A number of factors go into the selection of which antipsychotic might be best to use in acute mania, a mixed episode, or depression with psychosis.
Factors that steer the decision may include:
• Patient choice, Have you been on a medication that agrees with you and has worked in the past?
• Side effect profile, Each of the antipsychotics has a unique side-effect profile. Some, which are very sedating, can be useful when treating someone with insomnia and daytime agitation. Or, if someone is feeling too sedated, the choice might be to use one that is more potent and less sedating.
• Cost, Will you be able to afford this medication? Is it covered on your insurance? Do you even have insurance?
• Drug interactions, Will this negatively interact with your other medications?
• Monitoring concerns, Is this a medication, like clozapine (Clozaril), that will require close monitoring and frequent blood work? Will this be too impractical?
• Medical concerns, Do you have other medical problems that will make particular medications less, or more, desirable.
• What forms of the medication are available? Is there a longacting form, a liquid, or an injectible?