Antipsychotics are a group of psychoactive drugs commonly but not exclusively used to treat psychosis, which is typified by schizophrenia. Over time a wide range of antipsychotics have been developed. A first generation of antipsychotics, known as typical antipsychotics, was discovered in the 1950s. Most of the drugs in the second generation, known as atypical antipsychotics, have more recently been developed. Both classes of medication tend to block receptors in the brain's dopamine pathways, but antipsychotic drugs encompass a wide range of receptor specificity. A number of side effects have been observed in relation to specific medications, including weight gain, agranulocytosis, tardive dyskinesia, tardive akathisia and tardive psychoses. The development of new antipsychotics, and the relative efficacy of different ones, is an important ongoing field of research. Antipsychotic medication is not generally regarded as a good treatment so much as the best available, and the most appropriate drug for an individual patient requires careful consideration.
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Antipsychotics are a group of psychoactive drugs commonly but not exclusively used to treat psychosis, which is typified by schizophrenia. Over time a wide range of antipsychotics have been developed. A first generation of antipsychotics, known as typical antipsychotics, was discovered in the 1950s. Most of the drugs in the second generation, known as atypical antipsychotics, have more recently been developed. Both classes of medication tend to block receptors in the brain's dopamine pathways, but antipsychotic drugs encompass a wide range of receptor specificity. A number of side effects have been observed in relation to specific medications, including weight gain, agranulocytosis, tardive dyskinesia, tardive akathisia and tardive psychoses. The development of new antipsychotics, and the relative efficacy of different ones, is an important ongoing field of research. Antipsychotic medication is not generally regarded as a good treatment so much as the best available, and the most appropriate drug for an individual patient requires careful consideration.
Terminology
Antipsychotics are also referred to as neuroleptic drugs. The word neuroleptic is derived from Greek: "νεύρον" (originally meaning sinew but today referring to the nerves) and "λαμβάνω" (meaning take hold of). Thus, the word means taking hold of one's nerves. This term reflects the drugs' ability to make movement more difficult and sluggish, which clinicians previously believed indicated that a dose was high enough.Fact: date=August 2007 The lower doses used currently have resulted in reduced incidence of motor side effects and sedation, and the term is less commonly used than in the past..
Antipsychotics are broadly divided into two groups, the typical or first-generation antipsychotics and the atypical or second-generation antipsychotics. There are also dopamine partial agonists, which are often categorized as atypicals.
Typical antipsychotics are also sometimes referred to as major tranquilizers, because some of them can tranquilize and sedate. This term is increasingly disused, as the terminology implies a connection with benzodiazepines ("minor" tranquilizers) when none exists.
Usage
Common conditions with which antipsychotics might be used include schizophrenia, mania, and delusional disorder. They might be used to counter psychosis associated with a wide range of other diagnoses, such as psychotic depression. In addition, these drugs are used to treat non-psychotic disorders. For example, some antipsychotics (haloperidol, pimozide) are used off-label to treat Tourette syndrome, whereas Aripiprazole is prescribed in some cases of Asperger's syndrome.
History
The original antipsychotic drugs were happened upon largely by chance and were tested empirically for their effectiveness. The first antipsychotic was chlorpromazine, which was developed as a surgical anesthetic. It was first used on psychiatric patients because of its powerful calming effect; at the time it was regarded as a "chemical lobotomy". Lobotomy was used to treat many behavioral disorders, including psychosis, although its "effectiveness" was (from a modern viewpoint) due to its tendency to markedly reduce behavior of all types. However, chlorpromazine quickly proved to reduce the effects of psychosis in a more effective and specific manner than the extreme lobotomy-like sedation it was known for.
