals in the brain (neurotransmitters). It is not clear exactly how these medicines work for the treatment of bipolar disorder. But they quickly improve manic episodes.

Why It Is Used

Each of these medicines has been approved by Health Canada’s Therapeutic Products Directorate (TPD) to treat bipolar disorder. Some medicines work better for some people than for others. Second-generation anti psychotic medicines may have fewer side effects than first-generation anti psychotic medicines. Be sure to talk with your doctor about how the medicine is working for you. Sometimes you might need to try more than one type of medicine before you find one that works best for you.
These medicines have all been found to be an effective treatment of manic episodes. Other anti psychotic medicines, such as olanzapine, are also being studied for the treatment of depression in bipolar disorder.

How Well It Works

Drugs in this classification work quickly in the treatment of bipolar disorder, especially in older adults. These medicines have all been found to be an effective treatment of manic episodes. Some studies show the combination of an antipsychotic and a mood stabilizer may be more effective than a mood stabilizer alone. 1

Side Effects

All medicines have side effects. But many people don’t feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.
Here are some important things to think about:
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• Usually the benefits of the medicine are more important than any minor side effects.
• Side effects may go away after you take the medicine for a while.
• If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.

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Call 911 or other emergency services right away if you have:
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• Trouble breathing.
• Swelling of your face, lips, tongue, or throat.

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Call your doctor if you have:
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• Hives.

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Neuroleptic Malignant Syndrome (NMS) is an extremely rare but serious side effect that has been reported by people who take anti psychotic medicines. NMS causes life-threatening problems with your body’s ability to regulate its temperatures.
Call 911 or other emergency services right away if you have a fever and:
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• Muscle rigidity.
• Fast or irregular heartbeat.
• Rapid breathing.
• Severe sweating.

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Other side effects of anti psychotic medicines include:
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• Weight gain.
• Restlessness.
• Sleepiness.
• High Cholesterol or High blood sugar
• Movement disorders, such as Tardive Dyskinesia.
• Managing side effects

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It may take several attempts to find the right dose and medicine to treat your bipolar symptoms. Effectiveness and side effects for each medicine vary from person to person.
Some side effects are minor. You can manage these through lifestyle changes such as exercise, relaxation techniques, and diet changes. Other side effects can be more serious and require changes to the dose or type of medicine.
See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

Before you take an anti psychotic medicine, be sure to tell your doctor if you have:
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• A heart condition.
• A seizure disorder.
• Problems with liver function.
• Problems with blood pressure.
• Diabetes or high blood sugar.
• Constipation.
• A history of breast cancer.
• Problems with swallowing.
• Problems with fainting.

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These medicines should be started in low doses. Talk with your doctor about any other medicines you may be taking to make sure there are no negative drug interactions.
You may need regular liver tests, blood tests, and blood pressure monitoring while taking an anti psychotic medicine. Your doctor may also monitor your weight and blood sugar.
Avoid herbal stimulants (such as ma huang, ginseng, or kola) while taking an anti psychotic medicine.
Talk to your doctor or pharmacist about drinking grapefruit juice while taking an anti psychotic medicine. Grapefruit juice can increase the level of these medicines in your blood. Having too much medicine in your blood increases the chances of having serious side effects.

Taking medicine

Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don’t take your medicines properly, you may be putting your health (and perhaps your life) at risk.
There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do.

Advice for women

Women who use this medicine during pregnancy have a slightly higher chance of having a baby with birth defects. If you are pregnant or planning to get pregnant, you and your doctor must weigh the risks of using this medicine against the risks of not treating your condition.

Checkups

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take.