Antipsychotic Medications: What You Need to Know

Antipsychotic drugs treat psychosis, bipolar mania, severe agitation, and sometimes as add-ons for depression. If you or someone you care for is starting one, you probably want clear, no-nonsense facts: what the medicine does, what to expect, and how to stay safe. This page gives the basics so you can have a smarter conversation with your doctor.

Common antipsychotics and what they do

There are two broad groups: first-generation (typical) and second-generation (atypical). Typical ones like haloperidol mainly block dopamine and can work fast for severe agitation. Atypicals — risperidone, olanzapine, quetiapine, aripiprazole — act on multiple brain chemicals and are often chosen for long-term treatment because they tend to cause fewer movement problems.

Which drug is right depends on symptoms, past responses, other health issues, and side-effect risks. For example, olanzapine works well for psychosis but often causes weight gain. Aripiprazole is less sedating for many people. Your prescriber should match the drug to your needs, not the other way around.

Side effects, timelines, and what to watch for

Side effects differ by drug but watch for these common ones: drowsiness, weight gain, higher blood sugar and lipids (metabolic changes), dry mouth, constipation, dizziness, and movement issues. Movement problems break down into early effects (shakiness, stiffness), mid-term (akathisia — a restless feeling), and long-term risk of tardive dyskinesia (involuntary facial movements).

Metabolic issues can show up over weeks to months. Movement-related effects often appear in days to weeks. Tardive dyskinesia may take months or years. That’s why baseline checks and regular follow-up matter.

Simple safety steps you can take now: keep a list of medicines to avoid drug interactions; report sudden mood changes or suicidal thoughts immediately; don’t stop the drug abruptly without checking with your prescriber; and avoid mixing alcohol with antipsychotics.

Monitoring your health makes a big difference. Expect your clinician to check weight, waist size, blood pressure, fasting blood sugar, and cholesterol before starting and on a regular schedule after that. Some people need ECGs if the chosen drug can affect heart rhythm.

If cost or access is an issue, talk to your provider about generics, patient assistance, or trusted pharmacies. Never buy prescription antipsychotics from an unverified site without a prescription — safety, authenticity, and correct dosing matter.

If side effects feel bad or your symptoms aren’t improving after a few weeks, schedule a follow-up. Medicine changes, dose adjustments, or adding supportive therapy can help. Remember: many people find a medication plan that stabilizes symptoms and improves daily life. You deserve clear information and steady support while you get there.