antipsychotica

Antipsychotica (often written antipsychotics in English) are medications used to treat psychotic disorders, notably schizophrenia, as well as bipolar disorder with psychotic features and some forms of mood-related psychosis. They help reduce hallucinations, delusions, and disorganized thinking and may aid in agitation management. They are available in oral formulations and long-acting injectable forms.

There are two main groups: typical (first-generation) and atypical (second-generation) antipsychotics. Typical agents, such as haloperidol and chlorpromazine, mainly block dopamine D2 receptors. They are effective for positive symptoms but carry a higher risk of extrapyramidal symptoms (EPS) and tardive dyskinesia with long-term use. Atypical antipsychotics, such as risperidone, olanzapine, quetiapine, aripiprazole, ziprasidone, and clozapine, block dopamine and serotonin receptors. They generally have lower EPS risk but can cause metabolic side effects (weight gain, dyslipidemia, diabetes). Clozapine is reserved for treatment-resistant cases and requires regular blood monitoring due to the risk of agranulocytosis.

Common adverse effects include EPS, akathisia, dystonia, sedation, anticholinergic effects, weight gain, metabolic disturbances, and hyperprolactinemia. Some agents may prolong the QT interval. Clozapine-specific monitoring is mandatory in many countries, and drug interactions with sedatives or medications affecting heart rhythm are possible.

Safety considerations include avoiding use for dementia-related psychosis in the elderly due to higher mortality risk and monitoring for metabolic and cardiovascular side effects. Antipsychotica are generally prescribed as part of a comprehensive treatment plan, including psychotherapy and social support.