Side Effects of Long-Acting Antipsychotic Injections

Q: Side Effects of Long-Acting Antipsychotic Injections

Hello： The physician may be concerned that if the medication is changed, the new drug may not effectively improve your psychiatric symptoms, which could increase the risk of relapse. <br>Therefore, if a medication change is necessary, it is advisable to proceed in a gradual manne

Drug side effects

Hello Dr.
Lin, I have a question again! Regarding the long-acting injection of Sustenna that I am currently receiving, I have discovered that it has the side effect of hyperprolactinemia (sexual dysfunction).
Today, during my follow-up appointment with the physician at National Taiwan University, I expressed my desire to switch medications, but the doctor advised against an immediate switch, stating that it could be dangerous and that I should wait another three months.
Is this true, Dr.
Lin?

Niming, 30~39 year old female. Ask Date: 2024/01/04

Dr. Lin Mianzhang reply Psychiatry

Hello: The physician may be concerned that if the medication is changed, the new drug may not effectively improve your psychiatric symptoms, which could increase the risk of relapse.
Therefore, if a medication change is necessary, it is advisable to proceed in a gradual manner.
During the transition, it may still be necessary to continue the original medication for treatment.
Additionally, you can ask the physician whether a blood test to check prolactin levels is warranted for confirmation.
It is recommended that you discuss this in detail with your physician.
Wishing you safety and good health.

Reply Date: 2024/01/04

More Info

Long-acting antipsychotic injections, such as the one you are currently receiving (善思達, or Paliperidone), are often prescribed to patients with mental health conditions, particularly schizophrenia and bipolar disorder, to ensure consistent medication adherence. These injections can be administered every two weeks or monthly, which helps to maintain stable drug levels in the body and reduce the risk of relapse due to missed doses. However, like all medications, they come with potential side effects that can vary from person to person.

One of the notable side effects of long-acting antipsychotics, particularly those that affect dopamine levels, is hyperprolactinemia, which can lead to sexual dysfunction, including delayed ejaculation or decreased libido. This is due to the drug's action on the dopamine pathways in the brain, which can disrupt the balance of hormones, including prolactin. Elevated prolactin levels can cause various symptoms, and it is essential to discuss these with your healthcare provider.

Regarding your concern about switching medications, it is not uncommon for doctors to recommend a gradual approach when changing antipsychotic medications. Abruptly stopping or switching medications can lead to withdrawal symptoms or a resurgence of the underlying mental health condition. This is particularly true for long-acting injections, as they can remain in your system for an extended period. Your doctor may want to monitor your response to the current medication and any side effects before making a change. This cautious approach is intended to ensure your safety and stability.

If your doctor has advised waiting for three months before considering a medication change, it is likely because they want to assess the full effects of the current treatment and ensure that any side effects can be managed appropriately. It is crucial to maintain open communication with your healthcare provider about your symptoms and any concerns you have regarding side effects. If the side effects are significantly impacting your quality of life, it is essential to express this to your doctor, as they may consider adjusting the dosage or exploring alternative medications sooner than planned.

In the meantime, there are several strategies you can employ to manage side effects. For instance, discussing the possibility of adjunctive treatments that may help alleviate sexual dysfunction could be beneficial. Additionally, lifestyle modifications, such as regular exercise, a balanced diet, and stress management techniques, can also support your overall well-being.

In summary, while the side effects of long-acting antipsychotic injections can be challenging, it is essential to work closely with your healthcare provider to find the best approach for your treatment. If you feel that your concerns are not being adequately addressed, seeking a second opinion from another psychiatrist may also be a viable option. Your mental health is paramount, and finding the right balance in your treatment plan is crucial for your overall health and quality of life.

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