People living with psychotic illness 2010

15. Medication use and psychosocial therapies

Page last updated: November 2011

15.1 Medications for mental health problems
15.2 Supplements for mental health problems
15.3 Medications for physical conditions
15.4 Medication benefits
15.5 Medication side effects attributed to medication for mental health
15.6 Psychosocial therapies

15.1 Medications for mental health problems

Most participants (91.6%) reported they were currently (that is in the four weeks prior to interview) taking prescribed medication for their mental health problems, with 94.4% taking medication for these in the past year.

There was little difference in current use between males and females (91.4% and 91.9% respectively), however, use was slightly lower in the younger age group (88.6% of 18-34 year olds compared with 93.8% of 35-64 year olds).

Four out of five (81.6%) participants were taking antipsychotic medications in the four weeks prior to interview. Three quarters (74.0%) were taking atypical antipsychotics, with 16.4% taking clozapine, which is prescribed most commonly in cases of schizophrenia that do not respond to other antipsychotic medications. Just 15.2% were taking first generation, typical antipsychotics.

Treatment compliance was high at 88.1% for antipsychotic medication use.

These antipsychotics do not control a number of other mental health problems, which are commonly experienced by people with psychotic disorders. Just over one third (37.4%) of participants were taking antidepressants and one quarter (26.7%) were on mood stabilisers. The proportion on anxiolytics, hypnotics and sedatives was 17.8%.

Given the relatively high levels of smoking, alcohol and drug use, a relatively small proportion of participants (3.5%) were taking medications to assist with the alcohol, nicotine or opioid dependence.

15.2 Supplements for mental health problems

Just over one-fifth (21.9%) of participants were using non-prescribed supplements for mental health, such as fish oil or St John's Wort. Half (53.8%) of these people had discussed supplement use with their doctor.

15.3 Medications for physical conditions

The survey also collected data on medications prescribed for physical conditions. Two-fifths (41.1%) of participants were taking medications for these reasons.

Almost one-fifth (18.2%) of participants were on medications for cardiovascular disorders, 14.7% were taking medications for endocrine disorders and 8.2% taking medications specifically for diabetes. One in eight people (12.8%) were taking medications for gastrointestinal disorders and 6.0% for respiratory conditions (figure 15-1).
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Figure 15-1. Current medication use


Refer to the following list for a text equivalent of figure 15-1. Current medication use

Text version of figure 15-1

Mental health problems:
  • Antipsychotic
    • Atypical antipsychotics: All - 74%
    • Clozapine - 16.4%
    • Typical antipsychotics - 15.2%
  • Other
    • Antidepressants - 37.4%
    • Mood stabilisers - 26.7%
    • Anxiolytics, hypnotics, sedatives - 17.8%
    • Anticholinergics - 4.2%
    • Alcohol, nicotine or opoid dependence related - 3.5%
  • Total on medication for mental health - 91.6%
  • Supplements for mental health - 21.8%
Physical conditions:
  • Cardiovascular - 18.2%
  • Endocrine (any) - 14.7%
  • Gastrointestinal - 12.8%
  • Respiratory - 6%
  • Blood and electrolytes - 4%
  • Neurological - 3.8%
  • Musculoskeletal - 3.7%
  • Genitourinary - 0.8%
  • Total on medication for physical health - 41.1%
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15.4 Medication benefits

Participants were asked to assess the benefit of the medications they were taking for their mental health problems. The majority of participants said that psychotropic medications gave them relief from the symptoms of their disorder, with 57.2% of those currently using medications reporting a lot of relief and 28.2% reporting some relief. Almost one in ten (9.6%) reported that the medication gave them no relief from their psychotic symptoms (table 15-1).

Table 15-1. Relief from symptoms for those currently taking medications for mental health problems

Table 15-1 is presented as a list in this HTML version for accessibility reasons. It is presented as a table in the PDF version.

Proportion by level of level of relief from symptoms:
  • A lot - 57.2%
  • A little - 28.2%
  • Not at all - 9.6%
  • Not known - 5.0%
  • Total respondents - 1,672

15.5 Medication side effects attributed to medication for mental health

While participants affirmed the benefits of the medications they were using for their mental health, many reported side effects and a consequent deterioration in quality of life, a decline experienced in addition to the primary effects of their illness.

Three quarters of participants (77.4%) complained of medication side effects. The average number of side effects reported by those on medication for their mental health was five. Three-fifths (61.0%) suffered impairment in their daily life as a result of these medication side effects and for 29.9% the impact of these impairments was moderate or severe (figure 15-2).

The side effects most frequently reported were drowsiness or sleepiness during the day (44.7%), mouth drier or more watery than usual (39.5%), weight increase (37.5%), inner restlessness (25.8%), trembling or shaking of limbs (23.9%) and inability to relax (20.8%).

Just over one third (37.5%) reported gaining weight as a medication side effect. These people reported weight gains of nine kilograms on average over the past six months. The amount reported gained was a little higher for males (10 kilograms) than females (nine kilograms) and for the younger age group (10 kilograms) compared to the older age group (nine kilograms).

Figure 15-2. Side effects in past 4 weeks attributed to medication for mental health problems


Refer to the following list for a text equivalent of figure 15-2. Side effects in past 4 weeks attributed to medication for mental health problems

Text version of figure 15-2

Side effects in past 4 weeks attributed to medication for mental health problems:
  • Drowsiness, sleepiness during day - 44.7%
  • Mouth dry or more watery than normal - 39.5%
  • Increase in weight - 37.5%
  • Inner restlessness - 25.8%
  • Trembling, shaking hand/arm/leg - 23.9%
  • Inability to relax - 20.8%
  • Inability to stand still, desire to move legs, pacing - 19.3%
  • Stiff, tensed muscles - 19%
  • Increased dreaming - 18.6%
  • Dizziness or vertigo - 18.6%
  • Trouble with eyesight - 17.2%
  • Unsteady when standing or walking - 16.8%
  • Slowing down of movements - 16.4%
  • Change in interest in sex - 16.2%
  • Nauseous/feeling sick - 15.9%
  • Constipation - 15.8%
  • Increased sweating - 15.1%
  • Period pain or change in frequency (women only) - 12.2%
  • Palpitations - 11.8%
  • Difficulty swallowing - 11.2%
  • Sexual dysfunction - 10.4%
  • Shuffling along - 7.2%
  • Skin rashes - 7.1%
  • Unwanted tongue movement - 7.0%
  • Swollen tender chest - 3.6%
  • Decrease in weight - 3.3.%
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15.6 Psychosocial therapies

Psychosocial interventions are playing an increasingly important role in the treatment of psychosis. However, the proportion of participants accessing psychosocial therapies was relatively small. The most common of the interventions participants had used were talking therapies, such as counselling, psychotherapy and group therapy (30.5%), cognitive behavioural therapy (22.3%) and family therapy (11.4%).

Figure 15-3 shows that females received more of these services than males, with just over one third (37.1%) receiving counselling, psychotherapy or group therapy compared with 26.0% of males, and 28.5% receiving cognitive behavioural therapy compared with 18.1% of males.

There was little difference in the use of psychotherapies between the younger and older age groups (figure 15-4).

Figure 15-3. Use of psychosocial therapies in past year by sex


Refer to the following table for a text equivalent of figure 15-3. Use of psychosocial therapies in past year by sex

Text version of figure 15-3

Male (%)Female (%)
Counselling, psychotherapy or group therapy
26
37.1
Cognitive behavioural therapy
18.1
28.5
Family intervention
11.1
11.8

Figure 15-4. Use of psychosocial therapies in past year by age group


Refer to the following table for a text equivalent of figure 15-4. Use of psychosocial therapies in past year by age group

Text version of figure 15-4

18-34 years (%)35-64 years (%)
Counselling, psychotherapy or group therapy
30.7
30.4
Cognitive behavioural therapy
24.6
20.6
Family intervention
14.4
9.2