classesAntipsychotics

Antipsychotics: Uses, most common brand names, and safety information

Medically reviewed by Jamie Winn, PharmD

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The use of antipsychotics began 90 years ago in France. Promethazine was developed and used as a calming agent based on its sedative side effects. Research began on derivatives of promethazine, which led to the development of chlorpromazine. It is considered the grandfather of first-generation antipsychotic drugs, or what we now call typical antipsychotics. It was originally used as a pre-surgery treatment for anxiety. Once doctors noticed its calming effect, they started using it as an antipsychotic. Prior to chlorpromazine, patients with psychosis were treated with electroconvulsive therapy and hydrotherapy. After chlorpromazine, pharmaceutical companies rushed to create their own antipsychotic drug. Today, we have newer generations of antipsychotic medications that have fewer side effects and are used to treat various mental health disorders.

The list below includes antipsychotics approved by the U.S. Food and Drug Administration (FDA) and their pricing:

List of Antipsychotics

Drug name	Indication
Haldol (haloperidol)	Haldol is indicated to treat schizophrenia and Tourette syndrome.
Prolixin (fluphenazine)	Prolixin is indicated to treat psychotic disorders.
Loxitane (loxapine)	Loxitane is indicated to treat schizophrenia.
Trilafon (perphenazine)	Trilafon is indicated to treat schizophrenia and nausea/vomiting.
Orap (pimozide)	Orap is indicated to treat Tourette syndrome.
Navane (thiothixene)	Navane is indicated to treat schizophrenia.
Stelazine (trifluoperazine)	Stelazine is indicated to treat schizophrenia and non-psychotic anxiety.
Abilify (aripiprazole)	Abilify is indicated to treat schizophrenia, bipolar mania, and major depressive disorder.
Clozaril (clozapine)	Clozaril is indicated to treat schizophrenia.
Geodon (ziprasidone)	Geodon is indicated to treat schizophrenia and bipolar disorder.
Latuda (lurasidone)	Latuda is indicated to treat schizophrenia and bipolar depression.
Zyprexa (olanzapine)	Zyprexa is indicated to treat schizophrenia and bipolar mania and bipolar depression.
Saphris (asenapine)	Saphris is indicated to treat schizophrenia and bipolar disorder.
Vraylar (cariprazine)	Vraylar is indicated to treat schizophrenia and bipolar disorder.
Invega (paliperidone)	Invega is indicated to treat schizophrenia and schizoaffective disorder.
Seroquel (quetiapine)	Seroquel is indicated to treat schizophrenia and bipolar disorder.
Lybalvi (olanzapine/samidorphan)	Lybalvi is indicated to treat schizophrenia and schizoaffective disorder.
Nuplazid (pimavanserin)	Nuplazid is indicated to treat Parkison’s disease psychosis.
Thorazine (chlorpromazine)	Thorazine is indicated to treat schizophrenia, nausea/vomiting, and hiccups.
Mellaril (thioridazine)	Mellaril is indicated to treat schizophrenia and depressive disorders.

What are antipsychotics?

Antipsychotics are a class of medications used in the treatment of schizophrenia and other mental health disorders. They are typically classified as first-generation or typical antipsychotics and second-generation or atypical antipsychotics.

Typical antipsychotics such as Haldol (haloperidol) and Mellaril (thioridazine) are older medications that are typically used to treat symptoms of schizophrenia such as hallucinations and delusions. They are also used for other conditions associated with psychosis. Typical antipsychotics are more likely to cause movement disorders such as tardive dyskinesia.

Atypical antipsychotics such as Abilify (aripiprazole) and Geodon (ziprasidone) are thought to work on dopamine and serotonin receptors to help treat psychiatric conditions including schizophrenia. They tend to have fewer side effects than typical antipsychotics. Atypical antipsychotics are less likely to cause movement disorders but are more likely to cause weight gain as well as worsening or new diabetes and heart disease.

Antipsychotics are available in oral, transdermal, suppositories, and injectable dosage forms. They can be taken alone but are often used in combination with antidepressants and mood stabilizers.

How do antipsychotics work?

First-generation or typical antipsychotics are thought to reduce symptoms of psychosis by blocking the neurotransmitter dopamine. They also block the actions of other neurotransmitters such as norepinephrine, acetylcholine, and histamine.

Second-generation or atypical antipsychotics work by blocking the action of dopamine and serotonin, which are thought to play an important role in regulating your mood. They can help treat schizophrenia in patients who didn’t respond to or couldn’t tolerate typical antipsychotics.

What conditions are antipsychotics used to treat?

Antipsychotics are used in several conditions, including:

Symptoms of schizophrenia
Major depressive disorder with psychotic symptoms
Acute mania
Bipolar disorder
Severe agitation
Borderline personality disorder
Tourette syndrome

Are antipsychotics safe?

The use of antipsychotics is relatively safe and effective when taken as prescribed. Before beginning treatment with antipsychotics, tell your healthcare provider if you have any of the following medical conditions:

Dementia-related psychosis in older adults
Known allergy to a specific medication
Cardiovascular disease
Arrhythmias
History of seizures
Diabetes
Narrow-angle glaucoma
Use of CNS depressants or anticholinergic medications
Enlarged prostate
Peptic ulcer disease
Suicidal thoughts or behaviors
Pregnant, plan on becoming pregnant or are breastfeeding

What are the common side effects of antipsychotics?

The adverse effects you experience from antipsychotics will depend on several factors including the medication and dose. Some common and/or serious adverse effects of antipsychotics include:

Dry mouth
Blurred vision
Constipation
Drowsiness
Restlessness
Weight gain
Increased blood sugar
Tardive dyskinesia (uncontrollable movements of the face and body)
Muscle stiffness and spasms
Involuntary muscle contractions (dystonia)
Tremors
Increased cholesterol
Urinary retention
High blood pressure
Increased risk of death in elderly patients with dementia
Arrhythmias
Increased risk of suicidal thoughts and behaviors
Glaucoma
Seizures
Sexual dysfunction

This is not a complete list of side effects and we encourage you to consult with your healthcare provider for medical advice about any possible side effects.

Who should not take antipsychotics?

You should not take antipsychotics if you have a known hypersensitivity to any ingredients in the product’s formulation. You should also avoid these medications if you have dementia, seizures, arrhythmias, severe cardiac disease, narrow-angle glaucoma, or prostate problems.

What is the most abused antipsychotic?

A study published in 2016 showed that Seroquel (quetiapine) was the most common atypical antipsychotic abused with 60% of cases, followed by Risperdal (risperidone) at 15% and Zyprexa (olanzapine) at 7%.

What antipsychotics are used to treat anxiety?

Atypical or second-generation antipsychotics such as Seroquel (quetiapine), Abilify (aripiprazole), and Risperdal (risperidone) are effective in treating anxiety and depressive symptoms in patients with schizophrenia and other schizoaffective disorders.

How much do antipsychotics cost?

Antipsychotics are very expensive with an average cost of around $5,000 per year.

You can purchase Antipsychotics for $49 per month from NiceRx if eligible for assistance. Prices at the pharmacy vary by location, strength, and quantity, as well as your insurance status.

Related resources for antipsychotics

The content on this website is intended for information purposes only. It does not constitute medical advice. The information on this website should not be relied upon and is not a substitute for professional medical advice. You should always speak to your doctor regarding the risks and benefits of any treatment.