Depot Medication
Mental
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What is antipsychotic medication?
It is a medication that is used for some types
of mental distress or illness, known as psychotic
illnesses, where you may hear voices, have difficulty
controlling your thoughts or feel very agitated. This happens most
often in bipolar disorder (otherwise known as 'manic depression')
and schizophrenia.
What is depot antipsychotic medication?
It is a special preparation of the medication,
which is given by injection. The medication is slowly released
into the body over a number of weeks.
It is important to know that the medication going into your body
by a depot injection is exactly the same as the medication going
into your body in tablet form. The only difference is the route
through which its enters. This means that the benefits and the
side-effects of the depot injection are the same as they would be
if you took the drug by mouth.
What happens when the nurse or doctor gives the depot
injection?
- You go into a private room with the nurse or doctor.
- The injection is usually given into the
buttock.
- After each injection the medicine stays in your body for a few
weeks.
How is it started?
- The first time you have this treatment you will usually be
given a small amount to check that it does not have any bad effects
on you.
- If you have no bad effects from the medication, you
start regular injections after a few days.
Why is it usually given into the buttock?
Because the injection is quite thick, it needs to be given into
a large muscle, so that there is less (or no) pain and
swelling.
Where can you have the injections done?
You can usually decide yourself where to have
the injections. The choices might be:
- At your doctor's surgery
- At a community mental health centre
- At an out-patient clinic
- At your home.
How often do you have to have these injections?
Between once a week and once a month.
How long do the injections go on?
This will depend on your illness. You should discuss this with
your doctor.
Trade name
|
Proper name
|
Dose/amount
|
How often
|
| Modecate |
Fluphenazine decanoate |
up to 100 milligrams |
1 injection every 2 to 5 weeks according to response and
severity of condition |
| Depixol |
Flupenthixol decanoate |
up to 400 milligrams |
1 injection every 2 to 4 weeks according to response and
severity of condition |
| Haldol |
Haloperidol decanoate |
up to 300 milligrams |
1 injection every 2 to 4 weeks according to response and
severity of condition |
| Piportil |
Pipothiazine palmitate |
up to 200 milligrams |
1 injection every 4 weeks |
| Clopixol |
Zuclopenthixol Decanoate |
up to 600 milligrams |
1 injection every1 to 4 weeks |
| Risperdal Consta |
Risperidone |
up to 50 milligrams |
1 injection every 2 weeks |
| Xepilon |
Paliperidone |
up to 150 milligrams |
1 injection every 4 weeks |
| ZypAdhera |
Olanzapine embonate |
up to 405 milligrams |
1 injection every 2 or 4 weeks |
Which depot to choose should be a joint decision between you and
your psychiatrist. All depots are broadly similar in how effective
they are. There are some slight differences in some of the effects
of the drugs. For example, Clopixol may be more suitable if you are
highly agitated, while Depixol may be more suitable if you have a
low mood associated with your illness.
There are also differences in the side-effects they may cause,
and this will influence your choice of depot.
What's good about having depot injections?
- You only have to have the medicine once a week or once a month.
(Pills have to be taken every day)
- You are less likely to forget your medicine, so less likely to
get ill.
- The medicine can reduce unpleasant experiences, like hearing
voices. It can also help you to feel calmer and think more
clearly.
What's bad about having depot injections?
- Some people feel uncomfortable about having
injections, perhaps due to anxiety about needles.
- Some people experience pain from the
injection which can last for a few days - this is usually
mild.
Apart from these problems, the side-effects of
the medication are the same as with the tablet version of the same
drug.
Most depot medications belong to the older group of antipsychotics ('first generation' or
'typical' antipsychotics). This means they will commonly be
associated with side-effects such as stiffness or shaking in your
arms and legs.
Can anything be done to avoid these problems?
Yes. Although having regular injections can be uncomfortable and
seem daunting to begin with, it is possible to get used to the
process, and you will gradually feel more comfortable with it.
Discussing any anxieties with your nurse or doctor can also
help.
The physical discomfort of regular injections can also be
reduced by alternating the injection site each time. Most depots
can be given at different intervals such as weekly,
every 2 weeks, every 3 months or monthly. Choosing a dose which
allows for less frequent injections can also be helpful.
If you experience side-effects from your depot medication,
having smaller amounts of the medicine can help, or you can take
another medicine to reduce the side-effects. It is usually best to
reduce the dose of medication to a level where these unpleasant
effects do not happen.
Can you say 'no' to having these
injections?
Yes you can, just the same as with any other
medication. But, if you are kept in hospital under a section of the
Mental Health Act, the doctors could make you have treatment
(again, like any other medication) even if you don't want it. After
3 months, if you say still don’t want the treatment, the hospital
has to ask an independent doctor from a different hospital to see
you and decide if you need the medicine or not.
What happens if you miss an injection?
If you miss an injection, you should have
another one as soon as you can. If you do not, over a few weeks or
months the medicine will stop working and some of the old problems
will come back, like hearing voices or feeling troubled or scared.
You may start to feel worse than before you started the medicine if
you keep missing the depot injections.
What if you are not happy about the
injections?
Talk to your doctor, nurse or key worker. They
might be able to help you feel OK about it, or suggest a different
treatment. If you have any questions about your medicine or if you
do not understand anything you have read here please ask your
doctor, nurse or key worker. They want to help.
Warnings
Depot injections may make you feel sleepy,
so:
- Be careful with alcohol - it will make you
even more sleepy
- Don't drive a car or work any machinery if
you are not fully awake or if you feel the medicine is affecting
your concentration
- Some other medicines, such as sleeping pills
or hay fever pills may make you feel more sleepy when you have
depot injections.
This leaflet was produced by the Royal College of
Psychiatrists' Public Education Editorial Board
Series Editor: Dr Philip Timms.
Expert review: Dr Michael Yousif
Information about treatments can change rapidly and the
College updates its mental health information leaflets
regularly.
© March 2013. Due for review: March
2015. Royal College of Psychiatrists.
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