Table of ContentsView AllTable of ContentsKey Similarities and DifferencesTypical AntipsychoticsAtypical AntipsychoticsPrecautionsWho Should Avoid Them?
Table of ContentsView All
View All
Table of Contents
Key Similarities and Differences
Typical Antipsychotics
Atypical Antipsychotics
Precautions
Who Should Avoid Them?
Antipsychoticsare medications used to manage and treat symptoms ofpsychiatric disorders. There are two main categories of antipsychotics: typical and atypical.Typical antipsychotics have been around longer and are known as first-generation antipsychotics.Atypical antipsychotics are a newer class, known as second-generation antipsychotics.
While typical and atypical antipsychotics are effective treatment options for similar health conditions, they differ in many ways.
This article will highlight what you need to know about what typical and atypical antipsychotics are, what they are used for, how they work, and their potential risks and benefits.
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Understanding Typical Antipsychotics
Typical antipsychotics are a class of medications primarily used to treat psychiatric disorders likeschizophreniaand severe agitation.
Dopamine is a neurotransmitter involved in many functions, including mood, behavior, and perception. In some conditions, dopamine activity can become dysregulated. By blocking these receptors, typical antipsychotics help reduce the overactivity of dopamine, resulting in a decrease in psychotic symptoms.
Benefits of Typical Antipsychotics
Typical antipsychotics offer several benefits, particularly in the treatment of acute psychotic episodes and chronic psychiatric conditions like schizophrenia.
One of their primary advantages is their effectiveness in quickly reducing severe symptoms. This rapid action can be crucial in stabilizing during acute episodes, preventing harm, and facilitating recovery.
Additionally, typical antipsychotics have been used for a long time and have been well-studied. They are generally less expensive than atypical antipsychotics, making them a more accessible option for some. Despite their potential side effects, typical antipsychotics remain a valuable tool in managing psychotic disorders, especially when newer medications are not effective or available.
Side Effects of Typical Antipsychotics
Typical antipsychotics, while effective, are associated with several potential side effects that can impact quality of life.
Because they interfere with normal dopamine function, one of the most significant concerns is the risk ofextrapyramidal symptoms(EPS), meaning they can affect the motor system, including causing tremors, muscle stiffness, and involuntary movements.
These medications can also cause sedation (sleepiness), weight gain, and anticholinergic effects (blocking a chemical messenger in the brain that sends messages to nerves and muscles like dry mouth and constipation.
They may also increase the risk of developing cardiovascular issues, such asorthostatic hypotension, which occurs when blood pressure drops upon standing, leading to dizziness or fainting.
Due to these potential side effects, it is essential for those taking typical antipsychotics to have regular follow-ups with their healthcare provider to monitor their health and adjust treatment as needed.
List of Typical Antipsychotics
Typical antipsychotics were among the earliest antipsychoticsdeveloped and include the following medications:
Understanding Atypical Antipsychotics
In addition, typical antipsychotics also affectserotoninreceptors, which help improve mood and reduce negative symptoms, such as social withdrawal and lack of emotion. This dual action of dopamine and serotonin helps regulate neurotransmitter activity more broadly, which is believed to improve symptoms of schizophrenia and other psychotic disorders.
Benefits of Atypical Antipsychotics
Atypical antipsychotics offer several benefits in the treatment of psychiatric disorders. Their dual action makes them effective for a broader range of symptoms with fewer movement-related side effects compared to older antipsychotics.
One significant advantage is their broader spectrum of efficacy compared to typical antipsychotics.They are effective not only in alleviating positive symptoms such as hallucinations and delusions but also in addressing negative symptoms like social withdrawal and lack of motivation, which are often more challenging to treat.
Atypical antipsychotics are also known for their reduced risk of causing movement disorders like tardive dyskinesia and extrapyramidal symptoms, which are common with typical antipsychotics.
Additionally, these medications may have mood-stabilizing properties, making them suitable for treatingbipolar disorderand major depressive episodes associated with psychosis.Their diverse mechanisms of action and improved tolerability profile have made atypical antipsychotics a preferred choice for many, offering a better quality of life and improved long-term treatment outcomes.
Side Effects of Atypical Antipsychotics
Common side effects associated with atypical antibiotics include weight gain, which can increase the risk of metabolic disorders such as diabetes and high cholesterol levels. Sedation and drowsiness are frequent, particularly when starting treatment or adjusting doses. Some individuals may experience anticholinergic effects like dry mouth, constipation, and blurred vision.
Additionally, atypical antipsychotics may also cause orthostatic hypotension. Although they generally have a lower risk of movement disorders compared to typical antipsychotics, some atypical antipsychotics may still cause mild extrapyramidal symptoms such as tremors or muscle stiffness.
Moreover, certain medications within this class, such as clozapine, require careful monitoring due to rare but serious side effects like agranulocytosis, which is a severe decrease in white blood cell count.
List of Atypical Antipsychotics
Examples of atypical antipsychoticsinclude these commonly prescribed medications:
Preventing side effects associated with both typical and atypical antipsychotics involves taking proactive steps and working closely with your healthcare provider to communicate any concerns.
Ways to prevent side effects include:
Lifestyle changes, such as maintaining a balanced diet and regular exercise to manage weight gain associated with some antipsychotics, can be beneficial.
Monitoring and managing metabolic parameters, such as blood sugar and cholesterol levels, are also necessary preventive measures. For those experiencing movement-related side effects, certain medications or adjunctive treatments may help alleviate symptoms.
Who Should Avoid Typical and Atypical Antipsychotics?
Determining whether to avoid typical or atypical antipsychotics depends on several factors related to your personal health history. Generally, you should avoid typical and atypical antibiotics if you have:
Based on Food and Drug Administration (FDA) requirements, all antipsychoticsmust include a black box warning stating their association with increased rates of stroke and death in older adults with dementia.
Summary
Typical and atypical antipsychotics are medications prescribed to manage psychiatric disorders such as schizophrenia and bipolar disorder. Typical antipsychotics primarily block dopamine receptors in the brain and are associated with a higher risk of movement disorders like tardive dyskinesia.
Many factors must be considered when choosing between typical and atypical antipsychotics. Each medication class has unique benefits and risks, and the decision often comes down to balancing symptom management with minimizing adverse effects.
While both types of antipsychotics can be highly effective, they each come with their own set of risks and benefits, making it crucial to tailor treatment plans to fit your individual needs.
8 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Ayano, G. “First generation antipsychotics: pharmacokinetics, pharmacodynamics, therapeutic effects and side effects: a review.“Research & Reviews: Journal of Chemistry(2016).National Institute of Mental Health.Mental health medications.Kishimoto T, Agarwal V, Kishi T, Leucht S, Kane JM, Correll CU.Relapse prevention in schizophrenia: a systematic review and meta-analysis of second-generation antipsychotics versus first-generation antipsychotics.Mol Psychiatry. 2013;18(1):53-66. doi: 10.1038/mp.2011.143Jones PB, Barnes TR, Davies L, Dunn G, Lloyd H, Hayhurst KP, Lewis SW.Randomized controlled trial of the effect on quality of life of second-vs first-generation antipsychotic drugs in schizophrenia: cost utility of the latest antipsychotic drugs in schizophrenia study (CUtLASS 1).Archives of General Psychiatry.2006;63(10):1079-1087. doi:10.1001/archpsyc.63.10.1079. doi:10.1001/archpsyc.63.10.1079National Alliance on Mental Health.Metabolic side effects of psychiatric medications.Omuench O, Hamer AM.Adverse effects of antipsychotic medications.Am Fam Physician.2010;81(5):617-622.National Alliance on Mental Illness.Tardive dyskinesia.Grinchii D, Dremencov E.Mechanism of action of atypical antipsychotic drugs in mood disorders.Int J Mol Sci.2020; 15;21(24):9532. doi: 10.3390/ijms21249532.
8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Ayano, G. “First generation antipsychotics: pharmacokinetics, pharmacodynamics, therapeutic effects and side effects: a review.“Research & Reviews: Journal of Chemistry(2016).National Institute of Mental Health.Mental health medications.Kishimoto T, Agarwal V, Kishi T, Leucht S, Kane JM, Correll CU.Relapse prevention in schizophrenia: a systematic review and meta-analysis of second-generation antipsychotics versus first-generation antipsychotics.Mol Psychiatry. 2013;18(1):53-66. doi: 10.1038/mp.2011.143Jones PB, Barnes TR, Davies L, Dunn G, Lloyd H, Hayhurst KP, Lewis SW.Randomized controlled trial of the effect on quality of life of second-vs first-generation antipsychotic drugs in schizophrenia: cost utility of the latest antipsychotic drugs in schizophrenia study (CUtLASS 1).Archives of General Psychiatry.2006;63(10):1079-1087. doi:10.1001/archpsyc.63.10.1079. doi:10.1001/archpsyc.63.10.1079National Alliance on Mental Health.Metabolic side effects of psychiatric medications.Omuench O, Hamer AM.Adverse effects of antipsychotic medications.Am Fam Physician.2010;81(5):617-622.National Alliance on Mental Illness.Tardive dyskinesia.Grinchii D, Dremencov E.Mechanism of action of atypical antipsychotic drugs in mood disorders.Int J Mol Sci.2020; 15;21(24):9532. doi: 10.3390/ijms21249532.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Ayano, G. “First generation antipsychotics: pharmacokinetics, pharmacodynamics, therapeutic effects and side effects: a review.“Research & Reviews: Journal of Chemistry(2016).National Institute of Mental Health.Mental health medications.Kishimoto T, Agarwal V, Kishi T, Leucht S, Kane JM, Correll CU.Relapse prevention in schizophrenia: a systematic review and meta-analysis of second-generation antipsychotics versus first-generation antipsychotics.Mol Psychiatry. 2013;18(1):53-66. doi: 10.1038/mp.2011.143Jones PB, Barnes TR, Davies L, Dunn G, Lloyd H, Hayhurst KP, Lewis SW.Randomized controlled trial of the effect on quality of life of second-vs first-generation antipsychotic drugs in schizophrenia: cost utility of the latest antipsychotic drugs in schizophrenia study (CUtLASS 1).Archives of General Psychiatry.2006;63(10):1079-1087. doi:10.1001/archpsyc.63.10.1079. doi:10.1001/archpsyc.63.10.1079National Alliance on Mental Health.Metabolic side effects of psychiatric medications.Omuench O, Hamer AM.Adverse effects of antipsychotic medications.Am Fam Physician.2010;81(5):617-622.National Alliance on Mental Illness.Tardive dyskinesia.Grinchii D, Dremencov E.Mechanism of action of atypical antipsychotic drugs in mood disorders.Int J Mol Sci.2020; 15;21(24):9532. doi: 10.3390/ijms21249532.
Ayano, G. “First generation antipsychotics: pharmacokinetics, pharmacodynamics, therapeutic effects and side effects: a review.“Research & Reviews: Journal of Chemistry(2016).
National Institute of Mental Health.Mental health medications.
Kishimoto T, Agarwal V, Kishi T, Leucht S, Kane JM, Correll CU.Relapse prevention in schizophrenia: a systematic review and meta-analysis of second-generation antipsychotics versus first-generation antipsychotics.Mol Psychiatry. 2013;18(1):53-66. doi: 10.1038/mp.2011.143
Jones PB, Barnes TR, Davies L, Dunn G, Lloyd H, Hayhurst KP, Lewis SW.Randomized controlled trial of the effect on quality of life of second-vs first-generation antipsychotic drugs in schizophrenia: cost utility of the latest antipsychotic drugs in schizophrenia study (CUtLASS 1).Archives of General Psychiatry.2006;63(10):1079-1087. doi:10.1001/archpsyc.63.10.1079. doi:10.1001/archpsyc.63.10.1079
National Alliance on Mental Health.Metabolic side effects of psychiatric medications.
Omuench O, Hamer AM.Adverse effects of antipsychotic medications.Am Fam Physician.2010;81(5):617-622.
National Alliance on Mental Illness.Tardive dyskinesia.
Grinchii D, Dremencov E.Mechanism of action of atypical antipsychotic drugs in mood disorders.Int J Mol Sci.2020; 15;21(24):9532. doi: 10.3390/ijms21249532.
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