Antipsychotic Medications

Living with a mental health condition can feel overwhelming, especially when symptoms cause hallucinations, illogical thoughts, or a disconnection from reality. For many, antipsychotic medications offer a pathway to stability, helping people reclaim their daily routines, maintain relationships, and improve overall well-being. Although the idea of taking antipsychotic medication can be daunting, learning how antipsychotics work can often ease uncertainty. The more informed someone is, the more empowered they become.

Defining Antipsychotic Medications

Antipsychotic medications are mainly used to help manage symptoms of psychosis, such as delusions, disorganized thinking, and hallucinations. Thus, these medications don’t cure mental health conditions. Still, they can significantly reduce or control distressing symptoms, making it easier for someone to participate in therapy, maintain relationships, and live more productively ^[1].

While scientists are still unclear precisely how antipsychotics decrease psychosis symptoms, they believe they restore chemical balance in the brain. Symptoms of psychosis are often linked to excessive activity of dopamine, a type of neurotransmitter. To help reduce this overactivity and limit psychotic symptoms, most antipsychotics work by blocking dopamine receptors. Additionally, some types of antipsychotics block receptors for other neurotransmitters, such as serotonin, but it’s unclear whether this makes them more effective ^[2].

As one might expect, different types of antipsychotics create different potential benefits and side effects. What’s more, thanks to a host of personal variables (e.g., physical health, other medications being taken, etc.), people react differently to the same antipsychotic ^[3]. Thus, it may take some time for healthcare providers and patients to identify the antipsychotic with the most benefits and least side effects for each person. For many, however, this time is well spent, as the wide range of antipsychotic options gives people multiple paths to relief.

Antipsychotic Drug Types

Antipsychotic medications fall into two main categories: typical (first-generation) and atypical (second-generation). Both types seem to reduce symptoms of psychosis, but they differ in how they interact with brain chemicals and in the side effects they can cause.

Typical antipsychotics primarily block dopamine receptors to relieve symptoms. However, they come with several significant side effects, including movement-related issues such as tremors or muscle stiffness, as well as dry mouth, constipation, and urinary retention ^[4]. Typical antipsychotic medications include: chlorpromazine (Thorazine), thioridazine (Mellari), fluphenazine (Prolixin), haloperidol (Haldol), and loxapine (Adusuve) ^[1].

Making up roughly 95% of antipsychotics prescribed in the United States today, atypical antipsychotics block both dopamine and serotonin receptors. Despite their popularity, however, science hasn’t definitively proven them to be more effective. Instead, their prevalence is more likely because they offer less troublesome side effects than typical antipsychotics ^[2]. While atypical antipsychotics are associated with significant weight gain and the development of metabolic syndrome, they have fewer movement-related side effects, which can be particularly disruptive ^[4]. Examples of atypical antipsychotics include: brexipiprazole (Rexulti), cariprazine (Vraylar), lumateperone (Caplyta), lurasidone (Latuda), and quetiapine (Seroquel) ^[1].

Another atypical antipsychotic, clozapine, stands out for its effectiveness in treating those who haven’t responded to other medications. However, clozapine carries serious risks such as seizures and suppression of bone marrow activity, which can lead to a rare but dangerous drop in white blood cells. Because of this, people taking clozapine require frequent blood monitoring and close medical supervision ^[2].

Conditions Treated with Antipsychotics

Although antipsychotics are commonly linked with the treatment of schizophrenia and its related spectrum of disorders, antipsychotics are also used to treat the following conditions ^[1]:

• Bipolar disorder
• Mania
• Major depressive disorder (with psychosis)
• Delusional disorder
• Severe agitation
• Borderline personality disorder
• Dementia and delirium 
• Substance-induced psychotic disorder

Additionally, some healthcare providers employ antipsychotics as a complementary treatment for other conditions such as: obsessive-compulsive disorder (OCD), tourette syndrome, Huntington’s disease, Parkinson’s disease, and Lesch-Nyhan syndrome ^[1].

When used as prescribed, antipsychotics seem to offer relief for a host of distressing symptoms across a wide range of conditions. However, as with all other mental health medications, their versatility highlights the importance of personalized treatment planning and ongoing medical guidance.

Antipsychotic Side Effects

Along with the aforementioned side effects specific to typical and atypical antipsychotics, several additional side effects are associated with antipsychotic medications, including drowsiness, muscle stiffness, tremors, and restlessness. In addition, rare but potentially fatal conditions such as neuroleptic malignant syndrome (characterized by fever, muscle rigidity, hypertension, and changes in mental function) and long-QT syndrome (a heart-rhythm disorder) have also been reported ^[2].

While usually only seen in elderly patients or those undergoing long-term treatment with antipsychotics, tardive dyskinesia is a particularly troubling potential side effect ^[3]. Symptoms of this hyperactive involuntary movement disorder include writing of the arms or legs and puckering of the tongue or lips. Although tardive dyskinesia is more common with the use of typical as opposed to atypical antipsychotics, once the condition develops, it may persist even after use of antipsychotics is stopped ^[2].

Stigma Around Antipsychotic Medications

Despite their potential benefits, many people view antipsychotic medications through a lens of stigma and misunderstanding. Some assume doctors prescribe them only in extreme cases or believe that taking them signals a person is out of control or poses a danger to themselves or others. These stigmas and stereotypes around mental illness not only misrepresent the reality of mental disorders but can also discourage people from seeking effective treatment ^[5].

Stigma can take many forms, from internalized shame to judgment from family, friends, or society. For someone managing a mental health condition, this pressure can create emotional barriers to starting or continuing medication. It may also lead to secrecy, delay in care, or abrupt discontinuation of treatment, all of which can interfere with recovery.

The reality is that antipsychotic medications are legitimate medical treatments that help many people manage their symptoms. Just as someone with diabetes needs insulin or someone with high blood pressure needs medication, people with certain mental health conditions may need antipsychotics to maintain their health and well-being. Promoting open dialogue and education helps build a culture where seeking help is seen as a sign of strength, not shame. 

Additional Psychosis Treatment Options

Antipsychotic medications are often a key part of psychosis treatment, but they are rarely used in isolation. For most people, the best outcomes are born of a combination of treatment approaches tailored to their needs, symptoms, and life circumstances. This might include therapy, social support, lifestyle changes, medication, and structured care programs ^[6].

Many treatment plans include therapy to help address thought patterns and behaviors, along with self-care strategies that support long-term well-being. Together, these components offer a more comprehensive path to recovery than medication alone.

Psychotherapy

While not a substitute for medications, psychotherapy plays an essential role in treating psychosis. One widely used approach is cognitive behavioral therapy (CBT), which helps people identify and reframe unhelpful thoughts, manage stress, and develop practical coping strategies. For those experiencing delusions or hallucinations, CBT can also provide tools to reduce distress and improve insight into symptoms ^[7].

Family interventions are another valuable component. These sessions focus on improving communication, reducing stress within the household, and helping everyone understand the nature of psychosis. The idea is that stronger support systems can lead to better outcomes and reduce the likelihood of relapse ^[7].

In addition to personal and family therapy, some people benefit from group therapy or peer support groups. These settings offer connection, shared experiences, and encouragement, which can ease feelings of isolation and promote a sense of belonging ^[7].

Self-Care Strategies

Self-care is a vital, though often overlooked, part of managing psychosis and maintaining mental health. While medication and therapy address symptoms directly, daily habits and routines can make a meaningful difference in long-term stability and quality of life. Small, consistent choices often add up to a stronger foundation for recovery ^[6].

Basic self-care strategies include getting enough sleep, eating nutritious meals, and staying physically active, all of which support brain health and emotional balance. Avoiding alcohol and recreational drugs is especially important, as substance use might worsen symptoms or interfere with medications. 

Creating a structured daily routine can also help reduce stress and confusion, particularly during times of instability. Meanwhile, practicing stress-reduction techniques like deep breathing, mindfulness, or journaling can provide a sense of calm and control.

Mental Health Treatment Programs

To meet each person’s unique needs, comprehensive mental health care often combines multiple approaches, including medication, therapy, skill-building, and supportive environments. Often, these approaches are combined into a comprehensive treatment program. Professional programs for mental health treatment include:

• Inpatient or Residential Treatment: This level of care offers 24-hour support in a structured environment. It’s often used during severe episodes or when someone is at risk of harming themselves or others. Inpatient treatment provides immediate stabilization and ongoing access to medical and psychiatric professionals.
• Partial Hospitalization Program (PHP): A PHP is a step down from inpatient care but is still highly structured. People attend treatment during the day, usually multiple days a week, and return home in the evenings. It allows for intensive therapy and medication management without full hospitalization.
• Intensive Outpatient Program (IOP): IOPs provide a flexible yet supportive setting for those who need more than weekly therapy but don’t require daily care. Programs typically meet three to five times a week and focus on group therapy, coping skills, and relapse prevention.
• Outpatient Treatment: Outpatient care includes regular appointments with a therapist, psychiatrist, or treatment team. It’s often used for ongoing maintenance, medication follow-up, or step-down care after a more intensive program.

Choosing the right combination of services helps create a personalized, sustainable plan for long-term mental health and well-being.

A Personal Path Toward Wellness

Antipsychotic medications offer hope and stability to many people living with psychiatric conditions. Particularly when combined with therapy, support systems, and self-care strategies, these medications can help people manage their symptoms effectively and regain their quality of life.

Finding the right treatment combination might take time, and side effects and stigma may present challenges. However, numerous medication options and levels of care are available to help people regain clarity, reconnect with others, and rebuild a sense of control in their lives. Armed with proper medical supervision and mental health support, people can find their unique path toward stability, hope, and new possibilities.