People living with psychotic illness 2010
15 MEDICATION USE AND 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.
15.2Supplements 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).
71
72
People living with psychotic illness 2010
Figure 15-1. Current medication use
Mental Health Problems
Antipsychotic
74.0
Atypical antipsychotics: All
Clozapine
16.4
Typical antipsychotics
15.2
Other
Antidepressants
37.4
26.7
Mood stabilisers
17.8
Anxiolytics, hypnotics, sedatives
Anticholinergics
4.2
Alcohol, nicotine or opioid dependence related
3.5
91.6
Total on medication for mental health
21.9
Supplements for mental health
Physical conditions
Cardiovascular
18.2
14.7
Endocrine (any)
12.8
Gastrointestinal
6.0
Respiratory
Blood and electrolytes
4.0
Neurological
3.8
Musculoskeletal
3.7
Genitourinary 0.8
41.1
Total on medication for physical health
0
10 20 30 40 50 60 70 80 90 100
Proportion (%)
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
Level of relief from symptoms
Proportion (%)
A lot
57.2
A little
28.2
Not at all
9.6
Not known
5.0
Total respondents
1,672
People living with psychotic illness 2010
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
Drowsiness, sleepiness during day
44.7
39.5
Mouth dry or more watery than normal
37.5
Increase in weight
25.8
Inner restlessness
Trembling, shaking hand/arm/leg
23.9
20.8
Inability to relax
Inability to stand still, desire to move legs, pacing
19.3
Stiff, tensed muscles
19.0
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
0
10
20
30
40
Proportion (%)
50
60
73
74
People living with psychotic illness 2010
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.
Figure 15-3. Use of psychosocial therapies in past year by sex
Counselling, psychotherapy
or group therapy
Counselling, psychotherapy
or group therapy
therapy
Cognitive behavioural
26.0
18.1
Cognitive behavioural therapy
Family intervention
Family intervention
0
11.1
11.8
11.1
11.8
10
0
10
37.1
26.0
37.1
28.5
18.1
28.5
20
Proportion (%)
20
Proportion (%)
30
Male
Female
Male
Female
40
30
40
There was little difference in the use of psychotherapies between the younger and older age groups
(Figure 15-4).
Figure 15-4. Use of psychosocial therapies in past year by age group
Counselling, psychotherapy
or group therapy
Counselling, psychotherapy
or group therapy
therapy
Cognitive behavioural
24.6
20.6
Cognitive behavioural therapy
Family intervention
Family intervention
30.7
30.4
30.7
30.4
14.4
9.2
0
9.2
10
0
10
20.6
14.4
20
Proportion (%)
20
Proportion (%)
24.6
18-34 (years)
35-64 (years)
18-34 (years)
30
35-64 (years)
40
30
40