OPIOIDS &

ATYPICAL
ANTIPSYCHOTICS
A resource for people who use drugs

A BIT ABOUT ATYPICAL ANTIPSYCHOTICS

Atypical antipsychotics are the most common type of antipsychotics used in
Australia and are mainly prescribed for schizophrenia, psychosis and bipolar
disorder. They can also sometimes be used for anxiety, sleep problems and drug
withdrawal.
It is generally believed that the neurotransmitter dopamine plays an important
role in some of these conditions. People with schizophrenia or psychosis may
have difficulty regulating dopamine levels and the atypical antipsychotic may
work to treat psychosis by decreasing the level of dopamine and dampening
down activity in the dopamine system.
Atypical antipsychotics also affect serotonin, another neurotransmitter in
the brain which regulates mood, sleep and appetite. It is thought atypical
antipsychotics may help with the treatment of negative symptoms associated
with schizophrenia, like difficulty thinking and lack of motivation.

SOME OF THE SIDE EFFECTS

Drowsiness is one of the most common side effects of atypical antipsychotics.
Some atypical antipsychotics (such as clozapine, olanzapine, risperidone and
quetiapine) can increase your appetite and lead to weight gain. Other side effects
can include anxiety, agitation, a feeling of being unable to sit still, drowsiness,
hormonal changes and an increased heart rate.

FOR EXAMPLE:
Amisulpride (e.g. Solian)
Aripiprazole (e.g. Abilify)
Asenapine (e.g. Saphris)
Clozapine (e.g. Clozaril)
Lurasidone (e.g. Latuda)
Olanzapine (e.g. Zyprexa)
Paliperidone (e.g. Invega)
Quetiapine (e.g. Seroquel)
Risperidone (e.g. Risperdal)

1. Normal function

DOPAMINERGIC
NEURON

2. With atypical

Sometimes people get something called extrapyramidal side effects these are
symptoms which can look a bit like Parkinsons disease. This includes trouble
moving, shuffling walk, muscle stiffness, spasms and tremor. Let your GP know
straight away if this happens to you.
Of particular note, people taking clozapine require regular blood tests to check
their white blood cell levels. Clozapine can occasionally cause a loss of these
blood cells and this can be very dangerous.

Supported by:

The information provided in these fact sheets are a guide only. We recommend speaking with
your GP or prescriber about your individual circumstances.

IN THE CASE OF AN EMERGENCY, DIAL 000

For more information visit

www.qnada.org.au

OPIOIDS & ATYPICAL ANTIPSYCHOTICS

HOW OPIOIDS WORK
Opioids act on many places
in the brain and nervous system

Some opioids are compounds extracted from poppies,

whereas others (eg fentanyl or methadone) are synthetic.
Opioids depress the central nervous system, slowing
down messages from your brain to your body. They bind
to opioid receptors in your brain and spinal cord the
areas that deliver pain messages, thereby offering pain
relief. Opioids can slow your breathing, lower blood
pressure and pulse, cause an irregular heartbeat and
lower body temperature.

Opioids affect the limbic system, which

controls emotions to increase feelings
of pleasure.
Opioids affect the brain stem, an area that
regulates automatic body functions e.g.
breathing.

Tolerance to opioids can develop rapidly. Over time, they

can modify and slow down brain function.

Opioids block pain messages from being

transmitted to the body.

The specific ingredients in street heroin are unknown

and this presents an additional risk - it depends on who
manufactured it and where. This obviously makes it
difficult to predict the types of interactions it may have
with other drugs or medications.

SOME FUN FACTS ABOUT OPIOIDS

THE GOOD

THE BAD

THE REALLY BAD

Opioids manage pain

Hyperanalgesia (an increase in sensitivity

to pain)

Frequent use can quickly lead to

dependence

Intensifies feelings of pleasure

Can cause mood swings

Risk of overdose

Can increase feelings of wellbeing

Depression and memory impairment can

occur

Risk of injecting related harm such as

blood borne viruses

Skin, heart and lung infections

Heart, liver, lung and brain damage

WHAT HAPPENS WHEN YOU TAKE OPIOIDS

AND ATYPICAL ANTIPSYCHOTICS TOGETHER?
This resource provides general advice regarding some of the
potential side effects of using opioids and atypical antipsychotics
together. Opioids include prescription drugs such as tramadol
and fentanyl and also include illicit drugs such as heroin. It is
important to note there may be additional or different interactions
depending on genetic factors, the amount, type and purity of the
opioids you are consuming or if you are also taking other types
of drugs. As these resources provide general advice only, please
speak with your GP, prescriber or health professional for more
information about potential interactions and impacts.
Both opioids and atypical antipsychotics are central nervous
system depressants, meaning that they suppress your brain
activity and slow down the messages your brain sends out to

your body. Combining an atypical antipsychotic with opioids can

make you excessively drowsy and can even slow (or stop) your
breathing and heart rate, leading to a coma or death.
For some people, combining methadone or heroin with an
antipsychotic can have dangerous effects on heart function and
should be avoided.
It isnt recommended to take opioids and atypical
antipsychotics together, so make sure you speak with your GP
about your options to see if an atypical antipsychotic is the
right drug for you.

Supported by:

The information provided in these fact sheets are a guide only. We recommend speaking with
your GP or prescriber about your individual circumstances.

IN THE CASE OF AN EMERGENCY, DIAL 000

For more information visit

www.qnada.org.au