Antipsychotics are prescription drugs which are used to treat psychoses, a family of psychiatric conditions associated with a loss of connection with reality. In addition to being used for psychosis, antipsychotics are also used off-label to treat some other conditions, such as Asperger's Syndrome. Off-label use is controversial in some cases, reflecting the fact that antipsychotics have not been tested for such uses. Because antipsychotics interfere with brain chemistry, these drugs may also have long-term effects which have not been fully explored, an issue which is of special concern when antipsychotics are used on children.
Psychosis can take a number of forms. Mania, delusional disorders, bipolar disorder, and schizophrenia are all forms of psychosis, for example. As a general rule, psychotics are profoundly disconnected from reality, and they may experience hallucinations, disorganized thinking, changes in personality, and violent episodes. Antipsychotics are designed to help normalize the brains of psychotic patients so that additional therapeutic techniques such as sessions with a psychologist can be used.
All antipsychotics work in essentially the same way: they block the dopamine pathways in the brain, interfering with the function of this critical neurotransmitter. Different drugs block different receptors, with some being more specific, while others are more broad. Because brain chemistry can be very tricky, sometimes it takes multiple antipsychotics to find one which works, and the dosage may have to be experimented with as well. Most of these drugs have a tranquilizing effect, which leads some people to mislabel them as “tranquilizers.”
There are two main types of antipsychotics: typical, and atypical. Typical or first-generation antipsychotics were developed in the 1950s, when medical researchers really began understanding and experimenting with brain chemistry. Atypical antipsychotics were developed after the 1950s, and they are generally viewed as more advanced, since they target more specific pathways. You may also hear antipsychotics described as “neuroleptic” drugs.
These drugs come with a hefty list of side-effects, including weight gain, tremors, tachycardia, listlessness, repetitive movements, and twitching. It is also critical that these drugs be taken on time when they are used therapeutically, and that patients be weaned from antipsychotics, rather than being abruptly taken off the drugs. Sudden changes in dosage or timing can negatively impact brain chemistry, causing serious problems for the patient. For this reason, doctors usually discuss the use of antipsychotics carefully with patients and their caregivers, to ensure that everyone involved knows how to use the drugs safely.