Atypical Antipsychotics: Effects & Mechanism of Action

Instructor: Sarah Lavoie

Sarah has taught Psychology at the college level and has a master's degree in Counseling Psychology.

The discovery of atypical antipsychotics was a great step in the treatment of schizophrenia. Learn about how these drugs work and what effects patients have to deal with. Then you may test your knowledge with a quiz.

What Are Atypical Antipsychotics?

Historically, schizophrenia has been one of the most difficult mental illnesses to treat. Prior to the 1950s, the most common treatment for people suffering with schizophrenia was hospitalization. Then a class of drugs called antipsychotics were developed to treat psychosis, specifically schizophrenia, which allowed many people with schizophrenia to lead more normal lives. Unfortunately, these drugs have significant side effects, most notably problems with motor control that can even become permanent.

The first new antipsychotic medication, called clozapine (brand name Clozaril), was released and became commonly used in the United States in the early 1990s. The use of clozapine sparked new interest in developing better antipsychotic drugs. These drugs were named second-generation antipsychotics, or atypical antipsychotics. Since then, atypical antipsychotics have become the most common treatment for schizophrenia and are also used to treat bipolar disorders and mania. The original group of antipsychotics came to be known as typical antipsychotics or first-generation antipsychotics to differentiate the two groups of drugs.

Mechanism of Action

Like many drugs used to treat mental disorders, it is not precisely known how atypical antipsychotics work on the brain. What is known is that these drugs impact the receptors of two major neurotransmitters, dopamine and serotonin. However, it appears that these drugs are more active with dopamine and block dopamine receptors.

Since antipsychotic compounds were discovered, scientists have studied the links between dopamine and schizophrenia. It is now agreed that levels of dopamine and dopamine receptors are related to schizophrenia. However, the symptoms of schizophrenia can vary widely, and it's agreed that the dopamine theory of schizophrenia doesn't explain the disease in its entirety.

Effects and Side Effects

Although the main use of atypical antipsychotics is for treating schizophrenia, the FDA has approved the use of these drugs for other diseases, including bipolar disorder, acute mania and other psychotic symptoms. Atypical antipsychotics reduce what are known as the positive symptoms of schizophrenia. Positive symptoms of schizophrenia include those that show a distortion of reality, including hallucinations and delusions. They are less effective at controlling the negative symptoms of the illness. Negative symptoms include those that show a loss of normal functioning, including loss of emotion and socialization. However, some believe that atypical antipsychotics are better suited to treating negative symptoms than typical psychotics, marking a significant difference between the two.

Side effects are one of the most serious issues in the treatment of schizophrenia. As with first-generation psychotics, atypical antipsychotics can cause severe side effects. The most well-known group has been labeled extrapyramidal side effects. This group of side effects tends to mimic symptoms of Parkinson's disease, including abnormal muscular motions and postures, tremors, gait changes and unusual motions of the jaw and lips.

Additional side effects are listed here:

  • dizziness
  • sedation
  • blurred vision
  • fatigue
  • weight gain
  • drooling
  • restlessness
  • sexual dysfunction

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