Typical Antipsychotics


Overview: Typical Antipsychotics – commonly referred to as First Generation antipsychotics – are a class of antipsychotics. Typical antipsychotics are prescribed to treat various forms of Psychosis, most noticeably Schizophrenia and Bipolar Disorder. Typical antipsychotics are commonly used in conjunction with a form of Psychotherapy. Typical antipsychotics have largely been replaced by the newer Atypical antipsychotics due to improvements in safety. However, the typical antipsychotics are still sometimes prescribed.





How do they work?: Both typical and atypical antipsychotics work in the same way. Antipsychotics cannot help cure mental health conditions, but they are usually effective in reducing and controlling some of the symptoms associated with many conditions. The medication works by blocking the action of dopamine. It is believed psychotic episodes are caused by the brain producing too much of the chemical dopamine. The medication also regulates levels of other chemicals that are responsible for regulating mood – such as noradrenaline and serotonin.


How effective are they?: Research on the efficacy of Antipsychotics is generally positive. Typical antipsychotics are renowned for causing more shaking than atypical antipsychotics – however the more modern medicines are likely to lead to weight gain. Antipsychotics in general are believed to work strongly on areas like hallucinations and delusions, but not so well on improving thought processes, apathy or social interaction. Therefore, using Antipsychotics alongside some form of Psychotherapy is recommended.


Treatment Course: Typical antipsychotics generally come in tablet form, though some can be injected (known as depot injection) or taken as a liquid if required. Once prescribed, the lowest dose that will result in improvement will be prescribed. Typical antipsychotics are generally recommended to be taken on a long-term basis – especially with severe conditions like Schizophrenia and Bipolar disorder. Anxiety should reduce within hours of administration, though it can take a few weeks for hallucinations or delusions to be controlled. If after around a month has passed without success, it is worth talking to your GP or mental health specialist regarding switching Antipsychotics. It is highly likely you will experience some side effects early in the treatment. It is crucial however that you continue to take the tablets. Some typical antipsychotics can only be prescribed by a mental health specialist, not a GP. Prior to being prescribed any antipsychotic, a patient should undergo a blood test and physical examination.


Types of Typical Antipsychotics: There are fifteen Typical antipsychotics that are prescribed in the United Kingdom.



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Side Effects

We recommend consulting the individual page for each antipsychotic for information on side effects – as they differ from tablet to tablet. Furthermore, the leaflet that comes with each pack of tablets contains enhanced information on side effects. Side effects can last just a few days in some cases, though it is common for side effects to last for weeks or months, or even permanently. You will often see a GP during the first month of treatment to see how you are reacting.


People taking Typical antipsychotics will generally experience more adverse effects than patients using Atypical antipsychotics. Common side effects include a dry mouth, muscle stiffness and cramps, tremors and movement disorders. Among these movement disorders are shaking – like that of someone who suffers from Parkinson’s disease. A very serious movement disorder is Tardive Dyskinesia – which is incurable. Research suggests around 30% of people taking a Typical antipsychotic will develop this disorder, which sees involuntary and repetitive movements. Overdoses and sudden withdrawal of antipsychotics should be avoided.




As with any medication, you must be careful when taking antipsychotics. Your GP or mental health professional should make you aware of any types of medicine or foods that you should avoid. Some frequently used medications, even over-the-counter ones shouldn’t be used with antipsychotics. It is worth looking at the individual page of each antipsychotics to see cautions, but an overview is provided here.


Other Medicines: Never combine an Atypical antipsychotic with a Typical antipsychotic. Don’t combine antipsychotics with a Tricyclic antidepressant. Benzodiazepines, Lithium and Trazodone are other medicines that should be avoided. Please note this isn’t an exhaustive list.


Alcohol: Alcohol sedates an individual, therefore it ideally shouldn’t be consumed when antipsychotics are being taken.


Pregnancy and Breastfeeding: Antipsychotics generally aren’t recommended for pregnant women. Taking antipsychotics while breastfeeding also isn’t recommended.


Young People: Antipsychotics are often prescribed to people from 13 years and over, though it is recommended to wait until 18 to take them. Therapy should be offered as a first line of treatment for 13-18 year olds.


Illicit Drugs: The use of illegal or recreational drugs isn’t recommended, as they can react unpredictably with Antipsychotics.


As always, ensure you read the information leaflet.