Antipsychotic

Antipsychotic
Drug class
Olanzapine, an example of a second-generation (atypical) antipsychotic
Class identifiers
Synonyms	Neuroleptics, major tranquilizers[1]
Use	Principally: Schizophrenia, Schizoaffective disorder, Dementia, Tourette syndrome, Bipolar disorder, irritability in autism spectrum disorder
Clinical data
Drugs.com	Drug Classes
External links
MeSH	D014150
Legal status
In Wikidata

Antipsychotics, previously known as neuroleptics^[1] and major tranquilizers,^[2] are a class of psychotropic medication primarily used to manage psychosis (including delusions, hallucinations, paranoia or disordered thought), principally in schizophrenia but also in a range of other psychotic disorders.^[3][4] They are also the mainstay, together with mood stabilizers, in the treatment of bipolar disorder.^[5] Moreover, they are also used as adjuncts in the treatment of treatment-resistant major depressive disorder.

Use of antipsychotics is associated with reductions in brain tissue volumes,^[6][7] including white matter reduction,^[8] an effect which is dose-dependent and time-dependent.^[6][7] A recent controlled trial suggests that second generation antipsychotics^[9] combined with intensive psychosocial therapy^[10] may potentially prevent pallidal brain volume loss in first episode psychosis.^[11][8]

The use of antipsychotics may result in many unwanted side effects such as involuntary movement disorders, gynecomastia, impotence, weight gain and metabolic syndrome. Long-term use can produce adverse effects such as tardive dyskinesia, tardive dystonia, and tardive akathisia.

First-generation antipsychotics (e.g., chlorpromazine, haloperidol, etc.), known as typical antipsychotics, were first introduced in the 1950s, and others were developed until the early 1970s.^[12] Second-generation antipsychotics, known as atypical antipsychotics, arrived with the introduction of clozapine in the early 1970s followed by others (e.g., risperidone, olanzapine, etc.).^[13] Both generations of medication block receptors in the brain for dopamine, but atypicals block serotonin receptors as well. Third-generation antipsychotics were introduced in the 2000s and offer partial agonism, rather than blockade, of dopamine receptors.^[14] Neuroleptic, originating from Ancient Greek: νεῦρον (neuron) and λαμβάνω (take hold of)—thus meaning "which takes the nerve"—refers to both common neurological effects and side effects.^[15]