Dr. Gillaspy has taught health science at University of Phoenix and Ashford University and has a degree from Palmer College of Chiropractic.
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.
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.
For some types of psychotic disorders, such as schizophrenia, antipsychotic medications may be prescribed for a long period of time, and patients are asked to keep taking the medication even if symptoms have been relieved. This can help prevent relapse.
A patient should never stop taking an antipsychotic medication without consulting with his or her doctor. Abruptly stopping the medication could cause an exacerbation in symptoms or cause the person to feel unwell. Therefore, stoppage of treatment needs to be medically supervised as the patient is weaned off the medication over time.
A psychotic disorder is a mental condition that causes abnormal thinking and changes in the way reality is perceived. Examples include 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.
Dopamine and serotonin are examples of neurotransmitters that can influence emotions, moods, thoughts and behaviors. Psychotic disorders, like schizophrenia, have been linked to changes in neurotransmitter activity within specific areas of the brain.
There are two main types of antipsychotic drugs that work by altering dopamine and/or serotonin receptors. First-generation antipsychotics can result in movement disorders. Second-generation antipsychotics have a lower risk of muscular side effects; however, they have been found to cause weight gain, type 2 diabetes and lipid disorders. Because of these side effects and other factors, finding the right antipsychotic drug for a patient can take some trial and error.
Antipsychotic medications tend to have a lag time before their benefits are experienced, and side effects can crop up before therapeutic benefits. Patients are often prescribed antipsychotics long term even if their symptoms improve. This helps prevent relapse. Patients should never abruptly stop taking antipsychotics; doing so can cause worsening of symptoms or ill feelings.
Solid recollection of this lesson's main elements will factor into your ability to:
- Characterize the term 'psychotic disorder'
- Define schizophrenia
- Give an overview of brain chemistry
- Contrast the two antipsychotic (typical and atypical) drugs
- Discuss the treatment for psychotic disorders
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