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First and Second Generation Antipsychotics
Psychosis is a symptom of mental illness that involves disturbed or unusual thinking, strong or inappropriate emotions, and hearing, seeing, or believing things that aren’t real.
Antipsychotic medications are used to treat psychosis in Schizophrenia, Schizoaffective Disorder, Bipolar Disorder, Personality Disorders, Depression, as well as agitation in Alzheimer’s Disease. Antipsychotics don’t cure Schizophrenia and related disorders but they help to reduce hallucinations, delusions, anxiety, confusion, muddled thinking, mania, and violent or disruptive behavior. Patients report thinking more clearly, experiencing less agitation, and feeling an overall restored balance after beginning antipsychotic therapy. As with any medication, antipsychotics have side effects and everyone experiences their medications differently. Talk with your doctor to find the right care plan for you.
First generation antipsychotics also known as typical or conventional antipsychotics were first discovered in the 1950’s when Chlorpromazine was found to calm patients who were about to undergo surgery. A boom of antipsychotic medications were introduced between the 1950’s and 1970’s to treat symptoms of psychosis.
Typical/Conventional First Generation Antipsychotics include:
- Haldol (haloperidol)
- Loxitane (loxapine)
- Mellaril (thioridazine)
- Moban (molindone)
- Navane (thiothixene)
- Prolixin (fluphenazine)
- Serentil (mesoridazine)
- Stelazine (trifluoperazine)
- Trilafon (perphenazine)
- Thorazine (chlorpromazine)
Side Effects of Conventional Antipsychotics – Movement Disorders
As groundbreaking as first generation antipsychotics were, they often had major side effects. Most notably, serious long-term effects on cognition and extrapyramidal effects on movement such as rigidity, akinesia (poverty of spontaneous movement), bradykinesia (slowness of movement), dystonia (involuntary muscle contractions), tardive dyskinesia (involuntary repetitive movements), tremors, and seizures. Other side effects of typicals include but are not limited to: drowsiness, dizziness, lightheadedness, increased saliva production, stomach/abdominal pain, constipation, and weight gain.
Atypical Second Generation Antipsychotics (SGAs)
Clozapine ushered in the era of second generation antipsychotics in 1959 when it showed improvement of psychotic symptoms with less debilitating extrapyramidal side effects. The class of second generation antipsychotics grew and became popular in the 1990s and represent 95% of the antipsychotics prescribed today.
Common second generation antipsychotics:
- Abilify (aripiprazole)
- Clozaril (clozapine)
- Fanapt (iloperidone
- Geodon (ziprasidone)
- Invega (paliperidone)
- Latuda (lurasidone)
- Risperdal (risperidone)
- Saphris (asenapine)
- Seroquel (quetiapine)
- Zyprexa (olanzapine)
Side Effects of Atypical Antipsychotics – Metabolic Syndrome
Second generation antipsychotics have many of the same side effects of first generation antipsychotics but carry a much lower risk of tardive dyskinesia and the other extrapyramidal effects making life for the patient much more bearable. However, they have increased metabolic side effects such as significant weight gain. Along with weight gain comes high cholesterol, increased blood sugars, increased risk of diabetes and hypertension this is called metabolic syndrome.
We are currently enrolling in two clinical trials aimed at reducing the weight gain associated with atypical antipsychotics. If you are interested in participating in a clinical trial fill out the contact form or read our blog post about antipsychotic-induced weight gain.
For more information on each clinical trial, click on the below study links at www.clinicaltrials.gov: