Antipsychotic Medications for Adults: How They Work, Benefits, and Side Effects
When it comes to mental health difficulties, finding the right methods to manage and treat them is essential. There are situations where lifestyle changes or therapy with a specialist are just not enough. Imagine a tool that can calm the chaos of your mind, helping with emotional turbulence or even delusions and hallucinations. Antipsychotic medications do just that, sometimes being the best treatment option.
Antipsychotics are a group of medications that are generally used to treat psychosis, a condition where you cannot distinguish between what is and what is not real.1 However, their use is not limited to that. Antipsychotic medications can also be used in severe depression or anxiety conditions, often as a complementary tool to other treatment methods.
However, many people are still not familiar with their benefits or even the possible risks or side effects that they can bring. Understanding how these medications work is essential to making informed choices for your mental well-being. If you’re going through this process, this article can help by discussing:
- What are Antipsychotic Medications?
- How do Antipsychotics Work?
- Side Effects of Antipsychotics
- Stopping Antipsychotics Safely
- Reach Out Today for Mental Health Support
What are Antipsychotic Medications?
Antipsychotics are medications that are generally prescribed by psychiatrists to treat various psychotic conditions. These conditions are characterized by symptoms that make the world feel like a maze of confusion, fear, or even danger – both to you and to others around you when experiencing them.
Imagine hearing voices that no one else hears or seeing a person in front of you who is not real (hallucinations). In other cases, you might believe something that is not based on reality (such as the belief that someone is following you or that you have supernatural powers), which doesn’t change when you face facts. Other symptoms that may be associated with psychosis or other severe conditions are intense anxiety or mood swings, confusing speech, distorted thinking, trouble sleeping, or social withdrawal.2
If you live with conditions like schizophrenia, psychosis, or severe bipolar disorder, these experiences can make you feel isolated and overwhelmed. These symptoms don’t just affect your mood, but they can distort your entire sense of reality, making everyday tasks, your relationships, or even self-care feel impossible.
Psychiatric medications are a lifeline for these situations. They often won’t completely eliminate these symptoms, but they will make them milder and more manageable. Doing so means they can increase the stability you feel and improve your quality of life.
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 (typical) and second-generation (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.
Side Effects of Antipsychotics
These medications are usually safe and their benefits are essential in treating severe mental health issues.6 However, they also have their possible side effects, which shouldn’t scare you, but you should be aware of. Don’t forget: It is your mental health, so being informed about everything related to it, is so important. Some of the antipsychotics’ side effects and complications are:
1. Movement-Related Side Effects
Some antipsychotics, especially older “typical” ones, can sometimes disrupt dopamine pathways, affecting motor control.7 These symptoms may include:
- Slowness: Stiffness, tremors, or slowed movement
- Akathisia: Restlessness or an inability to sit still
- Involuntary Movements: Repetitive, involuntary movements (e.g., lip smacking) that may become permanent
2. Metabolic Changes
These possible side effects can happen as newer “atypical” antipsychotics often interfere with insulin and fat regulation.8 That means that they can be messing up how your body controls blood sugar and stores or burns fat. These symptoms include:
- Weight Gain: Increased appetite and slowed metabolism.
- High Blood Sugar/Diabetes: Insulin resistance triggered by certain drugs.
- High Cholesterol: Elevated lipids which raises cardiovascular risks.
3. Hormonal Imbalances
The changes in dopamine levels or blockade can mess with prolactin levels, a hormone regulating reproduction. This can make you experience:
- Breast Swelling/Milk Production: In men and women (galactorrhea).
- Menstrual Irregularities: Missed periods or fertility issues.
- Low Sex Drive: Reduced libido or erectile dysfunction.
4. Sedation & Cognitive Effects
Antipsychotics often block histamine or adrenaline receptors, which can cause:
- Drowsiness: Heavy fatigue, especially with older drugs.
- Brain Fog: Trouble concentrating or memory lapses.
5. Cardiovascular Issues
Some antipsychotics affect heart rhythm or blood pressure, which may contribute to these symptoms:
- QT Prolongation: Irregular heartbeat (riskiest with drugs like ziprasidone).
- Dizziness/Low Blood Pressure: Sudden drops when standing up.
Other general possible symptoms of antipsychotics include:
- Dry mouth
- Constipation
- Blurred vision
- Urinary retention
- Dangerously low white blood cells (linked to clozapine)
- Immune disruption
- Dizziness
- Headaches.
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.
Reach Out Today for Mental Health Support
Antipsychotic medications play a crucial role in the treatment of severe mental health conditions. Understanding how they work, their benefits, and their potential side effects or risks is an important step toward managing your mental well-being. Effective pharmacological treatment is based on an individualized plan, as everyone is unique. Regular appointments and check-ins with your doctor are essential for a proper diagnosis and treatment. Open communication about changes in symptoms, mood, or daily functioning allows for timely adjustments and helps you maintain the best possible quality of life.
But medications are just one part of a comprehensive care plan, especially when you are in the tapering medication process. Therapy – whether one-on-one counseling, group sessions, or skills workshops – can provide invaluable tools that will help you to deal with this process. At Mission Connection, we offer a full spectrum of these complementary services, including:
- Psychoeducation
- Peer support groups
- Evidence-based therapies tailored to your needs
By combining thoughtful medication management with complementary therapeutic guidance, you’ll have great support for achieving and sustaining wellness over the long term.
Reach out to us today and so we can support you on your journey!
References
- Chokhawala, K., & Stevens, L. (2023, February 26). Antipsychotic medications. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK519503/
- Understanding psychosis. (n.d.). National Institute of Mental Health (NIMH). https://www.nimh.nih.gov/health/publications/understanding-psychosis#:~:text=People%20with%20psychosis%20typically%20experience,do%20something%20or%20criticizing%20them).
- Kapur, S., Agid, O., Mizrahi, R., & Li, M. (2006). How antipsychotics work—From receptors to reality. NeuroRx, 3(1), 10–21. https://doi.org/10.1016/j.nurx.2005.12.003
- Demirci Ö, Adar İ, Erbaş O. An Overview of Antipsychotics: Mechanisms of Action. JEB Med Sci 2023;4(1):62-70.
- Ananth, J., Burgoyne, K. S., Gadasalli, R., & Aquino, S. (2001, November 1). How do the atypical antipsychotics work? https://pmc.ncbi.nlm.nih.gov/articles/PMC167197/
- Arana, G. W. (2000). An overview of side effects caused by typical antipsychotics. PubMed, 61 Suppl 8, 5–3. https://pubmed.ncbi.nlm.nih.gov/10811237
- Miller, D. D., Caroff, S. N., Davis, S. M., Rosenheck, R. A., McEvoy, J. P., Saltz, B. L., Riggio, S., Chakos, M. H., Swartz, M. S., Keefe, R. S., Stroup, T. S., & Lieberman, J. A. (2008). Extrapyramidal side-effects of antipsychotics in a randomised trial. The British Journal of Psychiatry, 193(4), 279–288. https://doi.org/10.1192/bjp.bp.108.050088
- Üçok, A., & Gaebel, W. (2008). Side effects of atypical antipsychotics: a brief overview. World Psychiatry, 7(1), 58–62. https://doi.org/10.1002/j.2051-5545.2008.tb00154.x
- Keks, N., Schwartz, D., & Hope, J. (2019). Stopping and switching antipsychotic drugs. Australian Prescriber, 42(5), 152. https://doi.org/10.18773/austprescr.2019.052
- Read, J. (2022). The experiences of 585 people when they tried to withdraw from antipsychotic drugs. Addictive Behaviors Reports, 15, 100421. https://doi.org/10.1016/j.abrep.2022.100421
