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Schizophrenia is a serious and debilitating mental disorder. It is a heterogeneous disorder that can present with numerous symptoms. In general, the symptoms of the disorder can be divided into positive symptoms (excesses) that include hallucinations and delusions, and negative symptoms (deficits) that include a paucity of speech, a paucity of emotional expression, and a paucity of movement. Antipsychotic medications have been used to address primarily the positive symptoms of schizophrenia; however, newer antipsychotic medications have some effect on the negative symptoms. In addition, these medications are used to treat other disorders, including other psychotic disorders, the hallucinations that occur in psychotic depression, bipolar disorder with delirium, and hallucinations occurring as a result of drug abuse or overdose. They are even used to treat agitation in patients who have dementia or a hyperactive type of delirium.
There are numerous antipsychotic medications, and basically, the major effects of the antipsychotic medications are actually dependent on their order of development. Each generation of antipsychotic medications has a slightly different primary mechanism of action, and this produces both different therapeutic effects as well as different side effect profiles. Since a complete list of the side effect profile of every psychotic medication would be massive, it is useful to conceptualize the main side effects associated with the major developmental classes of antipsychotic medications.
According to pharmaceutical manuals like The Manual of Clinical Psychopharmacology and Stahl’s Essential Psychopharmacology: Neuroscientific Basis and Practical Applications, antipsychotic medications can be broken down into three categories.
It is important to understand that different antipsychotic medications have slightly different mechanisms of action even if they belong to the same overall class. This results in each specific medication having a specific side effect profile that produces side effects that are either relatively common or less common in individuals who use the drug. Because antipsychotic medications are often associated with unpleasant side effect profiles, compliance with these medications often becomes an issue for patients.
Antipsychotic medications do not produce euphoria and are not significant drugs of abuse. Even with individuals who are prescribed them, they are rarely abused, except in cases where individuals may have serious cognitive issues that affect their judgment and may take too much of the medication. When individuals take more of antipsychotic medication than prescribed, the potential for the above side effects is significantly increased. In some cases, serious side effects, such as neuroleptic malignant syndrome or extrapyramidal side effects, are likely.
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