Antipsychotic Medication

Antipsychotic medications act against the symptoms of psychotic disorders such as schizophrenia, bipolar, and delusional disorder. These medications cannot “cure” the illness, but they can reduce, or even eliminate the symptoms. The effects of antipsychotic medication can vary between users, some symptoms may diminish in days; others take weeks or months.  Once you begin an antipsychotic medication regimen, it is important to stay on the medication even after you feel better.  Medication should not be neglected or decreased without direct medication supervision.

Antipsychotic medication is a group of medication used primarily to treat psychotic features like bizarre behaviors, illogical speeches, delusions and hallucinations. Common diseases that present with psychotic features are schizophrenia, schizoaffective disorders, bipolar disorders and delusional disorders. The first antipsychotic medication was introduced in 1950. Later in the 1990’s, new generation antipsychotics were introduced to treat psychotic disorders.

Antipsychotic medications are currently classified into two main categories:

• Conventional, or Typical or First Generation antipsychotic.
• Atypical, or Second Generation antipsychotic.

First Generation: Blocks the dopamine system

Second Generation: Experts believe that the second generation antipsychotic medication blocks both the serotonin and dopamine system simultaneously instead of just the dopamine system like in the first generation medication. This unique nature of second-generation antipsychotic medication is thought to help patients by lessening:

• psychosis features like delusions, hallucinations, etc.
• negative features associated with psychotic disorders.
• neurological side effects compared to the first generation antipsychotics.

Nobody knows exactly how antipsychotic medications work but we shall focus on certain popular treatment logics understood by clinicians. Our focus will be on two brain chemicals called Dopamine and Serotonin. 

Experts believe that people experience psychotic thinking due to high or overactivity of dopamine brain chemical in certain parts of the brain known as the mesolimbic area. 

Normal dopamine activity in the brain = No psychotic thinking.

Overactivity of dopamine in the brain = Psychotic experience.  

When antipsychotic medication is taken, it blocks the dopamine system in your brain. This reduces the unwanted brain chemical overactivity, which inevitably reduces the psychotic experience. This improves the patient’s logical thinking and functioning.

Medications are usually prescribed to achieve a desired effect and when unwanted effects are noticed, they are classified as side effects. While the primary goal of antipsychotic medication is to reduce the dopamine overactivity, there may be some unwanted or undesired side effects experienced when the medication blocks all of the dopamine even in areas that does not need to be blocked. Common side effects of antipsychotic medications include the following:

Side Effects of Most Antipsychotics:

• Drowsiness
• Dry mouth
• Dizziness when changing positions
• Blurry vision
• Rapid heartbeat
• Sensitivity to the sun
• Skin rashes
• Menstrual problems for women.

Side Effects of Atypical Antipsychotics:

• Weight gain and changes in metabolism. (This may increase a person’s risk of getting diabetes and high cholesterol.)

Side Effects in Typical Antipsychotics:

• Persistent muscle spasms
• Tremors
• Restlessness.

Long-term use of typical antipsychotic medications may lead to a condition called tardive dyskinesia (TD) which is uncontrolled muscle movement