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the these disorders. Their main drawback is their addiction potential,
hence there are inappropriate for long-term use. They have very
limited side effects; hence they are superior to all other psychotropic
medications. Infrequent use is the most beneficial way to treat
occasional anxiety.

Psychotic Disorders

Psychosis is a very common presentation in this population. This may
include paranoid ideation, delusions and even frank hallucination.
Patients may not understand the seriousness of psychosis, and the
evaluator has to ask specific questions about hearing voices, seeing
things, confusion, and thinking problems. If anger and impulsivity
compound psychosis, disastourous results may affect such patients for
the rest of their lives. In most situations, hallucinations require
immediate if not urgent evaluation and intervention.

Psychosis is commonly seen with depression, although it can present
itself as “drug induced” psychosis, which improves fast. Visual
hallucinations are more common with drug induced psychosis and
mania, and auditory hallucinations are more common in schizophrenia.
Only 1-2% of this population is truly schizophrenic, and requires long-
term care and sometimes institutionalization. Although there are
different forms of schizophrenia, for practical purposes and treatment,
there are grouped together as one major diagnosis category. Typically,
schizophrenic are treated by department of mental health due to the
chronic nature of this disease.

Typical antipsychotics, like Haldol, Navane and Stelazine are rarely
used nowadays due to their long-term side effects. Atypical or newer
antipsychoticts have less side effect profile, are better tolerated, hence
compliance is better. Not only psychosis improves, but depression, to
some extent, also gets better with these newer agents. There are six
agents approved for use in this country, and include Clozaril, Zyprexa,
Seroquel, Geodon, Abilify and Risperdal.

Polypharmacy is a term used when more than two or three psychiatric
medications are used. Apart from cost, added intolerable side effects,