Typical vs. Atypical Antipsychotics: What’s the Difference?
Medically reviewed by Lindsay Cook, PharmDMedically reviewed by Lindsay Cook, PharmDAntipsychotics are medications used to manage and treat symptoms of psychiatric disorders. There are two main categories of antipsychotics: typical and atypical. Typical antipsychotics have been around longer and are known as first-generation antipsychotics. Atypical antipsychotics are a newer class, known as second-generation antipsychotics.While typical and atypical antipsychotics are effective treatment options for similar health conditions, they differ in many ways.This article will highlight what you need to know about what typical and atypical antipsychotics are, what they are used for, how they work, and their potential risks and benefits.
Getty Images | Maca and Naca
Antipsychotics
Typical
Atypical
Approved Use
Schizophrenia, psychosis, agitation
Schizophrenia, bipolar disorder, major depressive disorder
Side Effects
Sedation, weight gain, metabolic changes, anticholinergic effects, extrapyramidal symptoms, tardive dyskinesia
Sedation, weight gain, metabolic changes, anticholinergic effects
Dosing Considerations
Side effects are dose-dependent
Some medications require specific titration schedules
Efficacy
Manages positive symptoms (such as hallucinations and delusions)
Manages positive and negative symptoms (such as low energy and social withdrawal)
Duration of Use
Used for acute treatment and long-term management
Recommended for long-term, chronic use
Understanding Typical AntipsychoticsTypical antipsychotics are a class of medications primarily used to treat psychiatric disorders like schizophrenia and severe agitation. These medications work by blocking dopamine receptors in the brain, which can help reduce symptoms such as hallucinations and delusions. They are highly effective in managing acute psychotic episodes (or episodes of psychosis, symptoms affecting the mind and including a break with reality) and are an essential tool in the treatment of chronic psychiatric conditions.Dopamine is a neurotransmitter involved in many functions, including mood, behavior, and perception. In some conditions, dopamine activity can become dysregulated. By blocking these receptors, typical antipsychotics help reduce the overactivity of dopamine, resulting in a decrease in psychotic symptoms.Benefits of Typical AntipsychoticsTypical antipsychotics offer several benefits, particularly in the treatment of acute psychotic episodes and chronic psychiatric conditions like schizophrenia. One of their primary advantages is their effectiveness in quickly reducing severe symptoms. This rapid action can be crucial in stabilizing during acute episodes, preventing harm, and facilitating recovery.Additionally, typical antipsychotics have been used for a long time and have been well-studied. They are generally less expensive than atypical antipsychotics, making them a more accessible option for some. Despite their potential side effects, typical antipsychotics remain a valuable tool in managing psychotic disorders, especially when newer medications are not effective or available.Side Effects of Typical AntipsychoticsTypical antipsychotics, while effective, are associated with several potential side effects that can impact quality of life. Because they interfere with normal dopamine function, one of the most significant concerns is the risk of extrapyramidal symptoms (EPS), meaning they can affect the motor system, including causing tremors, muscle stiffness, and involuntary movements.Another serious side effect is tardive dyskinesia, a condition characterized by repetitive, involuntary movements, often of the face and tongue, which can be irreversible.These medications can also cause sedation (sleepiness), weight gain, and anticholinergic effects (blocking a chemical messenger in the brain that sends messages to nerves and muscles like dry mouth and constipation. They may also increase the risk of developing cardiovascular issues, such as orthostatic hypotension, which occurs when blood pressure drops upon standing, leading to dizziness or fainting.Due to these potential side effects, it is essential for those taking typical antipsychotics to have regular follow-ups with their healthcare provider to monitor their health and adjust treatment as needed.List of Typical AntipsychoticsTypical antipsychotics were among the earliest antipsychotics developed and include the following medications:Haldol (haloperidol)Mellaril (thioridazine)Prolixin (fluphenazine)Trilafon (perphenazine)Understanding Atypical AntipsychoticsSimilar to typical antipsychotics, atypical antipsychotics work by blocking dopamine receptors in the brain. This action helps to reduce psychotic symptoms like hallucinations and delusions. In addition, typical antipsychotics also affect serotonin receptors, which help improve mood and reduce negative symptoms, such as social withdrawal and lack of emotion. This dual action of dopamine and serotonin helps regulate neurotransmitter activity more broadly, which is believed to improve symptoms of schizophrenia and other psychotic disorders.Benefits of Atypical AntipsychoticsAtypical antipsychotics offer several benefits in the treatment of psychiatric disorders. Their dual action makes them effective for a broader range of symptoms with fewer movement-related side effects compared to older antipsychotics.One significant advantage is their broader spectrum of efficacy compared to typical antipsychotics. They are effective not only in alleviating positive symptoms such as hallucinations and delusions but also in addressing negative symptoms like social withdrawal and lack of motivation, which are often more challenging to treat.Atypical antipsychotics are also known for their reduced risk of causing movement disorders like tardive dyskinesia and extrapyramidal symptoms, which are common with typical antipsychotics.Additionally, these medications may have mood-stabilizing properties, making them suitable for treating bipolar disorder and major depressive episodes associated with psychosis. Their diverse mechanisms of action and improved tolerability profile have made atypical antipsychotics a preferred choice for many, offering a better quality of life and improved long-term treatment outcomes.Side Effects of Atypical AntipsychoticsCommon side effects associated with atypical antibiotics include weight gain, which can increase the risk of metabolic disorders such as diabetes and high cholesterol levels. Sedation and drowsiness are frequent, particularly when starting treatment or adjusting doses. Some individuals may experience anticholinergic effects like dry mouth, constipation, and blurred vision.Additionally, atypical antipsychotics may also cause orthostatic hypotension. Although they generally have a lower risk of movement disorders compared to typical antipsychotics, some atypical antipsychotics may still cause mild extrapyramidal symptoms such as tremors or muscle stiffness.Moreover, certain medications within this class, such as clozapine, require careful monitoring due to rare but serious side effects like agranulocytosis, which is a severe decrease in white blood cell count. List of Atypical AntipsychoticsExamples of atypical antipsychotics include these commonly prescribed medications:Abilify (aripiprazole)Clozaril (Clozapine)Invega (paliperidone)Latuda (lurasidone)Rexulti (brexpiprazole)Risperdal (risperidone)Seroquel (quetiapine)Vraylar (cariprazine)Zyprexa (olanzapine)PrecautionsPreventing side effects associated with both typical and atypical antipsychotics involves taking proactive steps and working closely with your healthcare provider to communicate any concerns.Ways to prevent side effects include:Starting with the lowest effective dose and gradually increasing as instructed by your healthcare provideAdhering to your prescribed medication therapyCommunicating openly with your healthcare team about any concerns or changes in symptomsLifestyle changes, such as maintaining a balanced diet and regular exercise to manage weight gain associated with some antipsychotics, can be beneficial.Monitoring and managing metabolic parameters, such as blood sugar and cholesterol levels, are also necessary preventive measures. For those experiencing movement-related side effects, certain medications or adjunctive treatments may help alleviate symptoms.Who Should Avoid Typical and Atypical Antipsychotics?Determining whether to avoid typical or atypical antipsychotics depends on several factors related to your personal health history. Generally, you should avoid typical and atypical antibiotics if you have:A history of severe movement disorders like tardive dyskinesia may be advised to avoid typical antipsychoticsCardiovascular or neurological conditions Severe metabolic disordersRisk of agranulocytosisBased on Food and Drug Administration (FDA) requirements, all antipsychotics must include a black box warning stating their association with increased rates of stroke and death in older adults with dementia.SummaryTypical and atypical antipsychotics are medications prescribed to manage psychiatric disorders such as schizophrenia and bipolar disorder. Typical antipsychotics primarily block dopamine receptors in the brain and are associated with a higher risk of movement disorders like tardive dyskinesia.Atypical antipsychotics, on the other hand, work by blocking both dopamine and serotonin receptors, offering a broader spectrum of symptom relief with a reduced risk of movement-related side effects. Many factors must be considered when choosing between typical and atypical antipsychotics. Each medication class has unique benefits and risks, and the decision often comes down to balancing symptom management with minimizing adverse effects.While both types of antipsychotics can be highly effective, they each come with their own set of risks and benefits, making it crucial to tailor treatment plans to fit your individual needs. Read the original article on Verywell Health.
Welcome to Billionaire Club Co LLC, your gateway to a brand-new social media experience! Sign up today and dive into over 10,000 fresh daily articles and videos curated just for your enjoyment. Enjoy the ad free experience, unlimited content interactions, and get that coveted blue check verification—all for just $1 a month!
Account Frozen
Your account is frozen. You can still view content but cannot interact with it.
Please go to your settings to update your account status.
Open Profile Settings