Antipsychotics

Antipsychotics are used in the treatment of mental disorders, including schizophrenia, bipolar disorder, and other severe mood disorders.

These medications effectively relieve alleviate psychotic symptoms such as hallucinations, delusions thoughts, and other manifestations like aggression or disorganized thinking.

Antipsychotics exert their therapeutic effects by modulating neurotransmitters in the brain, such as dopamine and serotonin.

Antipsychotics are prescribed for the following conditions:

• Schizophrenia
• Psychosis

In children and adolescents, they are used for conditions such as:

• Childhood psychoses (early onset schizophrenia, bipolar disorder, depression)
• Tourette’s syndrome
• ADHD
• Severe conduct disorders

Common side effects of antipsychotic medications include:

• Parkinson's-like symptoms such as tremors or muscle stiffness
• Dystonia (involuntary muscle contraction)
• Tardive dyskinesia (involuntary twisting movements that may affect the face, mouth, and body)
• Drowsiness
• Weight gain

The classical antipsychotics have been haloperidol and chlorpromazine. Currently, there are more than 100 antipsychotic medications used depending on whether they are for acute episodes or chronic treatment.

Antipsychotic medications are characterized by their antagonism of the dopamine receptor, although many also act on other receptors, such as serotonin (5-HT).

These medications can be classified into:

• Typical or first generation: They primarily act by blocking the dopamine receptor 2 in the brain.
  • Haloperidol (for schizophrenia) and chlorpromazine: Used to treat schizophrenia, bipolar disorder, and other mental disorders.
  • Other typical antipsychotics include perphenazine, fluphenazine, pimozide, zuclopenthixol, flupentixol, and loxapine.
• Atypical or second generation: In addition to dopamine receptors, they affect other neurotransmitters like serotonin.
  • Risperidone (with paliperidone as a derivative): Used for psychosis with potential adverse effect like insomnia or agitation.
  • Clozapine (olanzapine is very similar): Used for schizophrenia that does not respond to classical antipsychotics.
  • Sertindole: Indicated for schizophrenia.
  • Quetiapine: Used for schizophrenia and mania.
  • Aripiprazole: For schizophrenia in adults and children over 13 years.
  • Lurasidone: For schizophrenia and bipolar disorder.
  • Ziprasidone: Treatment for schizophrenia and mania associated with bipolar disorder.