Antipsychotics: What They Are, How They Work, and What Alternatives Exist

When someone experiences psychosis—like hearing voices or having false beliefs—they may be prescribed antipsychotics, a class of medications designed to reduce symptoms of psychosis by balancing brain chemicals like dopamine. Also known as neuroleptics, these drugs are a cornerstone in treating conditions like schizophrenia, bipolar disorder, and severe depression with psychotic features. They don’t cure these illnesses, but they help people think more clearly, feel less anxious, and live more stable lives.

There are two main types: first-generation (typical) and second-generation (atypical) antipsychotics. First-gen drugs like haloperidol work mainly by blocking dopamine, but they often cause movement problems like tremors or stiffness. Second-gen drugs like risperidone, olanzapine, and quetiapine affect both dopamine and serotonin, which lowers the risk of those movement side effects—but they can lead to weight gain, high blood sugar, or high cholesterol. The choice depends on the person’s symptoms, medical history, and how they respond to past treatments. Doctors don’t just pick one and stick with it; they adjust based on what works and what doesn’t.

Antipsychotics aren’t the only option. Some people benefit from therapy, like cognitive behavioral therapy for psychosis, or lifestyle changes that reduce stress and improve sleep. Others try supplements like omega-3s, which studies show may help reduce symptoms when used alongside medication. In cases where side effects are too strong, doctors might switch to a different antipsychotic or combine it with another drug to manage the side effects—like using benztropine for tremors or metformin for weight gain. And sometimes, if a person doesn’t respond to oral meds, long-acting injectable versions are used to make sure they get consistent dosing without daily pills.

What you’ll find below is a collection of real-world comparisons and practical guides that touch on these themes. You’ll see how antipsychotics stack up against other psychiatric treatments, how side effects are managed, and how people navigate long-term use. Some posts look at drug alternatives in mental health, others at how medication reviews help older adults avoid dangerous combinations. There’s also insight into how social support and sleep affect recovery—factors that often get overlooked when focusing only on pills. These aren’t theoretical discussions. They’re based on what patients and clinicians actually deal with every day.