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What are Antipsychotics?

Mary McMahon
Updated Mar 03, 2024
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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.

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Mary McMahon
By Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a The Health Board researcher and writer. Mary has a liberal arts degree from Goddard College and spends her free time reading, cooking, and exploring the great outdoors.

Discussion Comments

By anon344636 — On Aug 11, 2013

They numb you but sometimes its necessary if you are manic and won't quit with mere words. The problem is the akanthesia (makes you keep moving about one hour after taking them). It's a catch-22 situation. After stopping, you act more bizarre than you did to begin with. Why can't a drug be formulated that doesn't hurt you in another way?

By anon326873 — On Mar 24, 2013

I would just like to clarify something, if I may. I don't have schizophrenia, but I have taken antipsychotics for another reason.

In my personal experience, the personality changes you speak of (as part of schizophrenia) are in fact, caused by the medication itself. These drugs turned me into a shell of a person, anesthetized me, and damaged my brain.

When you are dead inside, (the side effect akinesia), due to a drug, obviously your personality changes. This is due to the drugs themselves, not the condition.

I'm not saying everyone should go off their meds, but only the newer style drugs should be used, sparingly, in the lowest dose possible, they should be used only for psychosis and schizophrenia, and in conjunction with cognitive behavioural therapy.

By anon277300 — On Jun 29, 2012

Why would you put this crap into you're body? When it makes such a dramatic impact. It is a wonder that they're legal. The last thing a person who is already vulnerable needs is this.

They don't solve the problem. They just cover it up and then when you are "feeling well" the symptoms come back but even worse, because the body has been messed around with.

And with all those horrible side effects, I don't know what's best. None of it is good enough. The scientists have to find a way out. There has not been enough proper research done on mental illness.

By allenJo — On Feb 16, 2012

I would like to say these drugs work wonders, but sometimes I think they create more problems. I had a friend who could never hold down a job and also suffered from mild forms of paranoia, where he always thought that people were out to get him.

Finally he agreed to take antipsychotic medication. While it caused him to be a little subdued, the condition eventually got worse. He finally had to get off the medication and one of his doctors honestly confided that the medication was not that helpful.

My friend got involved in therapy which seemed to help him. But I think he should have never gotten on the drugs to begin with. Doctors prescribe this stuff too easily in my opinion.

By SarahSon — On Feb 15, 2012

@JaneAir - Antipsychotic medications are very expensive and I don't know how people without insurance are able to afford them.

I have a friend who is on total disability because of her mental condition. Because of this, her medications are paid for and she does not have to work.

Honestly, I don't know how she would be able to hold down a job. Even when she takes her medications as directed, she would not be able to handle a full time job.

The antipsychotics help keep her stable, but without assistance, she would really be in bad shape.

By julies — On Feb 14, 2012

Do they prescribe antipsychotics for dementia? We are noticing my grandpa is having a hard time remembering anything.

Along with this dementia, we have also seen personality changes and some aggressive behavior.

One day he seems just fine and everything appears fine, and the next day he doesn't remember who you are. There have been a few violent episodes towards my grandma, and these are becoming more frequent.

I know he is going to have some testing done, and wonder if the right antipsychotic medication would help with some of these symptoms.

My grandma is hoping to keep him at home as long as possible, but doesn't know how much longer she will be able to do so.

By myharley — On Feb 14, 2012

Any kind of mental illness is hard for everyone to deal with. One of my aunts takes antipsychotics for bipolar disorder.

I know this has been just as hard on my uncle as her caretaker, as it is on my aunt. One of the things they struggle with most is how she feels after taking the antipsychotic drugs on a regular basis.

My aunt gets to the point where she is feeling pretty good and no longer feels like she needs to take the medication. The last thing you want to do is abruptly stop taking medications like this.

It doesn't take long for the symptoms to return, and many times they come back with a vengeance. My uncle has to constantly monitor her medications to make sure she takes them on a regular basis no matter how well she thinks she is feeling.

By LisaLou — On Feb 13, 2012

My sister had some brain trauma as a result of a car accident when she was younger. As she has aged, this has resulted in a diagnosis of schizophrenia.

It has been quite a battle to find a medication that works for her on a long term basis. It seems like one will work for awhile, then it no longer helps with her symptoms.

It has been a long balancing act of trying different dosages and different medications. Before she started taking any antipsychotic drugs, she was having some strange personality changes and said her husband was a stranger.

While these drugs have made her life better in one sense, taking antipsychotics has caused weight gain too. She put on over 70 pounds over the course of a year of being on these medications.

By JaneAir — On Feb 13, 2012

When it comes to antipsychotic medicines, I worry about the price. I have a few friends that are on antidepressants who don't have insurance, and their medicine isn't cheap. I imagine that antipsychotics are probably expensive as well.

I doubt someone with a psychotic disorder can hold down a job when they're unmedicated, so how would they ever get the money together to go on antipsychotic medications?

I personally think this medicine should be discounted for people that truly need it. I think it would benefit all of society.

By strawCake — On Feb 12, 2012

@JessicaLynn - Yeah, since antipsychotics interfere with brain chemistry, I don't think it's a very good idea to use them in children. We just don't know what the long term effects are.

If I feel comfortable with anyone using antipsychotics, elderly people would be it. When you're elderly, your brain has already finished developing. So, if antipsychotics can help with disorders like dementia that affect the elderly, I think it's worth a try.

Imagine spending your whole life filling your brain with knowledge and memories, only to have it taken away? I think I would risk the side effects in that case.

By JessicaLynn — On Feb 12, 2012

@ysmina - I have never heard of such a thing, although it is true that the general public is safer when psychotic people are treated for their disorders. However, I believe it is better for the psychotic person as well.

People with psychotic disorders often experience very scary hallucinations and changes to their personality. I don't know about you, but that sounds pretty awful. It's obviously better to treat these symptoms than just leave them alone.

I will say, though, that I don't agree with the use of this second generation antipsychotics for something like Asperger's syndrome. Asperger's isn't a psychotic illness, so this makes no sense to me.

By ysmina — On Feb 11, 2012

@feruze-- Just as this article implied, I've read that antipsyhotic drugs permanently alter the brain by limiting blood flow to one part. If I remember correctly, I believe it is the frontal lobe of the brain that is affected by the drugs and shrink over time as the medication is used regularly.

Some people even say that newer antipsychotics are used to control individuals with psychotic illness to prevent any negative effects on society. If that's true, it's not really a treatment, but rather a safety precaution for people who come in contact with this individual on a regular basis.

Has anyone heard about this? Do you think this is true? Do you think that there are alternative treatments out there for psychotic illnesses instead of antipsychotics?

By bear78 — On Feb 10, 2012

@Perdido-- The reason for this is that antipsychotics are highly addictive as most drugs that alter the functions of the brain, including antidepressants and anti-anxiety medications. And the longer that an individual is on them, the harder it is to quit the medication and the more serious the withdrawal symptoms will be.

So someone who has been on antipsychotics for more than six months can expect to have some bad withdrawal effects if he or she skips or lowers a dose. If the dose is lowered very slowly and over a long period of time, the side effects will be more easier to deal with.

But most psychotic illnesses which require typical and atypical antipsychotic drugs are seen as a life-long treatment. Doctors don't usually use it as a temporary treatment, and don't expect the patient to quit abruptly.

By fify — On Feb 09, 2012

Psychotic illnesses run on my dad's side of the family. He is bi-polar and even though his father was never diagnosed, he has all of the same symptoms as well.

From my dad's experience with antipsychotic drugs and everyone else I've met who have been on them, they sound horrible. My dad gained a lot of weight while on them and he pretty much became dysfunctional and couldn't even go to work. It was like he was spaced out all of the time and just wanted to sleep all day.

He seemed much better off when he wasn't on them. Granted he had some issues and was highly irritable and angry. He would be real nice one second and so mean and ruthless the next. But at least he could do every-day things, go to work, buy groceries, meet friends and so forth. Antipsychotics seemed to just "numb" him instead of dealing with the root causes of his illness.

By lighth0se33 — On Feb 09, 2012

My grandmother's doctor prescribed her an antipsychotic for her dementia. So far, it seems to be helping.

We knew something was up when she started getting very angry when we would disagree with her. She would insist that we went to the zoo yesterday, when in fact, we went three years ago.

One day, she wandered off into the woods alone. We were terrified when we found that she was missing, but we located her before nightfall.

My mother took her to the doctor right away, and he decided that she needed help in the form of an antipsychotic drug. I don't know how conventional this treatment is for dementia, but it appears to be working for her.

By Oceana — On Feb 09, 2012

Antipsychotics for schizophrenia work wonders. I have an aunt with this disorder, and though I know she will never be cured from it, the antipsychotics have made her life bearable.

I remember before she started taking medication for it. She would talk to invisible people, and she would become extremely agitated when the conversations weren't going well.

When she started cutting herself because one of the voices she heard told her that this was the only way to rid herself of the voice, my uncle had her committed. While she was in the facility, she started taking an antipsychotic drug, and it made her sane enough to have a normal conversation with us.

By kylee07drg — On Feb 08, 2012

@Perdido – The withdrawal effects are very noticeable and unpleasant. I have a close friend who is bipolar, and it is scary how dependent she is on her medication.

I suppose just as a person with chronic high blood pressure will have to take medicine to treat that for the rest of their life, a person with a mental disorder needs their medicine. It is sad to think what would happen to my friend if she ever became stranded somewhere without it.

She had been on antipsychotics for a year when she went on vacation with me and forgot them. She became extremely agitated, and she went back and forth between sobbing and screaming. I thought she was in danger of committing suicide, so I called her doctor and had him call in her medicine to a pharmacy near the hotel.

By Perdido — On Feb 07, 2012

I have often heard people describe someone with bizarre behavior as being “off their meds.” This must be because of the side effects of stopping the medication cold turkey.

I would imagine that since the condition these drugs are correcting is quite severe, suddenly being without the medication would be a shock to the system. I personally would not want to be around someone who had stopped taking their medication.

You often hear of murders that occurred because the murderer had quit taking their medicine, which they so desperately needed. Some lawyers have even argued for temporary insanity in such situations.

Mary McMahon

Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a...

Learn more
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