How Antipsychotic Drugs Work in the Brain

Lesson Transcript
Instructor: Rebecca Gillaspy

Dr. Gillaspy has taught health science at University of Phoenix and Ashford University and has a degree from Palmer College of Chiropractic.

Psychotic disorders, such as schizophrenia, mania due to bipolar disorder, severe depression and severe anxiety, are treated with antipsychotic drugs. Learn how antipsychotic drugs work in the brain to lessen symptoms.

Psychotic Disorders

How you feel mentally has a lot to do with your brain chemistry. We've all experienced up and down mood swings. These common, everyday changes are normal and, typically, short lived. However, for a person with a psychotic disorder, which is a mental condition that causes abnormal thinking and changes in the way reality is perceived, thinking and emotions may be so impaired that medication is required.

Schizophrenia, which is a severe mental disorder characterized by impaired thinking, emotions and behaviors, and other mental conditions, such as mania caused by bipolar disorder, severe depression and severe anxiety, may require antipsychotic medication as a part of treatment. In this lesson, we will learn about antipsychotic drugs and how they work in the brain.

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  • 0:01 Psychotic Disorders
  • 0:56 Brain Chemistry
  • 1:46 How Antipsychotics Work
  • 3:18 Treatment
  • 4:26 Lesson Summary
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Brain Chemistry

To best understand how antipsychotic drugs work, it will be helpful to gain some understanding of brain chemistry. Your brain is the control center of your body. It's where physical actions are coordinated, thoughts are generated and body processes are regulated.

Your brain consists of billions of nerve cells, called neurons. Neurons communicate with each other by releasing chemical messengers called neurotransmitters. There are many different neurotransmitters within your brain. Dopamine and serotonin are examples of neurotransmitters that can influence emotions, moods, thoughts and behaviors. Psychotic disorders, such as schizophrenia, have been linked to changes in neurotransmitter activity within specific areas of the brain.

How Antipsychotics Work

Antipsychotic medications have an effect on neurotransmitter activity. By altering these chemical messengers, symptoms of psychotic disorders, such as hallucinations, delusions and mood swings, can be controlled or lessened. There are two main types of antipsychotic drugs that basically work by altering dopamine and/or serotonin receptors.

One type is referred to as typical antipsychotics or first-generation antipsychotics. There are also atypical antipsychotics or second-generation antipsychotics. First-generation antipsychotics were the first of the two types to be developed, sometime around the 1950s. These drugs work by blocking a certain dopamine receptor called the D2 receptor. They're often successful in lessening psychotic symptoms, but their use can result in movement disorders, such as involuntary muscle movements, restlessness or problems initiating movement.

The second-generation antipsychotics were introduced from about 1990 onward. These drugs work by blocking the D2 receptors as well as a specific serotonin receptor called 5-HT2A receptor. They provide treatment for psychotic symptoms and have a lower risk of muscular side effects; however, they have been found to cause weight gain, type 2 diabetes and lipid disorders.


Both first- and second-generation antipsychotic drugs are still in use today. Finding the right medication for a patient, however, may take some trial and error.

Antipsychotic medications tend to have a lag time before their benefits are experienced. A patient may need to take the drugs for weeks, or even months, before a decrease in symptoms is noticeable. Unfortunately, the side effects of the drugs tend to be experienced before the therapeutic benefits.

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