Examples 

• Aripiprazole (Abilify), brexpiprazole (Rexulti), 
• paliperidone (Invega), risperidone (Risperdal), 
• olanzapine (Zyprexa), quetiapine (Seroquel), asenapine (Saphris), ziprasidone (Zeldox), 
• lurasidone (Latuda), clozapine (Clozaril)     
    

What is it used for?

Atypical antipsychotics are usually used to treat conditions involving psychosis. Psychosis may be experienced as a distortion or loss of contact with reality. Living with these symptoms makes it diffi.cult for you to make decisions and carry out your daily activities. Atypical antipsychotics can also be used to help regulate mood in cases of depression or bipolar disorder. Clozapine is exclusively used to treat schizophrenia and your prescriber can further explain if it is a suitable option for you. 
  

How does it work?

Atypical antipsychotics work by restoring the balance of brain chemicals, such as dopamine and serotonin. These “atypical” antipsychotics are newer medications than “typical” antipsychotics and are less likely to cause movement side-effects. They should be taken regularly and as prescribed to avoid the risk of relapse. The best treatment results are obtained when these medications are taken in combination with other supports, such as counselling. 
  

How is it taken?

Depending on the type of antipsychotic, it can be taken by mouth, dissolved under the tongue or injected into the muscle. Options for injections include aripiprazole, paliperidone and risperidone. Injections are usually given every 2 to 12 weeks and work as well as oral antipsychotics. Injections can be more convenient than taking an oral medication every day.        
  

How long does it take to work?

Some of your symptoms may improve within 2 weeks of starting the medication. However, it may take up to 4 to 8 weeks at a therapeutic dose (the dose of medication that is needed to get the desired effect) to see the maximum benefit. If you don’t experience even a minimum response after 8 weeks, it might not be the right medication for you. Your prescriber will discuss other options with you. 
  

How long do I have to take it for?

The length of your treatment depends on many factors, including your diagnosis. If you want to make changes to your medication or would like to stop it, talk to your prescriber first.
  

What happens if I miss a dose?

If you forget to take a dose, take it as soon as you remember, unless it is close to your next dose. If it is almost time for your next dose, skip the missed dose. Do not double dose. If you are unsure about what to do, ask your pharmacist.
  

What are the potential side-effects?

All medications can have side-effects but each person can have a different experience. You may not experience any side-effects at all. Some atypical antipsychotics are more likely to cause certain side-effects than other atypical antipsychotics. Your prescriber will work with you to choose the medication that is best suited to you so that you can carry out daily activities and enjoy life. 

Some potential side-effects are listed below. If you do experience any side-effects, it is important to let your prescriber know. Tips on how to manage potential side-effects are also included.
  

Metabolic Effects

(such as weight gain, increased blood pressure or risk of diabetes)

If weight gain does occur, it typically occurs early, within the first 12 weeks of starting a medication.

• Try to do regular physical activity.
• Make healthy food choices:
  • Try to eat plenty of fresh vegetables and fruits, or frozen ones if fresh options aren’t available or are too expensive.
  • Try to eat whole grains and proteins.
  • Try to prepare your own meals, and limit eating highly processed foods as they are often higher in sugar, sodium and fat.
  • Try to drink water instead of sugary drinks.
• Schedule regular doctor appointments to measure your weight, blood sugar and cholesterol levels.
• Consider talking with a dietitian or checking out the Canada Food Guide for tips on making healthy eating choices, including eating healthy on a budget (https://food-guide.canada.ca/en/).
    

Movement Effects

(such as tremor, feeling restless or stiff)

Let your prescriber know if you experience these side-effects. They may be able to recommend treatment options to help reduce these side-effects.
  

Sedation

(such as feeling sleepy or groggy or having low energy)

Some people may have sedation when starting an atypical antipsychotic or when the dose is increased. This usually goes away with time.

• Try taking the atypical antipsychotic at bedtime.
• Do not drive or perform activities that require you to be alert if you are feeling sleepy or groggy.
    

Hormonal Effects

(such as decreased sex drive/function, missed periods, discharge from breast)

Let your prescriber know if you experience these side-effects—they can often be reduced or minimized. 
  

Other Effects 

Dry mouth

• Try to drink sips of water throughout the day.
• Try sucking on sugarless lozenges or chewing sugarless gum.
• Consult with your dentist about how to manage dry mouth.

Difficulty urinating

• Talk to your prescriber for ways to help.

Constipation

• Try to drink plenty of water and eat high fibre foods such as vegetables, fruits and whole grains.
• Talk to your pharmacist about laxative medications.

Dizziness or feeling lightheaded

• Get up slowly if you are sitting or lying down. Sit down when you feel dizzy. 
• Stay hydrated.
    

Can side-effects be serious?

There is a rare and serious side-effect of these medications called neuroleptic malignant syndrome (NMS). It can occur even if you have been taking the medication for a long time. If you experience muscle rigidity, fever (38°C or higher) or changes in your blood pressure or level of con.sciousness, go to your nearest emergency room.    
  

Are there any drug interactions I should be aware of?

Certain medications may interact with atypical antipsychotics. It is important to talk to your prescriber or pharmacist before starting any new prescription medications, over-the-counter medications or natural health products, such as vitamins or herbal remedies.
  

Are there any dietary considerations I should be aware of?

Talk to your prescriber or pharmacist about whether you should take your atypical antipsy.chotic with or without food. Alcohol might increase drowsiness or worsen your symptoms. Talk to your prescriber or pharmacist about alcohol use during treatment.   
  

What other precautions should I take while taking these medications?

• Avoid exposure to extreme heat and and stay well hydrated since these medications may affect your body’s ability to regulate temperature.
    

Can these medications be used in pregnancy?

If you are thinking of becoming pregnant or think you may be pregnant, talk to your prescriber about your medication. It’s important to take care of your mental health during pregnancy and atypical anti.psychotics may be needed to do so. It is important to discuss the risks and benefits of treatment with your prescriber. 
  

What else can I do to help my recovery?

• Starting or continuing substance use, such as street drugs, alcohol or marijuana, may make it harder it to get well. Speak with your health care team about this. 
• Participating in other treatments such as talk therapy can help with the recovery process.