Antipsychotics

Antipsychotics are a class of medication primarily used to manage psychosis, including delusions, hallucinations, paranoia, or disordered thought, principally in conditions such as schizophrenia and bipolar disorder. They are also increasingly being used in the management of non-psychotic disorders.

Types of Antipsychotics

Antipsychotics are broadly classified into two categories:

• Typical antipsychotics (also known as first-generation antipsychotics)
• Atypical antipsychotics (also known as second-generation antipsychotics)

Typical Antipsychotics

Typical antipsychotics, discovered in the 1950s, are known for their effectiveness in treating the positive symptoms of schizophrenia, such as hallucinations and delusions. However, they are associated with a higher risk of extrapyramidal symptoms (EPS), which are drug-induced movement disorders.

Atypical Antipsychotics

Atypical antipsychotics, developed more recently, are used to treat both the positive and negative symptoms of schizophrenia. They are generally preferred over typical antipsychotics due to their lower risk of EPS. However, they can be associated with other side effects such as weight gain, diabetes, and dyslipidemia.

Mechanism of Action

Antipsychotics primarily work by blocking dopamine receptors in the brain, particularly the D2 receptors. This action helps to reduce the symptoms of psychosis. Atypical antipsychotics also affect other neurotransmitter systems, such as serotonin receptors, which may contribute to their efficacy and side effect profile.

Uses

Antipsychotics are used to treat a variety of mental health conditions, including:

• Schizophrenia
• Bipolar disorder
• Major depressive disorder (as an adjunct)
• Tourette syndrome
• Autism spectrum disorder (for irritability)

Side Effects

Common side effects of antipsychotics include:

• Sedation
• Weight gain
• Metabolic syndrome
• Extrapyramidal symptoms
• Tardive dyskinesia
• Hyperprolactinemia

History

The first antipsychotic, chlorpromazine, was discovered in the 1950s. This discovery revolutionized the treatment of psychosis and led to the development of many other antipsychotic drugs.

Controversies

The use of antipsychotics, particularly in children and the elderly, has been controversial due to concerns about over-prescription and the potential for severe side effects.

See Also

• Psychiatry
• Psychopharmacology
• Mood stabilizer
• Antidepressant
• Anxiolytic