Schizophrenia Typical & Atypical Antipsychotic Medication

Typical Antipsychotic Medication

The first medications designed to treat schizophrenia are now called typical antipsychotic medications, or first-generation antipsychotics. Many of these early medications are still used today, and are helpful for many patients. Some examples of these medications are chlorpromazine and haloperidol. Typical antipsychotic medications work by blocking the effects of dopamine. Because of this primary function, some call these medications neuroleptics, which literally means "seizing the neuron."

Typical antipsychotic medications are most effective in treating positive symptoms such as hallucinations and delusions. Although some patients may improve after only a week or two of treatment, the most complete effects of these medications are usually seen after six to eight weeks. Unfortunately, treatment with typical antipsychotic medications does cause some uncomfortable side effects. Many patients experience significant weight gain, drowsiness, or dry mouth. Some patients experience extra-pyramidal side effects (EPS), which are uncontrollable bodily movements such as muscle spasms or shaking. Other medications can be used to minimize extrapyramidal side effects, although the relief is only temporary.

In fact, studies have shown that patients who take typical antipsychotic medications for 10 years or more may develop a serious condition called tardive dyskinesia in which patients experience involuntary movements of the tongue, lips, and neck. Tardive dyskinesia is very uncomfortable and can be embarrassing to many patients.

Atypical Antipsychotic Medication

Although the typical antipsychotic medications are effective in treating positive symptoms, they are relatively unsuccessful in treating negative symptoms. Additionally, these medications cause unpleasant side effects. In the 1980s, researchers focused on developing medications that treated more aspects of schizophrenia and did so without disabling side effects. These medications that are used frequently today are called atypical antipsychotic medications, or second-generation antipsychotics.

Clozapine was the first atypical antipsychotic and was designed to help patients who did not respond well to traditional neuroleptics. It became available in the United States in 1989 and now is prescribed widely by psychiatrists. Newer atypical antipsychotic medications include risperidone and olanzapine. These medications provide relief for patients without the uncomfortable side effects. Unlike early antipsychotic medications, atypical antipsychotic medications are effective at treating both positive and negative symptoms.

How do these medications differ from earlier medications?

Researchers speculate that traditional antipsychotic medications completely block one kind of dopamine receptor, leaving other types of dopamine receptors unaffected. Atypical antipsychotics appear to block many kinds of dopamine receptors less completely.