Antipsychotic Medications for Adults

How Do Antipsychotics Work?

Antipsychotic medications work by targeting a neurotransmitter in the brain called dopamine. It plays an important role in a variety of functions, such as mood, thinking, and perception.^[3]

In fact, dopamine is also known as the “pleasure” or “feel-good” hormone. Imagine a nice day off, where you spend time with your loved ones having fun. The feeling of pleasure on these days comes particularly from the increase in dopamine levels in the brain.

In the aforementioned psychotic conditions (such as schizophrenia) dopamine levels are thought to be very high. This causes the appearance of hallucinations or delusions, otherwise known as “positive symptoms.”

However, there may be cases when dopamine levels in certain parts of the brain are low, which is mainly related to symptoms such as lack of pleasure, social interest, or motivation – otherwise known as “negative symptoms.”

Antipsychotics work by balancing dopamine, which then improves your symptoms.

Types of Antipsychotic Drugs

There are two main types of antipsychotics: first-generation antipsychotics (typical) and second-generation antipsychotics (atypical).^[4]

First-generation medications primarily target those dopamine receptors in the brain that we were talking about. These drugs, like chlorpromazine, haloperidol, and perphenazine, are effective at treating “positive” symptoms such as the voices in your head, the person who looks at you in your room, or the belief that someone is trying to harm you. Knowing that such treatment options exist and you may benefit from them, gives you the power to reach for help.

Second-generation antipsychotics target both dopamine and serotonin receptors.^[5] Drugs like aripiprazole, risperidone, olanzapine, and clozapine are often preferred because they may improve “negative” symptoms and mood-related issues.

That sense that you can’t feel anything or you have lost interest in social interactions? These types of antipsychotics typically deal with that. Whether you need this dopamine or serotonin targeting, there is always an option for you.

Choosing the right type depends on your symptoms, health history, and how you tolerate side effects. Doctors often start with second-generation options, but individual needs vary, and finding the best fit may take time. So, it’s not a one-fit-all process. What really matters is how they work for you.

Stopping Antipsychotics Safely

If you are feeling better and your symptoms have improved these last months, you may be considering stopping taking your antipsychotics.

Fortunately, this is something usually recommended by your doctor, but in a specific way. What’s important is to do it slowly and always with the help and guidance of a professional.

The medication you have been taking affects how your brain works, so this is a delicate process that should proceed smoothly.

Stopping or reducing them too quickly can cause possible serious side effects, like agitation, sleep problems, or even worsening or return of the symptoms you were being treated for.^[9]

Some people may also experience withdrawal effects, so that’s also something it’s important for you to keep in mind. This is a physiological or physical response to the sudden stopping or slowing of these medications.^[10]

Think about it this way: When the time comes for you to sell your first, much-loved car, letting it go is not easy. That’s the same thing that happens with your body. Your brain is used to them, so you have to be gentle and patient with this process.

That’s why doctors often advise people to reduce antipsychotics gradually instead of stopping all at once. Keep in mind that everybody responds differently, so the plan to come off the medication is individual.

It might take several weeks or even a few months, depending on the dosage and how long you’ve been using it.

While tapering, it’s a good idea to pay attention to your mood, sleep, and overall well-being, and share any concerns with your doctor, so you can manage any of these side effects.