Antipsychotics are prescription medications that are used to help dampen symptoms of psychosis. These symptoms can impact individuals dealing with a wide variety of mental health concerns. According to the National Alliance of Mental Illness, over 100,000 Americans experience psychosis each year. They also found that approximately three out of every 100 people will experience psychosis at some point in their lives.6
Psychosis can prevent an individual from living the most fulfilling life possible. Symptoms can be severe, impacting someone’s ability to perceive and take part in the world around them successfully. While antipsychotics may help certain individuals manage their symptoms, others have found relief in alternative solutions. If you or a loved one have experienced the symptoms of psychosis, it is imperative to determine the best long-term solution to managing your condition—and antipsychotics may not be the answer.
Which Mental Health Concerns May Warrant Antipsychotic Medications?
Researchers continue to investigate the complex ways our brains function. In fact, researchers have focused heavily on chemicals in the brain itself. As a result, research regarding treatments for both mental and physical health concerns increasingly involve pharmaceutical medications meant to target brain chemistry. Typically, no other investigation takes place before a prescription of antipsychotic medication. And while it may be warranted during a crisis, often other non-drug treatments may prove more helpful for long-term treatment and recovery.
If you feel that you may be struggling with a mental health concern, it is crucial that you speak with your doctor. Only a medical professional with experience regarding the above concerns has the knowledge to ensure you receive the proper diagnosis. Your general practitioner, a psychiatrist, or a specialist may have prescribed antipsychotics. However, your treatment options may be more varied than you think. It is important to understand all your care options, including alternatives to pharmaceutical medications.
What Is Psychosis?
Psychosis is a symptom of many different mental conditions rather than a condition itself. It is often referred to as psychotic symptoms, psychotic episodes, or a psychotic experience. Psychosis is often described as a break from reality, altering the way a person processes the world around them. Many individuals experience hallucinations, delusional thoughts, repetitive movements, paranoia, hostility, and overall agitation. If your loved one is experiencing psychosis, you may notice that their speech seems slurred and incoherent.
Research continues to develop to better understand what psychosis is, how it develops, and what is the most successful treatment option.1 Antipsychotics have long been the go-to treatment option to help manage psychosis. However, while antipsychotics can help some individuals, everyone responds to them differently. It can take weeks to reduce symptoms, and sometimes takes months before the medication works to its full capacity. It is also important to remember that there are numerous antipsychotic options available, and they all react differently depending on the mental health condition and the individual. As a result, it could take several trial-and-error prescriptions before finding a medication that addresses psychosis and harbors minimal side effects.
How Do Antipsychotics Work?
It is important to understand that antipsychotics are not a cure. They are a tool that doctors use to help individuals struggling with mental health concerns manage and control the different symptoms they may be experiencing. In some people, antipsychotics can help control:
Delusions and hallucinations
Anxiety and severe agitation
Confusion
Incoherent speech
Muddled thinking
Violent behavior
Mania
Neurotransmitters are chemicals in the brain responsible for carrying messages from one part of the brain to another. Dopamine is a neurotransmitter that has been linked to creating common psychosis symptoms—when there is a surplus of dopamine in the brain, symptoms may occur.2 Many antipsychotics are used to block the effects of excess dopamine, which can help provide relief from symptoms associated with psychosis. Other brain chemicals that can be impacted by antipsychotics include serotonin, noradrenaline, and glutamate, which are all associated with regulating mood.
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Health care providers currently prescribe two main types of antipsychotics: typical and atypical. In some individuals, these can aid in reducing and preventing some of the common symptoms linked with certain mental health disorders. It is important to note that typical and atypical antipsychotics each include a wide variety of antipsychotic medications, all with different success rates and risks of serious side effects.
Typical or First-Generation Antipsychotics
Typical antipsychotics have been used since the 1950s. They are the first medications developed to treat symptoms of psychosis and act upon dopamine receptors. Typical psychotics can be divided into different chemical groups that could act in a similar way or share similar side effects. As such, the side effects caused by typical antipsychotics can vary significantly. Some simply make the user drowsy, while others can cause a negative impact on body movement that resembles the physical symptoms of Parkinson’s disease (Parkinsonism).3 In some instances, the user may develop psychological symptoms, such as a lack of emotion or a disinterest in activities they once enjoyed.
Common typical antipsychotics are often used to treat schizophrenia and associated disorders, and include:
Fluphenazine
Chlorpromazine
Loxapine
Haloperidol, and more
Atypical or Second-Generation Antipsychotics
Atypical antipsychotics have been in use since the 1990s and are often referred to as “second-generation” antipsychotics. This category of medication antagonizes dopamine-serotonin receptors and tends to have different side effects than typical antipsychotics. For example, most muscular side effects are less severe, as are side effects that can cause sexual issues. However, these medications are more likely to cause metabolic issues such as rapid weight gain or dramatic changes in blood sugar levels.
Common atypical antipsychotics are used to treat schizophrenia, schizoaffective disorder, bipolar disorder, and major depressive disorder. Those include:
Quetiapine
Aripiprazole
Clozapine
Risperidone
Olanzapine
Ziprasidone
What Side Effects Might I Experience from Taking Antipsychotics?
Every antipsychotic medicine is unique and has its own set of potential side effects. When prescribing a medication, your doctor should thoroughly explain any risks to you, including those listed on the information packet provided when you pick up your medication from a pharmacy. Some individuals may not experience any side effects with antipsychotics, but many do.
Typical side effects with antipsychotics could include:
Antimuscarinic Effects
These side effects are caused by changes to the levels of acetylcholine in your body. Acetylcholine is an important neurotransmitter in your body that contracts and relaxes muscles, dilates blood vessels, increases bodily secretions, and slows your heart rate. When this neurotransmitter is blocked or prevented from working as it should, a person can experience:
Blurred vision
Confusion
Severe constipation
Drowsiness
Dry mouth
Hot or dry skin
Low blood pressure
Nausea
Erectile dysfunction
Difficulty urinating
Blood Disorders
Antipsychotic medication use can trigger blood disorders in some individuals. It can cause agranulocytosis, which is the loss of one type of white blood cell. This can make it easier to contract infections and lower your ability to fight them successfully. Other blood-related side effects include blood clotting disorders and a general reduction in white blood cells.
Metabolic Syndrome
Second-generation or atypical antipsychotics are most associated with creating side effects that can develop into metabolic syndrome, a group of conditions that occur together and increase your chances of developing heart disease and diabetes. A person doesn’t have to experience all these symptoms to be categorized with this condition.
Symptoms of metabolic syndrome can include:
Weight gain
High blood sugar
High blood pressure
High cholesterol
Diabetes
A doctor may recommend that you commit to a healthier lifestyle when taking antipsychotic drugs to combat any excess weight gain. Dealing with rapid weight gain can be difficult both physically and emotionally, so it is important to discuss any concerns with your doctor.
Parkinsonism
As previously mentioned, this side effect is often associated with first-generation antipsychotics but can present itself in second-generation medication as well. Parkinson’s disease is associated with loss of dopamine, but is also associated with mood stabilizers, antidepressants and other drugs, vascular lesions, trauma to the brain, and other factors.7 Since many antipsychotics work to block dopamine, a person can experience Parkinson’s-like symptoms such as:
Stiff or weak muscles
Mouth hanging open
Difficulty controlling facial expressions
Slow tremor, often in the hands
Difficulty with small movements, such as gripping a pen
Sexual Side Effects
Antipsychotics can cause numerous side effects frequently associated with sex hormones like testosterone and estrogen. These can include:
Developing acne
Increased hair growth
Reduced sexual desire
Inability to orgasm
Difficulty getting aroused
Breast development and milk production, even in men
Emotional Side Effects
Antipsychotic side effects are not just physical—they can be emotional as well. When the brain’s chemical is artificially altered, even in an attempt to restore balance, emotions can be unpredictable and hard to manage. Potential emotional side effects include:
Anxiousness or excitability
Agitation to the point of possible aggression
Depression
Restlessness, potentially leading to insomnia
Detachment from reality
Social withdrawal
Suicidal thoughts4
Any unexpected changes in your emotional state should be taken seriously, especially if you experience thoughts of suicide. If you experience these side effects, it is important to speak with a medical professional as soon as possible. They may be able to prescribe a different type of medication or help you cease use of your current medication in a safe and controlled manner.
Stopping Antipsychotics
There are several reasons a person may choose to stop using their antipsychotic medication. You may be experiencing unpleasant side effects, or you may want to explore your alternative options to manage your mental health concerns. Whatever your desire might be, it is important to cease antipsychotic medications carefully—halting the use of a medication often comes with its own side effects. If you are considering stopping your antipsychotics, remember these three tips.
Don’t Stop Suddenly
It takes time for antipsychotics to start working within your brain and body, and it takes time for them to stop affecting you as well. This medication is altering the chemical balance of your brain, so stopping suddenly could pose a serious risk to your health. Stopping suddenly can trigger an overwhelming relapse of psychotic symptoms. Another concern when stopping antipsychotics suddenly is tardive dyskinesia, which occurs when withdrawal from an antipsychotic after extensive use causes new psychotic symptoms to develop.
Take It Slow
The safest way to stop taking your medication is to do so slowly and gradually. The longer you’ve been using an antipsychotic, the longer it could take to gradually wean away from the drug. A slow tapering method involves reducing your daily dose of medication over weeks and potentially months to ensure it isn’t a shock to your system.
Get Professional Support
It is important to avoid ceasing your medication alone. Mental health can be hard to manage, and it can feel impossible without support. Your best support options include your doctor or psychiatrist. They can provide the expert advice and tools you need to make an informed decision about seeking alternative care routes. You can also benefit from support from your friends and family or even peer support groups.
Alternatives to Antipsychotics
Many individuals manage their mental health disorders without medication. If you’d like to explore ceasing use of your antipsychotic medication, discuss your options with your doctor or psychiatrist. Some antipsychotic alternatives can be used in conjunction with antipsychotics or as a means to replace the need for antipsychotic medication.
Talk Therapies
Therapy continues to prove itself a useful tool for individuals dealing with mental health issues. Therapy allows you to discuss your concerns, understand your triggers, and find alternate solutions to handle your unique symptoms. Cognitive behavioral therapy5 or dialectical behavioral therapy are both great options for in-person support.
Arts and Creative Therapies
If traditional therapies simply aren’t enough, creative therapy is a great alternative or addition to talk therapy. These therapies enable your ability to communicate your emotions and deal with your symptoms in a way that doesn’t rely on expressing yourself verbally. Creative therapies may include painting, sculpting, music, drama, and more.
Ecotherapy
Ecotherapy utilizes nature and outdoor activities to provide an alternative focus for those experiencing mental health issues. It can provide both physical and mental relief. Options may include working on a conservation project, gardening, hiking, and biking.
Complementary and Alternative Therapies
This is a large category that can range from aromatherapy to acupuncture and everywhere in between. Complementary and alternative therapies often focus on holistic approaches that can provide relief from a wide variety of symptoms associated with mental health concerns.
Finding What Is Right for Your Personal Health Needs
Antipsychotics are medications that were created to combat some of the common psychotic symptoms associated with mental health disorders. While these medications are beneficial to some, others experience severe side effects that impact their quality of life and affect their physical and mental health. If antipsychotics are negatively affecting your life, it is important to discuss the potential for alternative therapies with your doctor or psychiatrist.
Alternative to Meds Center offers alternative treatment options for those who want to stop relying on antipsychotic medications. Managing and recovering from mental health disorders can be possible without pharmaceutical medications.Learn about antipsychotic withdrawal and begin to explore the possibility of finding long-term success without these risky medications.
1. Fusar-Poli, P., de Pablo, G. S., Correll, C. U., Meyer-Lindenberg, A., Millan, M. J., Borgwardt, S., … & Arango, C. (2020). Prevention of psychosis: advances in detection, prognosis, and intervention. JAMA psychiatry, 77(7), 755-765.
2. Kesby, J. P., Eyles, D. W., McGrath, J. J., & Scott, J. G. (2018). Dopamine, psychosis, and schizophrenia: the widening gap between basic and clinical neuroscience. Translational psychiatry, 8(1), 1-12.
3. d’Errico, A., Strippoli, E., Vasta, R., Ferrante, G., Spila Alegiani, S., & Ricceri, F. (2021). Use of antipsychotics and long-term risk of parkinsonism. Neurological Sciences, 1-9.
4. Read, J., & Williams, J. (2018). Adverse effects of antidepressants reported by a large international cohort: emotional blunting, suicidality, and withdrawal effects. Current drug safety, 13(3), 176-186.
5. Kingdon, D., & Turkington, D. (2019). Cognitive therapy of psychosis: Research and implementation. Schizophrenia Research, 203, 62-65.
7. Höllerhage M. Secondary parkinsonism due to drugs, vascular lesions, tumors, trauma, and other insults. Int Rev Neurobiol. 2019;149:377-418. doi: 10.1016/bs.irn.2019.10.010. Epub 2019 Nov 21. PMID: 31779822.
This content has been reviewed and approved by a licensed physician.
Dr. Samuel Lee
Dr. Samuel Lee is a board-certified psychiatrist, specializing in a spiritually-based mental health discipline and integrative approaches. He graduated with an MD at Loma Linda University School of Medicine and did a residency in psychiatry at Cedars-Sinai Medical Center and University of Washington School of Medicine in Seattle. He has also been an inpatient adult psychiatrist at Kaweah Delta Mental Health Hospital and the primary attending geriatric psychiatrist at the Auerbach Inpatient Psychiatric Jewish Home Hospital. In addition, he served as the general adult outpatient psychiatrist at Kaiser Permanente. He is board-certified in psychiatry and neurology and has a B.A. Magna Cum Laude in Religion from Pacific Union College. His specialty is in natural healing techniques that promote the body’s innate ability to heal itself.
Lyle Murphy is the founder of the Alternative to Meds Center, a licensed residential program that helps people overcome dependence on psychiatric medication and addiction issues using holistic and psychotherapeutic methods.
Medical Disclaimer: Nothing on this Website is intended to be taken as medical advice. The information provided on the website is intended to encourage, not replace, direct patient-health professional relationships. Always consult with your doctor before altering your medications. Adding nutritional supplements may alter the effect of medication. Any medication changes should be done only after proper evaluation and under medical supervision.
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